A Grim Prognosis

HIV infection is soaring in the Latino population. Can El Futuro slow it down?

A honey-skinned Chicano in jeans and a sport coat, who'd shown up not knowing the event was in Spanish, tries to keep up with Connick's PowerPoint presentation, but mostly gazes out the window. After about thirty minutes, he excuses himself and disappears into the park.

Cheesman Park has been a hot zone for AIDS outreach since the '80s, when the disease developed from a shadowy phenomenon to an all-out epidemic. Beginning in 1983, the all-volunteer Colorado AIDS Project flourished as a grassroots campaign to prevent infection and support those living with the virus. In the field, CAP activists distributed both condoms and information to at-risk groups, primarily gay men. Capitol Hill has always been at the heart of the effort.

To date, more than 5,000 people have died from AIDS in Colorado. But there has been reason, at times, to believe that the state was turning a corner on the epidemic. In 1987, there were 586 cases of new HIV infection reported, according to the Colorado Department of Health and Planning's HIV Surveillance Program. By 1999, that number had plunged to 212 new infections. And as new drugs rendered AIDS a livable condition, death rates showed promising declines as well.

Out and about: Justin McCarthy hits gay bars and 
clubs, recruiting new members for El Futuro.
Anthony Camera
Out and about: Justin McCarthy hits gay bars and clubs, recruiting new members for El Futuro.

The news was better for some than others. Activists stressed that AIDS does not discriminate between white, black, brown, gay or straight; everyone was at risk. But white people have overwhelmingly enjoyed the most notable reductions. African-Americans currently account for nearly 20 percent of Colorado's new cases, though they represent less than 4 percent of the population. Hispanics, who claim about 13 percent of the population, account for 20 percent. The death rate from AIDS among African-Americans is still three times that of whites; AIDS is twice as likely to kill Hispanics as Caucasians.

"It's discouraging for us, because we're seeing a second generation of many of the same problems that we had twenty years ago," says Terry Tiller-Taylor, STD/HIV section chief of Coloradans Working Together to Fight HIV, a planning committee that determines the state's yearly program for HIV prevention. "HIV/AIDS is as much of an issue now as it ever was. It's just shifted to a different population."

But while data from the Colorado Department of Health and Environment indicates that African-Americans are slowly chipping away at their numbers, the rates of HIV infection in the Latino community have gone in retrograde, leaping by 30 percent over the past five years. Statistically, Latinos are less likely to access services, or to be tested in the first place. And by the time many enter the public health-care system, they're already in the throes of the full-blown AIDS virus -- very sick, but at a loss, or unwilling, to explain how they got that way.

"Latinos have a lot of reasons why they don't trust the system," says Maria Lopez, who does case management and client advocacy through Servicios de la Raza, a northwest Denver community organization that helps Spanish-speaking men and women navigate life in the United States. "I have one client who wouldn't get tested for HIV because she thought the doctors would call INS on her. But what keeps many of them from getting tested is that they don't want to have to deal with it. It's less the fear of the illness than the fear of having to tell people. There's a tremendous fear of being disconnected from their families or communities if they admit how they got it.

"I had a client who swore he got it from a cut on his hand; another said it was from some brown thing on the sink in the bathroom," Lopez adds. "Even when it's obvious to both of us, some of the men just won't acknowledge that they've had sex with another man. It's just not something that is talked about or accepted in the culture."

That refusal is putting many women at risk. Although they accounted for only 2 percent of cases in the first wave of HIV in the '80s, women have seen their rates double since 1990. And nearly 40 percent of them report contracting the virus through heterosexual sex with their husbands or boyfriends, presumably men who have sex with other men but who deny being gay (see story).

It's hard to protect people who don't realize they may be in danger. Language, a lack of education, and cultural barriers such as religion and homophobia can create a formidable trifecta of risk to Latinos, especially gay and bisexual men from rural areas in northern Mexico who arrive with a vague awareness of HIV or AIDS.

"I feel like I'm reliving the '80s all over again," says Jorge del Mazo, who directs the Colorado Aids Project's prevention program. "The services to this community are still in their infancy. HIV will continue to be a massive problem if we don't address some of the misinformation, fear and machismo that is preventing us from reaching this community.

"We are a community in denial," adds del Mazo. "We haven't made a dent in changing norms to support the epidemic. You're talking about thousands of years of believing certain things. Those cultural beliefs are embedded. But unless we affect social norms, we could be facing a catastrophe."

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