“We must STILL fight”
December 1, 2014
I came of age during the AIDs crisis. I lived it front and center in New York City, which remains one of the most important battlegrounds to fight the epidemic that has claimed so many lives. My organization Voces Latinas came into being in order to address the many disparities around HIV/AIDS within the Latino community, specifically in Queens. Today, after over a decade of frontline work on HIV/AIDS prevention and education, Latinos continue to be overrepresented with regard to people living with HIV/AIDs. Latinos constitute over one fourth of new diagnoses, with less than one half of those being amongst men who have sex with men. What does this reveal? While great advances have reduced the overall rate of transmission and prolonged the lives of many living with the disease in the United States, within the Latino community we are still challenged by the shame, silence, and stigma that continues to create hurdles to access care and support. These cultural barriers then produce inequalities around resources, information, and education which can prove deadly for some, and dangerous for all.
I would like to highlight the importance of culturally competent care when addressing health outcomes concerning HIV/AIDS since this is at the heart of our approach at Voces Latinas but remains a challenge within the overall field of HIV/AIDS. The need for cultural capacity in HIV/AIDS cannot be minimized. In fact, it should be prioritized. The communities hardest hit by HIV/AIDS since the epidemic began are the same. They are socially, economically, and politically disenfranchised either because they are poor, sexual minorities, abuse controlled substances, and sometimes in order to survive, are compelled to make decisions that place them at risk. We know that health disparities are complicated by the intersections of income, immigration status, ethnicity, race, and sexual orientation. Language and low educational attainment further exacerbate the disproportionate amount of Latinos that still do not get tested, do not disclose, and/or simply do not care. For this reason we cannot view education as a separate strategy, but rather, it should be at the forefront of any tactic that seeks to effectively eradicate this epidemic. In the year 2014, they are still individuals who still do not correlate risky behaviors with vulnerability because they are deprived of choice, a sense of safety, or a basic understanding of risks. Others simply are not empowered to negotiate preventative measures such as the use of condoms or may even lack access to them.
Unfortunately, HIV/AIDS no longer appears as an urgent issue in our media, nor is it politicized enough to mobilize interventions and increase funding for innovative strategies to link individuals to care upon learning of their status. Voces Latina’s mobile testing unit is sometimes out at 3 in the morning offering testing to some of the most vulnerable members of our community who cannot afford the time, space, and opportunity to get tested. This strategy has proven fruitful because it has opened up a space for us to uniquely contribute to the fight, leveraging our culturally nuanced understanding of the community’s needs. Our relationships with the community are crucial in advancing our work because we know firsthand that sometimes a cafecito, a smile, a familiar accent, and an ear to listen can empower individuals to get tested. Getting tested is often a lifesaving decision.
I would like to state that for this reason I awaited with great optimism Governor Cuomo’s plan to reduce the rate of HIV/AIDS by 2020 in New York State. I was greatly pleased when he highlighted the role of cultural competence as an imperative within his plan. Given our work at Voces Latinas, we know that within our Latino immigrant community, there is a historical mistrust when engaging with healthcare institutions that have failed, isolated, or pathologized them. While HIV is now a chronic illness, health outcomes are contingent on first and foremost learning your status. Hence testing continues to be key in the struggle to fight against the disease of apathy and stigma to which HIV/AIDS is a direct consequence. I would like to affirm that I will continue to fight to educate our community on the importance of testing, because at the end of the day, “HIV/AIDS (still) affects us all.”