Ceci Connolly, Washington Post, July 23, 2008
AIDS rates in the nation’s Latino community are increasing and, with little notice, have reached what experts are calling a simmering public health crisis.
Though Hispanics make up about 14 percent of the U.S. population, they represented 22 percent of new HIV and AIDS diagnoses tallied by federal officials in 2006. According to a survey by the Kaiser Family Foundation, Hispanics in the District have the highest rate of new AIDS cases in the country.
So far, the toll of AIDS in the nation’s largest and fastest-growing minority population has mostly been overshadowed by the epidemic among African Americans and gay white men. Yet in major U.S. cities, as many as 1 in 4 gay Hispanic men has HIV, a rate on par with sub-Saharan Africa.
Blacks still have the highest HIV rates in the country, but language difficulties, cultural barriers and, in many cases, issues of legal status make the threat in the Hispanic community unique. For those who arrived illegally, in particular, fear of arrest and deportation presents a daunting obstacle to seeking diagnosis and treatment.
Even with the United States embroiled in a fierce debate over immigration policy, the problem of AIDS in Latinos had received scant attention from political and public health officials. At the Centers for Disease Control and Prevention, where only two of 17 approved HIV programs target Hispanic Americans, officials have added Spanish-language hotlines, confidential testing sites and other initiatives aimed at filling the gap.
“Hispanics are overrepresented in this epidemic, and we need to target our efforts to them,” CDC epidemiologist Kenneth Dominguez said in an interview.
Officials do not have a precise tally of HIV infection nationwide, because many states have not reported figures to the CDC. The 22 percent, a figure that has not been previously released, includes 33 states and Puerto Rico, but not California, where more than 37 percent of the population is Hispanic.
“You combine the economic pressures, loneliness and immigration worries, and it pushes these individuals to be a hidden population,” said Frank Galvan of the Charles Drew University of Medicine and Science in Los Angeles.
The consequences, however, go well beyond the Hispanic community. If the United States does not begin to “make a dent” in the swelling crisis of HIV among Hispanics, Galvan said, “it will continue to spread to other populations.”
The nexus of AIDS and migration—the reality that viruses know no borders—will gain fresh prominence at the International AIDS Conference next month in Mexico City. It is a nexus that plays out in dramatic fashion in San Ysidro and other communities along the U.S.-Mexican border, where the tensions associated with immigration tend to exacerbate an already stigmatized illness.
Many are “objectified” by white men who view them as exotic. They play subservient roles to partners with citizenship or money. The “triple oppressive experiences of poverty, racism and homophobia” lead many to risky behavior, Diaz said. “People are looking for respite and relief from a sense of isolation, economic deprivation and low self-esteem. Sometimes sex is the place where men find that.”
The 45-year-old lesbian [Rosario Mancillas] epitomizes today’s increasingly common bi-national, border-straddling existence. She was born in Brownsville, Tex., but raised in the Mexican state of Sinaloa. When she got a job at a Costco store in Chula Vista, Calif., she chose to live across the border in Tijuana, where rents are cheaper and the culture more familiar.
Yet even as she adopted a more American lifestyle, Mancillas’s attitudes and beliefs were firmly rooted in her traditional Mexican upbringing. Feeling pressure to give her parents a grandchild, she investigated a sperm bank. But the prospect of insemination seemed cold and impersonal. Then a gay friend offered to try to impregnate her.
The brief heterosexual detour did not produce a baby, but she did contract HIV, discovering the infection three years later when she was stricken with terrible stomach pain. Mancillas went with her father to a hospital in Tijuana.
This report was supported by the Project for International Health Journalism Fellowship, a part of the Henry J. Kaiser Family Foundation’s Media Fellowships Program.