Sunday, December 21, 2014
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Latino HIV AIDS education takes to the streets
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On a Thursday night at Margarita Bella, the Latino bar in Minneapolis offers La Coco on stage. The drag queen entertains customers and does a little HIV education. (MPR Photo/Bianca Vazquez Toness)
New studies in Minnesota show that Latinos are getting HIV AIDS at a much higher rate than the white population. They are younger when they contract the virus and less likely to seek care. There are health education programs aimed at Latinos, but they're not well funded and may not last.

St. Paul, Minn. — It's Cinco de Mayo and as drums pulse in the background, traditional Aztec dancers move around a courtyard. Jesse Saavedra stands behind a table nearby.

He's sandwiched between women selling Avon products and a booth where people will paint the Mexican flag on your face. Saavedra wears dark sunglasses, and gold chains. Tattoos peek out from under his white guayabera, a traditional mans shirt from Latin America.

"I work with the Minnesota Department of Health and what I do is testing in the field," Saavedra explains.

Jesse got into AIDS work by accident. A recovering drug addict, he volunteered at Catholic Social Services, serving coffee and working as a bouncer. He had no interest in AIDS but the agency recruited him for an outreach position since he spoke Spanish and was respected in the Latino community.

Years later, he's working for the state doing the same thing and now he's learned how to work around regular rejection.

He talks about a time he was trying to track down a young man who had tested positive. The man kept avoiding him but finally they met up. It turned out that the young man believed he would be arrested for having HIV. That's what his friends on his soccer team told him. Jesse seized it as an opportunity.

"And I said, 'Maybe this is a good idea for me, to be able to come out to your soccer games and provide information.' (He said) 'Ah, I don't want people to see you. They're going to think I'm positive.' And I said, 'No, I won't even know you because of the confidentiality. I won't even approach you unless you come up and talk to me.'"

Jesse plans to hit weekend soccer games soon. It's a little hit and miss but this is the reality of HIV AIDS education in such a diverse community.

Sarah Senseman runs the AIDS program for West Side Community Health Services. Her clinic used to do outreach but those programs ended when grants ran out. Now the West Side clinic only provides service to people once they have HIV or AIDS. Senseman says Jesse Saavadra is the only person in the Twin Cities doing fulltime outreach and testing for Latinos and he was only hired temporarily.

Senseman says testing in the Latino community is relatively rare. Health educators worry that as a result people who do have the virus often aren't tested until it's well developed. Last year 59 percent of Latinos who tested positive for HIV already had full-blown AIDS.

"And that's serious," says Senseman. "That says that we're missing opportunities to catch people early and help them lead healthier lives. And we're also putting other people at risk because we're not able to get their viral loads down and prevent transmission to others."

On the other hand, whites typically get tested before they have any symptoms, when they are still just HIV-positive. Only a quarter of them have-full blown AIDS when they are first diagnosed.

Sarah Senseman says Latinos are less likely to have health insurance, and some fear they'll get deported if they have the disease. She says the state needs to spend more money on outreach, paying for people like Jesse to hit the streets, but also to use more traditional modes of communication.

"Doing things like Radio Rey and other spanish language media, would be a way to inform people about testing and break some of the myths about HIV. That's something that we're not really doing," says Senseman.

There are some people in the Latino community who've decided to do it on their own.

On a Thursday night at Margarita Bella, La Coco is on stage at the Latino bar in Minneapolis. The drag queen entertains customers and does a little HIV education.

La Coco moved here from El Salvador more than a decade ago and has been doing drag even longer than that.

During the day, La Coco is Mario and works at a clinic doing clerical work. He wears a sporty visor, sneakers, and baggy pants. He devotes every Sunday to his family, whom he helped move to the states.

But Thursdays, he does drag. For La Coco, it's an artform, and she enjoys immitating everyone from Madonna to classic Latin American divas.

Between songs she makes racy jokes with the crowd, but then points to the back of the room, where there's a table covered in condoms. Her message is clear. Use a condom and get tested. She says AIDS is now something you can live with for years if you get proper treatment. La Coco even lines up free testing at the bar.

Outside, after her performance she says she does this because no one else will.

"Yeah, there are other places to get condoms, but you have to remember that as Latinos, we're embarrassed to go to a clinic," La Coco says. "If we're here at the bar and have the opportunity to go home with someone, and don't want to pass by a gas station or pharmacy, or perhaps don't have money to buy them (condoms), you can get them here. I think we're directly meeting the public need."

Next La Coco plans to take condoms into Latino straight bars. La Coco would like to work full time doing outreach. The clinic where she works wants to hire her to do outreach. They plan to apply for a grant from the state, but it will be a while until they find out whether they'll get the money.

HIV AIDS is not something we should continue to hide in the closet, that we should continue to lock in rooms, that we should continue to whisper about.
- Jeese Saavedra

The state has identified target groups for prevention and education. Kip Beardsley manages the Minnesota Health Department's section on sexually transmitted diseases or STDs and HIV. He says the funding for this work has remained the same over the years. But, he says, there are more people now with a high risk of contracting HIV AIDS.

"There's going to have to be some redirection of resources," Beardsley says. "And we do that in a very careful way. And we try to constantly identify what mechanisms and populations we can put our resources into to have the biggest effect on the transmission of HIV."

Beardsley says there are two clear target groups in the Latino community, men who have sex with men, and heterosexual women. Almost all of the men who test positive for HIV, 98 percent, said they had had sex with men. And most of the women who tested positive where infected through heterosexual sex.

Most health educators agree that you have to have a comprehensive strategy to reach those people. It's not enough to go to gay bars, since not all Latino men who have sex with men identify themselves as gay. And heterosexual women at risk could be anywhere in the community. They are likely to be married or in a relationship and unaware that their husbands or boyfriends are having sex with men.

Back at the Cinco de Mayo celebration, Jesse Saavedra keeps hoping someone will take him up on his offer of a free HIV test. Then a woman he recognizes walks by. He tested her last week. He runs out to get her attention and give her the results.

He immediately tells her that she's negative. She tells him she couldn't sleep the night before, thinking about the results. She has no qualms talking about her tests.

Jesse says it's important to catch a wide cross section of people just out living their daily lives. They should get used to seeing him in public.

"HIV AIDS is not something we should continue to hide in the closet, that we should continue to lock in rooms, that we should continue to whisper about," Saavedra says. "We felt that going into the community talking and be there so we could develop a trusting relationship. If they test with you they know you're not going to be gone tomorrow."

Jesse knows he could actually be gone soon. His position as a fulltime tester ends in a few months. The state is now considering whether to fund his position for another year.

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