Once a week, a carload of construction workers pulls up to Centro Latino de Salud and dispatches a man to pick up a supply of condoms for the crew.
Since Centro Latino, in Parkade Plaza on Business Loop 70 West, opened three years ago, it has given away thousands of free contraceptives. But center director Eduardo Crespi knows that, with the rate of HIV infection increasing most rapidly among minorities, it’s only the first step in educating Columbia’s Hispanic population about AIDS.
“We need to let the population know that it is an individual decision to fight the disease,” Crespi said. “My commitment to fight the disease is to act locally and help the Latinos of our community receive the right information.”
Missouri has yet to implement an HIV-prevention program aimed specifically at the Hispanic population, said Lawrence Lewis, the community coordinator for HIV/AIDS services at the Missouri Office of Minority Health. However, Lewis said, state health officials are beginning to examine more closely the impact of the disease on the fastest-growing minority population in mid-Missouri.
“It’s something we’re working on to better the relationship so we can find out who’s already infected,” Lewis said.
Accurate data on the actual incidence of HIV infection among Hispanics have been hard to come by. The spread of the disease among African-Americans, however, has been well documented, and that information has given state health officials some clues about the importance of HIV education and prevention.
Since 2000, the number of new HIV cases among blacks has nearly tripled in a 33-county region of north-central Missouri, according to the state Department of Health and Senior Services. In Boone County, African-Americans made up 9 percent of the population but accounted for 29 percent of the total cases of HIV infection and 22 percent of full-blown AIDS cases.
Lewis said that, even as the disease was spreading in their community, African-Americans were not receiving enough information about HIV and how to prevent it. Two years ago, his office launched an emergency response plan aimed at helping community groups educate African-Americans about AIDS. The plan included setting up speakers bureaus in various settings around the state to encourage discussion about the disease.
“I feel that it’s been very successful,” said Joy Williams, who heads the Office of Minority Health. “We are creating a forum for people to address the issue.”
Until state health officials can implement a similar plan for Hispanics, Crespi is taking a proactive approach to prevention and education at Centro Latino de Salud. Crespi provides a wealth of health information on HIV/AIDS and sexually transmitted diseases and offers free HIV testing in cooperation with the Columbia/Boone County Health Department.
About 250 people were tested for HIV at Centro Latino last year, Crespi said, adding that if they hadn’t been tested in a culturally friendly environment, they wouldn’t have been tested at all. Many Hispanics are immigrants and fear they may be deported if authorities find out about their health status, Crespi said. They are also hesitant to go back to their countries of origin because they may not receive adequate health care.
Until state and local healthcare agencies do more aggressive outreach, Crespi said, many Hispanics will not get the information they need.
“The community at large is not doing a good job about prevention,” he said. “I think intervention should be more aggressive.”
The challenges of providing information about the disease to people of other cultures was the subject of a recent seminar organized by the Regional AIDS Interfaith Network and the Missouri Area Health Education Center. Nearly all of the roughly 50 health care providers who attended the seminar were white.
During his presentation to the group, Lewis said that many group members had little understanding of their own culture, let alone that of a minority or immigrant community.
“Do you know what their household looks and feels like? What’s going on in there?” Lewis asked. “It’s not that you don’t care, you just don’t get it.”
Lewis and others emphasized that, two decades after it was first discovered in the United States, HIV and AIDS are still widely misunderstood, though for different reasons. New medical advancements mean the disease is no longer an automatic death sentence, but more of a chronic condition people are learning to live with.
“It’s gone from learning how to die with a disease to learning how to live with a disease,” said Barbara Boshard, a surveillance report team leader from the Missouri Health Department.
And because people with AIDS are living longer, there is a perception that it is no longer a serious health problem. However, Crespi points out that treating HIV is expensive, and with cuts in funding for all kinds of public health problems, education about how to prevent further infections, particularly among poorer minority populations, is more important than ever.
“Abstinence and prayers help,” Crespi said, “but prevention, education and condoms save lives.”