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Transitions
Volume 15, No. 3, January 2004
This Transitions is
also available in [PDF] format.
Latino Adolescents and HIV/AIDS
By
Romàn Cruz, Director of Community Action, National
Latino Children's Institute, and Carolina
Godínez, Senior Program Coordinator, Institute
for Hispanic Health, NCLR
Latino
Youth Are at Risk.
- The Latino
population is the youngest and fastest growing ethnic
minority group in the United States. The U.S. Census
Bureau estimates that nearly 39 million Latinos live
in the United States.1
- Many
Latino youth are sexually active. According to 2001 data
from the CDC's Youth Risk Behavior Surveillance System
(YRBSS), 46 percent of all U.S. high school students
have had sexual intercourse, compared to 48 percent of
Latino youth.2
- Among
sexually active students in 2001, 58 percent reported
using a condom at most recent sex. Latino students (54
percent) were less likely than white or black students
(57 and 67 percent, respectively) to report using a condom.2
- HIV/AIDS
has disproportionately affected Latinos. Although, Latinos
represent 13 percent of the U.S. population, they account
for 20 percent of persons living with AIDS as well as
19 percent of cases first reported in 2001.3
Studies consistently
show that Latinos receive less preventive care than non-Latinos.4,5 Moreover,
preventive care may not be an immediate priority for individuals worrying
about how to meet the basic survival needs of their families, and Latinos
have less access to health education, health care, or culturally and
linguistically competent health care providers than do whites or African
Americans. 4,5 Thus, it is imperative to find ways to reach
Latino youth with information and services to promote responsible sexual
decisions.
Two projects addressing HIV prevention among Latino youth provide examples
of key strategies. They are Charlas Entre Nosotros from the National
Council of La Raza (NCLR), and Onda Sana from the National
Latino Children's Institute (NLCI). These projects use different approaches
and have been implemented in different geographical areas.
Charlas Entre Nosotros
Charlas Entre Nosotros (CEN),
a peer-to-peer HIV/STI prevention program implemented
by NCLR, is a five-year pilot project involving charter schools
and community-based organizations in developing and providing
peer-to-peer HIV/STI prevention for Latino youth, ages
13 to 19. CEN's goal is to reduce the incidence of HIV/STIs
among Latino youth through education, using effective and
culturally appropriate prevention strategies, and reinforcing
responsible sexual behavior. CEN works to strengthen 1) youth's
ability to resist peer/societal pressures and 2) young people's
self-concept, cultural values, and sexual health beliefs.
Currently CEN is in its fifth and final year.
Through Charlas Entre Nosotros, four community-based
organizations were selected to partner with NCLR.
Hispanic Health Council in Hartford, Connecticut,
offers a comprehensive, community-based approach to serving the Latino community
on issues such as maternal and child health, family health promotion, and
youth
development. Centro Hispano de Hawaii in Honolulu, Hawaii, focuses on community
advocacy, arts, and culture. As part of its arts and culture programming,
Centro Hispano de Hawaii operates a radio program
to reach out to youth, including
Asian and Pacific Islander youth. NCLR also partners with a charter school,
Calli Ollin Academy in Tucson, Arizona, and with a community clinic, Salud
Para La Gente in Watsonville, California, that provides health education
and services. Most CEN partners link with local
schools, and many youth receive
school credit for their CEN community service hours. At every site, youth
participate in a Charla, consisting of
four consecutive sessions involving 15 to 20 youth.
The four, two-hour sessions are led by youth facilitators
who
are trained to lead on basic concepts regarding HIV/ AIDS and STI prevention,
using an adapted version of Be Proud! Be Responsible! Charlas are
formed with two different age groups: 13- to 15-year-old youth and 16- to
19-year-olds.
Youth and youth leaders have provided evaluation
data, indicating that they have enjoyed being
part of CEN, being leaders, and having the chance
to
do
something of value for their community. To better meet the needs of Latino
youth participating in Charlas, NCLR has updated the curriculum
to include a module on values, while a module on sexual orientation and
gender identity is currently under development.
Onda
Sana
Onda Sana uses
cultural values and novel strategies to help young
Latinos ages nine to 15 to create una onda sana—a "healthy
wave"—in their community. Onda Sana builds
on culture and tradition to emphasize the importance
of young people's making healthy choices and creating
a cadre of like-minded peers. The goal of the program
is to reduce behaviors that
put young Latinos at risk for HIV infection and to
develop strong community leaders.
Several community-based organizations serving Latinos
throughout the United States served as pilot
sites for the development of program materials
and strategies.
The Onda Sana materials are flexible and can be used in a
variety of settings from schools to clinics. Materials developed by
youth—such
as stickers, posters, sample Web pages, and a tee shirt—provide
visual reminders to young people to choose una onda sana. In addition,
the program sponsors special events to provide community groups the opportunity
to discuss HIV/AIDS issues.
One of the strategies of Onda Sana is
group discussion. The program creates a safe
space for young people, as well as their parents,
to
discuss
topics that are generally taboo in the Latino family, including sex,
sexuality, substance abuse, and other behaviors
that put youth at risk for HIV infection.
Some Latino parents may avoid conversations about sexuality issues, saying De
eso no se habla. (We
don't talk about those things.)
The parent stance, the look, the pointing finger, the What will your grandparents
think? and other similar gestures and rhetorical questions are not
unusual when Latino parents attempt to communicate with their teens.
Most of the
time, such conversations end up with raised voices and accusations. You never
listen! Or, You are grounded!
Helping parents and youth communicate can
be difficult; but, with activities like "What
were you thinking?" the facilitator
helps break the ice among parents and they
begin
to recognize the similarities between their
teens and themselves
at that age. The facilitator starts by
sharing a story of his/her own youth. Most
people have
memories of actions that they realize could
have hurt others or themselves. After a
few such stories,
parents start to understand how their children,
who may now be engaging in similar behaviors,
are not very different from themselves
at the same
age. This exercise levels the playing field.
Parents are able to talk more calmly as
they begin to open
communication with their child. Onda Sana provides
these and many other activities to help Latino
youth and their parents develop and open
communication. The activities are designed
with Latino traditions
and customs to help Latino youth make healthy
and wise choices for life.
References
- U.S.
Census Bureau. Hispanic Population reaches All-Time
High of 38.8 Million, New Census Bureau Estimates Show. [Press
release] Washington, DC: The Bureau, June 18, 2003.
- Centers
for Disease Control & Prevention. Youth risk behavior
surveillance, United States, 2001. Morbidity & Mortality
Weekly Report, Surveillance Summaries 2002; 51(SS-4):1-64.
- Centers
for Disease Control & Prevention. HIV/AIDS Surveillance
Report 2001;13(2).
- Centers
for Disease Control & Prevention, National Center
for HIV, STD and TB Prevention. Protecting the Health
of Latino Communities. Atlanta, GA: Author, 2000.
- Kates
J. Latinos and HIV/AIDS. Menlo Park, CA: Kaiser
Family Foundation, 2001.
Transitions (ISSN 1097-1254) © 2004, is a quarterly publication
of Advocates for Youth—Helping young people make safe and responsible
decisions about sex. For permission to reprint, contact Transitions' editor
at 202.419.3420.
Editor: Sue Alford
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