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Study targets HIV rate in group
Mortality found to be much higher among Hispanics
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Published: August 12, 2008
Updated: 08/12/2008 12:20 am
It's little secret that socio-economic barriers and stigmas inhibit Hispanics' access to health care.
Studies have shown that several factors, such as low incomes, lack of health insurance, lack of preventive care and lack of communication, are affecting the health of Hispanics.
Determining whether a lack of trust in the health-care system is contributing to a disproportionately higher mortality rate among Hispanics with HIV is the goal of a study by Wake Forest University Baptist Medical Center.
The two-year study will begin next month. It is being paid for by the Foundation for AIDS Research.
Researchers plan to initially enroll 200 Hispanic participants, primarily from the Triad. The candidates are either living with HIV and receiving medical care, living with HIV without medical care or are at risk of contracting HIV through high-risk behavior.
"There are a number of different things that are affecting the attitudes and opinions toward medicine of the Latino community," said Scott Rhodes, the lead investigator and an associate professor in the Department of Social Sciences and Health Policy at the medical center.
"This study will give us a sense of all the variables that are affecting the trust or mistrust of medicine," he said. "From there, we can develop means to build trust and better communicate the value of medical treatment to Hispanics with HIV and preventive methods for those at risk of contracting HIV."
The Centers for Disease Control and Prevention said earlier this month that there were about 56,300 new HIV infections in the nation in 2006 -- up from an annual estimate of 40,000 used the past 12 years. The new figure is due to a better blood test and new statistical methods, and not a worsening of the epidemic, officials said.
That same CDC report found that Hispanics represented 17 percent of new HIV infections in 2006, compared with blacks at 45 percent and whites at 35 percent.
"Latinos generally do not go to the doctor to get tested to see if they are infected with HIV until they are very, very sick," Rhodes said. "And, once diagnosed, they don't take their medicine as prescribed, even when they have access to life-extending medicines."
Where the Triad and North Carolina come into play is that while the number of Hispanics with HIV is increasing nationally, "Latinos in North Carolina are experiencing a disproportionate HIV burden," the researchers said.
There has been at least a 400 percent increase in the state's Hispanic population in the past 20 years, studies show. A 2006 study from the Kenan-Flagler Business School at UNC Chapel Hill found that 45 percent of Hispanics living in North Carolina in 2004 were not authorized to be here.
Tim Monroe, the health director for Forsyth County, said that the benefit of building the trust of Hispanics in the health-care system goes beyond its population.
"For some Hispanics, there is a fear of their status in the country being compromised by seeking medical help, or that having a serious disease could somehow be held against them," Monroe said.
Monroe said that one reason that the local health department doesn't inquire about a person's legal status is concerns about the spread of communicable diseases.
"If a person who needs treatment for HIV or AIDS is fearful of coming forward, then the person in the same community who has tuberculosis may not come forward either," Monroe said. "That has the potential to put a greater percentage of the general population at risk."
The CDC lists migration as a contributing factor to the spread of HIV and AIDS among Hispanics not born in the United States.
"This may increase risk behaviors due to factors such as loneliness, isolation, separation from partners, which can result in new partners, drug use and inadequate access to health care," spokeswoman Jennifer Ruth said.
"Aggressively confronting the epidemic among Latinos is one of CDC's highest HIV prevention priorities," she said. "Prevention efforts must be designed to reach a multi-ethnic Latino population."
■ Richard Craver can be reached at 727-7376 or at rcraver@wsjournal.com.
HIV risk factors
Several factors are contributing to a higher level of HIV and AIDS cases among Hispanics:
• Limited access to health care.
• Language barriers that affect quality of care.
• Denial of being ill and cultural value of machismo reduce acknowledgement of risky behaviors.
• High rates of sexually transmitted diseases contribute to an increased risk of HIV transmission.
• The disease is often diagnosed too late in many Hispanics for them to fully benefit from life-extending treatment.
• Migration may contribute to HIV infection among those born outside of the United States.
Source: Centers for Disease Control
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