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HISPANIC/ LATINO AMERICANS AND HIV 1

HISPANIC/LATINO AMERICANS AND HIV

Student’s Name

COH 310- Culture and Health

XXXXXXXXXXXXX

November 22, 2013

HISPANIC/LATINO AMERICANS AND HIV 2

Abstract

The purpose of this paper will be to discuss the prevalence of HIV among the

Hispanic/Latino community and how some of the disparities such as poverty, lack of education

and access play a role in the overall poor health that the Hispanic/Latino community is facing. In

addition, we will also discuss these cultures values, health beliefs, health issues as well as their

morbidity and mortality rates. Finally, we will provide recommendations to promote awareness

within the community.

HISPANIC/LATINO AMERICANS AND HIV 3

Hispanic/Latino Americans and HIV

Introduction

HIV is among one of the top causes of death for Hispanics/Latinos. This disease affects

both men and women of this community. HIV is more prevalent among young Latino males

(MSM) men having sex with men. Women are also impacted because they may not be aware of

their male partner’s sexual activities. HIV can be transmitted by male to male sexual contact,

heterosexual contact, injected drug use, or injected drug use/ MSM. In 2009 Hispanic/Latinos

accounted for a substantial percentage of new HIV cases and many have died as a result from

AIDS. There are many disparities that plague the Hispanic/Latino community. Poverty,

Education and Access to care are only naming a few. This paper will discuss the impact of these

disparities on the community and the recommendations to educate, prevention and engaging

community stakeholders to assist. In addition, we will discuss the need for physicians and

medical trained personnel to be culturally competent and sensitive to the needs of this

community.

Human Immune Deficiency Virus is one of the leading causes of death amongst

Hispanics/Latinos. Of the 197,090 diagnoses of the HIV infection from 2008, Hispanic/Latinos

account for 21% of the total, 16% are women, 18% of the infection attributed to heterosexual

contact according to the Center for Disease Control. Hispanic/ Latinos represent 16% of the total

United States population making them the largest ethnic group in the Nation (CDC, 2012).

Hispanic/Latino Americans are persons of Cuban, Mexican, Puerto Rican, South or Central

American or other Spanish Origin. Hispanics/Latinos have been present in the United States

since 1565 and primarily resided in what is now known as the most populous states, California,

Texas and Florida (Kline and Huff, 2008).

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HISPANIC/LATINO AMERICANS AND HIV 4

According to the United States Census Bureau population rates as of July 1, 2011, there

are roughly 52.0 million Hispanics living in the United States, representing approximately 16.7%

of the U.S. total population, making people of Hispanic origin the nation’s largest ethnic or race

minority. The U.S. Hispanic population for July 1, 2050 is estimated to reach 132.8 million,

constituting approximately 30% of the U.S. population by that date (US Census, 2011).

Among Hispanic subgroups, in 2010, Mexicans ranked as the largest at 63%. Following

Mexicans were Puerto Ricans 9.2%, Cubans 3.5%, Salvadorans 3.3%, Dominicans 2.8%, and the

remaining 18.2% were people of other Hispanic or Latino origins. Latinos view ill health as an

imbalance between the individual and his or her environment, with variables such as emotions

and social, physical and spiritual factors accounting for sickness, individuals will often seek

assistance from folk healers which can be either female or male, the use of rituals, prayers,

pledges, and herbal baths into effect healing. In addition, the yerbalista will employ herbal

prescriptions which can be brewed into a broth or tea. Or they will seek treatment from a

sobadora, typically female who uses massage and manipulation of the bone and joints to treat.

Overall Hispanic/Latino culture emphasizes wellness rather than illness. Illnesses are thought to

have either natural or supernatural origins. They also believe that health is a gift from god.

When it comes to a Western medical approach, trust and cost are major factors (Kline & Huff,

2008).

Some of the disparities that Latinos face are poverty, lack of education and access to care.

Many Americans are faced with the issue of poverty but it is more prevalent in minority groups.

A 2009 Census estimates show that of the nearly 50 million Latinos in the country, 28.2% are

living below the poverty threshold of $23,500.00 (family of four) annually compared with 23.4%

African Americans. That is 742,000 more than the official poverty count of 13,346,000

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HISPANIC/LATINO AMERICANS AND HIV 5

Hispanics (US Census, 2009). The second disparity is the lack of education. Because of

poverty, many Hispanics/Latinos live in low income urban areas. There are few schools and the

student population is exceptionally high with minorities. Because of the segregation in these

educational institutions, schools who are predominantly minority tend to get less funding.

Without proper funding, schools have a lack of educational resources such as teaching materials.

There is also little funding to make structural improvements and they cannot purchase the latest

technology. In addition, teachers’ salaries are not competitive enough to draw the necessary and

vital personnel to teach the regular curriculum so that students can learn comprehension and

critical thinking skills which will help them further in their education. In 2005,

Hispanics/Latinos represented 11.8% who had a high school diploma compared to 29.4% of

whites followed by 16.1% African Americans and 54% Asian (Census.gov). Hispanics account

for 9% drop outs with a GED credential and African Americans accounted for 20% and whites

29% according to Pew Hispanic Center tabulations of the 2008 American Community survey.

