HIV risk hits Hispanic women

Health workers especially concerned for those not getting tests or treatment

Fernando Quintero, Rocky Mountain News

Friday, October 12, 2007

Juana Maldonado knew that morning sickness and missing her period could only mean one thing.

But when she went to a local clinic for a pregnancy test three years ago, she had a hunch there would be good and bad news.

She was right. She was pregnant. And she was HIV-positive.

"My husband had been using drugs - heroin, marijuana, crack cocaine. It was only logical that he would get infected, and that he would infect me," said the native of Mexico and mother of six.

Maldonado, 31, is one of 456 women living with HIV in Colorado, and among the disproportionate number of Hispanics contracting the deadly virus.

In Colorado, women of all ethnic and racial backgrounds represent the fastest-growing risk group for AIDS. But the risk for Hispanic women is five times greater than for non-Hispanic white women, according to the Colorado Department of Public Health and Environment.

More alarming are the numbers for black women: They are 31 times more likely to acquire the AIDS virus than white women are.

For minorities of both genders, sharp differences remain. Last year, nearly 30 percent of new HIV cases in Colorado were among Hispanics, who make up 17 percent of the population. Twenty percent of new cases were among blacks, who make up less than 4 percent of the population.

In Colorado and throughout the nation, a number of efforts have been made to reach out to high-risk groups since the beginning of the epidemic 25 years ago.

In observance of this year's fifth annual National Latino AIDS Awareness Day on Monday, local health care advocates are hoping the message of HIV prevention will reach more Hispanics.

A health fair and HIV screening will be from 11 a.m. to 4 p.m. Sunday at La Raza Park, West 38th Avenue and Osage Street.

Of particular concern among health workers is the growing number of undocumented Hispanic immigrants who may be HIV-positive but aren't getting tested or seeking treatment because they lack adequate information about the virus, are afraid to seek medical help because they are in the country illegally and are unable to communicate with health workers.

"We are seeing more immigrant women. Many of them are very ill and in crisis by the time they seek services," said Diane Guerrero, clinical consultant for Sisters of Color United for Education, a Denver-based organization that provides counseling and other support for minority women living with HIV.

Guadalupe Joyner, a case management worker for the Southern Colorado AIDS Project and former emergency room social worker in Mexico City, says she sees many Hispanics who are in advanced stages of AIDS and never knew they were HIV-positive.

She said most immigrants have little education, so they don't know about the risk of HIV infection.

"When people don't have access to medical services, they don't have the right information to get protected," she recently told The Gazette, of Colorado Springs.

'Double whammy'

Bernadette Berzoza, financial manager of Sisters of Color who is also HIV-positive, said she has seen a disturbing trend in the number of women who, like Maldonado, didn't find out they were infected with HIV until they had a pregnancy test.

"More than half of our monolingual Spanish-speaking women were diagnosed positive when they were pregnant," she said. "For a whole bunch of women, it's a double whammy: You find out you have HIV, and so does your baby."

Health workers attribute the rise in HIV infections among Hispanics and blacks to cultural taboos about homosexuality, which the disease is still associated with among both communities.

"We are finding a lot of Latinas with partners who inject drugs or have sex with other men but do not identify with the gay label," Guerrero said.

She said being gay or bisexual in the Hispanic and black communities carries more of a stigma, which results in men secretly having sex with other men while being in a relationship with a woman, putting their partners at risk.

"It is still common for many Hispanic men, including those who are married and with kids, to not consider themselves gay if they are the active sexual partner or 'top,' " said Reynaldo Mireles, director of El Futuro (The Future), an AIDS educational and counseling program in Denver for gay and bisexual Latino men.

Joyner named several other factors that make Latinos susceptible to HIV infection.

Catholicism is against the use of contraception, so many immigrants aren't accustomed to the use of condoms, she said.

Also, some migrant workers who travel to the United States and return to their native country are promiscuous and unknowingly transmit sexually transmitted diseases to their wives or partners back home, Joyner said.

Destructive drug abuse

Maldonado never doubted her husband was faithful. But that wasn't the problem.

It was his drug use that would eventually destroy not only his life, but the lives of his family.

"What happened to my husband and me is sad," she said. "We come to the United States to find opportunity. Instead, so many of us end up with vices that lead to our destruction. Or we end up working so hard for a better life that we neglect our children. It's all a sad contradiction."

Fortunately, Maldonado's baby tested negative for HIV. And she has found encouragement and support among the staff and clients at Sisters of Color.

Her relatives in Mexico have not been as understanding.

"In Mexico, having HIV is like having leprosy," she said. "People won't get close to you. My in-laws don't like it when I talk about it. They get uncomfortable."

Maldonado and her children live in Denver with her parents. Her husband was deported two years ago after serving two years in jail on drunk driving and drug possession charges.

"It wasn't necessary to confront my husband about what happened to us," Maldonado said. "He blamed himself and asked me to pardon him. But the pardon doesn't need to come from me. That is up to God."

Despite her problems, Maldonado seems serene. Her calm is occasionally punctuated by a toothy smile.

"Right now my life is a mess. But I still think God has a plan for me. To help others like me," she said. "For me, this isn't the end of my life. It's the beginning of something new. Something positive."

HIV and AIDS in Colorado

AIDS cases reported through June 30, 2007*

8,845 Total number of people in Colorado infected with AIDS, more than half of whom have died

4,200 Number living with AIDS.

3,744 Men

456 Women

By race:

2,652 White non- Hispanic).

836 Hispanic

624 Black

38 American Indian

28 Asian/ Pacific Islander

22 Other

A health fair, which includes free and confidential HIV testing, will be offered in observance of National Latino AIDS Awareness Day from 11 a.m. to 4 p.m. Sunday at La Raza Park, West 38th Avenue and Osage Street, Denver. For information, call 720-297-0771.

*The Centers for Disease Control estimates that 25 percent of people who are HIV-positive don't know they are.Source: Colorado Department Of Public Health And Environment.

quinterof@RockyMountainNews.com or 303-954-5250