Miami Herald - Thursday October 30, 2003
Andrea Robinson, arobinson@herald.com

Nieves bolts over, offers each a brown paper bag containing condoms and with evangelistic fervor launches into her rap: "When was the last time you took [an HIV] test?" she asks. "If you don't use a condom you're gonna die."

There is dead silence as Nieves explains the risks of unprotected sex. "Naw, I'm a church man," one young man finally says. Everyone walks away except for one girl who heads for the bus for an HIV test.

Score a small victory for Nieves, one of a growing number of outreach workers in Latino neighborhoods working to convince people to protect themselves against the fourth-leading cause of death among Hispanics between ages 25 and 44.

The aggressive outreach campaign is the brainchild of regional and local organizations in their effort to attract the attention of those who influence government AIDS policy, said Alberto M. Santana, HIV prevention program manager at the Washington, D.C.-based National Alliance of State and Territorial AIDS Directors. "They wanted . . . to bring awareness to policymakers that there is an epidemic that continues to grow," Santana said.

MESSAGE

As Nieves and others fan out across the county and the country, they push a straightforward message: "abre los ojos" (open your eyes) to the disease. But convincing Hispanics to embrace that admonition is an onerous task, local AIDS activists say.

More than 20 years after the AIDS epidemic began, many Latinos are still leery of talking about the disease because it requires broaching two subjects considered taboo: sex and drug abuse.

Latino men often shy away from HIV testing for fear it will raise questions about their masculinity or their sexual orientation.

In immigrant communities, some Latinos believe a positive diagnosis could mean deportation for undocumented migrants. And some activists say their cause is hurt by a dearth of brochures written in the language of Miami's immigrant groups.

The net result, too often, is that Latinos with the virus do not find out until they wind up in the emergency room with full-blown AIDS, said Vincent Delgado, director of Borinquen's Phoenix AIDS outreach program.

"In our community there's a certain taboo about the discussion of AIDS," U.S. Rep. Ileana Ros-Lehtinen, a Florida Republican, said in an interview. "We need to break through that and let people know how easy it is to get tested and prevent this disease."

In 2001, Florida received more than $32 million from federal and state sources for prevention and monitoring programs around the state. Part of those funds were allocated to local health departments to provide training and supplies for community groups such as Borinquen.

Nationally, statistics paint a sobering picture. Hispanics represent 14 percent of the U.S. population, but 18 percent of the total number of AIDS cases reported since 1981 and 19 percent of the cases reported in 2001.

The picture is somewhat different in Miami-Dade County, where Hispanics comprise 57 percent of the population and 33 percent of cumulative AIDS cases.

But Dr. Luis Miguel Garcia, surveillance specialist with the Miami-Dade County Health Department, said the total number of Latino cases is more than double that of non-Hispanic whites.

"Everyone in Miami-Dade County should be concerned," Garcia said.

"The numbers are too high."

CHURCH'S ROLE

Some AIDS outreach workers said their burden was made heavier recently when a top official of the Roman Catholic Church, which wields enormous influence among many Latinos, said condoms do not prevent the spread of AIDS.

"Our main [hurdle] is the Catholic Church," said Luis Penelas, executive director of Union Positiva and a longtime AIDS activist.

"It's important in our lives, but I'm embarrassed about how the church has shrugged its responsibility on this issue."

The Rev. Dennis Rausch, HIV/AIDS program administrator for the local branch of Catholic Charities, said the Archdiocese of Miami has helped people with the disease through its congregate living facility for 15 years.

For the past 12 years, Rausch said, AIDS education has been included in Catholic school curriculum, including discussions about condoms.

"The kids bring it up. If they don't we do in the context of medical information," he said.

Borinquen is based in Wynwood, but through its Phoenix program, outreach teams head out at least twice a week into Little Havana, Little Haiti, Allapattah and Overtown. Getting people to come on the bus requires patience, persistence and a bit of bribery in the form of pudding or fruit cups.

'STREET' TALK

Nieves, a self-described New Yorican (Puerto Rican from New York), said she uses her "street" persona -- no-nonsense bravado -- during the night outreach.

Last week, she approached three men who sat on a curb in Wynwood.

When Nieves offered the condom-filled brown paper bag -- which she calls "her hook" -- they weren't interested. One of the men said he lacked immigration papers.

"I'm not asking for your papers," she responded. "I'm interested in your health."

After 30 minutes of banter, one of the other men gave in. Nieves smiled, and walked him to the bus.

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