Finally, Access to care is also an issue for Latinos. There is a lack of minority medical students

within the United States. According to the AAMC, the U.S. Physicians by Race and Ethnicity,

2007, there are 2.8% Hispanic/Latino physicians across the nation. Because Hispanics/Latinos

represent such a high percentage of the population there are not enough Hispanic/Latino

physicians to treat this growing population (AAMC, 2013). Poverty levels, poor education and

the inability to obtain jobs that pay descent wages or offer medical health insurance, most

Hispanics/Latinos cannot afford the out of pocket costs for medical health insurance and rely on

public assistance such as Medicaid or they may not be covered by insurance at all. Because of

the inflated cost of healthcare and the drastic cuts to Medicaid, many are faced with having to cut

back on the care that they receive. In addition, for those who are not covered by insurance, other

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HISPANIC/LATINO AMERICANS AND HIV 6

life necessities come before medical care is rendered. For Latina women, their health is put

second to feeding their children and providing shelter for their families. In addition, most

impoverished Hispanics live in rural areas, in section 8 housing. These areas may not have the

funds to provide medical facilities for those in need. There could be an issue with the number of

HIV specialists that are available in rural areas or the HIV specialists are located in urban areas

and transportation can be an issue. In addition, language could be a barrier as well. Since there

are not enough Hispanic/Latino physicians the individual may not be inclined to seek treatment

from a white physician because they do not believe that the physician will listen. In regards to

mental health 1 of 10 Latinos report a major depressive episode. Mental ailments such as

depression are often related to physical health like being tired or having difficulty sleeping,

nervousness or irritabilityle and may not respond to individual and group therapies in the same

way as non-Latinos do (Kline & Huff, 2008). Latinos may not seek care for mental health

services due to access, lack of health insurance cost, or for lack of transportation.

In the Hispanic/Latino community most are not aware of their HIV+ status, they practice

don’t ask, don’t tell and/or they do not share their HIV status with their partners even if they do

know that they are HIV+. They will also decline treatment for lack of ability to pay for the

services, or will not follow treatment instructions given to them by physicians and take further

risk by dropping out of their antiviral treatment and ignore the disease. When this happens,

many find themselves seeking care in the emergency rooms. By that time, most individuals who

were not aware of their HIV status would have transitioned into AIDS. This creates an

opportunity for opportunistic diseases such as Pneumocystis pneumonia, viral or fungal

infections to invade the body because an individual loses their ability for their natural disease

defense system or immunity to fight the disease. Many AIDS patients have prolonged stays in

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HISPANIC/LATINO AMERICANS AND HIV 7

hospitals due to the lack of preventive care. Some AIDS patients are transferred to hospice care

for Palliative services when the patient is not responding to the treatment that is being given. At

this stage, palliative services are provided to support the patient, their family and to control the

patients pain until the patient expires (death occurs).

Young Latino males tend to be more at risk. Because they tend to have multiple partners

and may not be inclined to use a condom, many become infected with HIV or other sexually

transmitted diseases. According to the CDC there are 50,000 new HIV infections annually.

Every 9.5 minutes someone in the United States is infected with the HIV virus. One in five

people infected, are not even aware that they contracted this disease (AIDS.GOV, year?). In

2009, Hispanic/Latinos accounted for 79% of new HIV infections in the United States (CDC,

2012). Hispanic/Latino men were two and half times as high as that of white men. In addition,

men having sex with men (MSM) accounted for 81% of the HIV infections among all Latino

men and 20% among all MSM. Among Latino MSM, 45% of the new infections occurred in

those under 30 years of age. Hispanic/Latina women accounted for 21%. They were more than

four times that of white women. During their lifetime 1 in 36 Hispanic/Latino men and 1 in 106

Hispanic/Latina women will be infected with HIV. In addition, there have been 636,000 deaths

since this epidemic began. More than 96,200 Hispanics/Latinos with an AIDS diagnosis have

died since 1981(AIDS.GOV).

The barriers that impact the Hispanic/Latino population can be grouped into personal,

systemic and community based. Personal barriers can include mental health status, cultural and

linguistic background, education level and family structure. Individuals may not possess the

education capacity to follow along with the program. There is also the language barrier. Many

are limited in speaking the English language and they may not understand the verbal directions

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HISPANIC/LATINO AMERICANS AND HIV 8

they are given. Systemic issues could result from location of the clinic, transportation barriers,

hours of clinic operations and the appearance of the care facility. Community barriers may be

political in nature or simply a matter of tradition. Engaging community leaders and

collaborating with community needs may constitute the difference between the failure or success

of the program (Kline &Huff, 2008)

