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HIV rises in Southern, minority women

by Heather Woolwine
Public Relations
According to a recent article in USA Today, new HIV cases documented in the last couple of years show Southern, minority women as representative of 76 percent of the nation’s new HIV infections.
 
Juanmanuel Gomez, M.D., MUSC Internal Medicine-Infectious Diseases, finds the growth of cases among this demographic to be true here in Charleston, but “when we talk about a rise in cases, it doesn’t necessarily mean new infections,” he said. “For black women and Hispanics, many have had HIV infection but the disease was clinically dormant for years.”
 
Regardless of when the disease was contracted however, Gomez does see a connection with contracting the disease and a lack of health services and education.
 
“There is a definite lack of health education in black and Hispanic populations due, among other things, to a decreased access to health care. It’s really a problem for any minority, anywhere; they are disenfranchised so they don’t get the message, or if they do, they are unable to put it into practice,” Gomez said. “Most of the cases I’m seeing right now are people in their late 20s and 30s who never got the message about prevention or safe sex practices.”
 
Gomez cited the Hispanic population as especially vulnerable to infection. With the influx of Hispanics to Charleston (the population tripled in 10 years), Gomez and his colleagues have seen an increasing number of infected Hispanic women and men. Many are not legally in the United States, so access to federal or state support for health management or prevention is not available.
 
“It’s a very sensitive issue,” Gomez said. “But whether they should or shouldn’t be, these people are here and when they become ill, they become part of the health care system. It is cheaper to keep them healthy and out of the hospital no matter what the disease or condition. Most of the Hispanics who are here illegally are fulfilling a job that nobody else wants to perform, so if they become sick, they are no longer productive and become a more expensive burden to society.
 
“HIV medications are very expensive. Money for HIV programs is becoming scant, and with tighter budgets, regulators are trying to apply more restrictions in eligibility criteria for those programs,” he said.
 
While the surge in new, reported cases of HIV impacts both major minorities, Hispanics may be at a larger disadvantage because not only do they not have access to health education messages, but those messages often come in a language many do not understand.
 
Compounding that problem, Gomez said, “There are limited resources to get that message out in another language. Unfortunately, the federal government has directed federal funds for abstinence-only sex education programs. The Infectious Disease Society of America (IDSA) and the HIV Medical Association (HIVMA) have clearly signaled the need to repeal legislation directing the president to fund such programs, and have publicly stated the need to fund programs that are scientifically accurate and provide comprehensive education about the prevention of HIV/AIDS and other sexually transmitted diseases.”
 
Gomez said that many of the patients he’s seeing with new infections are second generation Hispanics who were born and raised in inner city environments. “They exhibit a lot of those behaviors characteristic of the inner city life, like unprotected sex, promiscuity, and IV drug use,” he said.
 
The Center for Disease Control’s National HIV Prevention Conference in Atlanta, a study of HIV risk factors out of the University of North Carolina School of Medicine, and researchers throughout the country all point to the need for expanded health and HIV education in vulnerable communities.
 
In fact, some researchers have begun testing programs that focus on those minority women with HIV risk factors like socioeconomic status, early sexual behavior, and drug use and work to increase their self-esteem so that a balance of power in relationships will help them say no to sex or persuade partners to use condoms.

What are we doing to help?
MUSC Infectious Diseases is part of the Lowcountry HIV Coalition and is a participant in a Ryan White grant, named for the boy who surged to the national forefront with his story of living with HIV and AIDS. In 1990, Congress passed the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act as a comprehensive response to the HIV epidemic and its impact on individuals, families, communities, cities and states. Title I of the Act provides emergency relief grants to eligible metropolitan areas disproportionately affected by the epidemic to provide community-based HIV-related health and support services.
 
The coalition includes several other state agencies like the Charleston Center (Alcohol/drug rehabilitation), Hospice of Charleston, and Lowcountry AIDS, among others. Much of what this coalition is working towards is more education and ways to prevent new infections from continuing within minority populations.
 
Within MUSC’s College of Nursing, the Hispanic Health Initiative is reaching out to the Hispanic community via health fairs and a Healthy Family Education series on John’s Island. The series includes topics such as growth and development, preventative health care, cardiovascular issues, family planning, diabetes, mental health issues, and nutrition. Within this forum, sexually transmitted infections, like HIV/AIDS are discussed at length in an effort to educate Charleston’s Hispanic population.
 
Vanessa Diaz, M.D., Family Medicine, also provides support to the Hispanic community in terms of HIV education and prevention, including a radio talk show on the Spanish radio station El Sol (WAZS 98.9).
 
Through her program, she has answered many questions and provided information related to sexually transmitted infections.

Friday, Nov. 4, 2005
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