The recommendations given to ensure the success of raising awareness of the

implications of HIV to the Hispanic/Latino community would be to raise awareness to those that

have not been infected in the community or do not have an understanding about the severity of

contracting this disease by providing them with brochures and pamphlets explaining their disease

in their primary language. Engaging those who do not know about HIV or who do not

understand HIV would be the primary target. Giving these individuals the opportunity to learn

more about the disease and how to prevent the spread of this disease would be extremely

valuable. The second recommendation would be to empower those who have already been

exposed to HIV. One way of doing this would be to target the population and educate them of

the importance of decreasing the risk of transmitting the disease to others and working with

physicians to educate this population with treatment options and resources such as free

medication programs and referrals to mental health specialists Mental health providers can then

offer emotional support to the patient and give them tools on ways to help them cope with their

disease and provide the patient with the necessary information so that he/she can make informed

decisions about their care. The third recommendation would be to focus on the framework to

ensure a reduction in the number of new HIV cases. Develop new programs that will help better

evaluate any approach to strengthening the preventative strategies to reduce health disparities as

HISPANIC/LATINO AMERICANS AND HIV 9

well as creating partnerships with stake holders for expansion of health education and promotion

of sexual health in the community. By developing partnerships with the stakeholders and

healthcare providers of the community, focus can be put on promoting awareness about HIV. It

will also set the stage to coordinate health fairs and raise awareness of HIV through World Aids

Day.

In conclusion, many Hispanic/Latinos male and female have been infected with HIV and

thousands of lives have been lost because of this devastating disease. Educating about the risks

associated with risky sexual behaviors and injection drug use can provide Hispanic/Latinos with

the necessary tools to better educate themselves about what they can potentially be exposed to

and if exposed, it would provide them with information on the treatment options so that he/she

can make an informed decisions about their care. In addition, increasing the number of culturally

competent physicians and medical personnel and setting protocols in place to meet the needs of

the community can impact the success of any program in a positive way.

HISPANIC/LATINO AMERICANS AND HIV 10

References

America Needs a More Diverse Physician Workforce. (2004). Retrieved November 21, 2013,

from AAMC: https://www.aamc.org/download/87306/data/

CDC(2011, August). Retrieved November 17, 2013, from Strategic Plan Division of HIV

Prevention: http://www.cdc.gov/hiv/pdf/policies_DHAP-strategic-plan.pdf

Department of Health. (n.d.)Retrieved November 17, 2013, from

http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/plan/stds/focus_area_1.htm

Health disparities Experienced by Latinos- United States. (2004, October 15). Retrieved

November 20, 2013, from CDC: http://www.cdc.gov.mmwr/preview/mmwrhtml/mm5340al.htm

HIV among Latinos. (2011, November). Retrieved November 20, 2013, from CDC:

http://www.cdc.gov/hiv/pdf/risk_latino.pdf

HIV/AIDS & Socioeconomic Status. (n.d.) Retrieved November 17, 2013, from American

Psychological Association: http://www.apa.org/pi/ses/resources/publications/factsheet-hiv-

aids.aspx

HIV/AIDS Patient Education. (n.d.)Retrieved November 17, 2013, from Vitals: HYPERLINK

"http://www.vitals.com/patient-education/hiv-aids" http://www.vitals.com/patient-education/hiv-

aids

Huff, M. V. (2008). Health Promotion in Multicultural Populations. Northridge: SAGE

Publications.

U.S. Statistics. (n.d.). Retrieved from AIDS.GOV: aids.gov/hiv-aids-basics/hiv-aids-

101/statistics/

(n.d.)Retrieved November 17, 2013, from http://aids.gov/hiv-aids-basics/hiv-aids-

101/statistics/index.html

Comment [AI14]: Not in proper APA format Many references are missing in-text

http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/plan/stds/focus_area_1.htm

http://www.cdc.gov/hiv/pdf/risk_latino.pdf

http://www.apa.org/pi/ses/resources/publications/factsheet-hiv-aids.aspx

http://www.vitals.com/patient-education/hiv-aids

HISPANIC/LATINO AMERICANS AND HIV 11

Outstanding

Achievement

Commendable

Achievement

Marginal

Achievement

Unsatisfacto

Achieveme

Faili

Identified a cultural

group

 Description of the

target group

 historical

perspective

 Demographics

Clearly defines

cultural group in

terms of history,

geography and

population

characteristics

Clearly defines a

cultural group

without adequately

describing some

characteristics

Defines a cultural

group without

adequately

describing many

important

characteristics

Lists a

cultural

group

without

further

definition

miss

ing

Identified health

disparities

 Health issues and

disparities

 Morbidity and

mortality rates

 Patterns of Care

 Access to care

 Mental health

issues

20%

Clearly identifies

disparities by

comparing

descriptive

epidemiology of

group to majority

group or other group

15%

Clearly identifies

disparities using

descriptive

epidemiology

however without

adequate

comparisons

10%

Correctly lists

health disparities

without adequate

descriptive

epidemiology

Lists health

disparities

incorrectly

miss

ing

Identified health

behaviors

 Preventive and protective health

behaviors

 Sick-role behaviors

 Illness behaviors

 Societal health behaviors

20%

Clearly describes all

common health

behaviors with

supporting evidence

15%

Clearly describes

most common

health behaviors

missing some