The Washington Blade; May 15, 1998
Kai Wright

Uriburu, a psychologist on loan to La Clinica from Whitman-Walker Clinic, is describing a new HIV prevention program for Latino Gay and bisexual men and transgender people. But he's not talking about condoms or even about safer sex. He's talking about Thomas Mann and the difference between "love and being in love."

Such conversations, he says, are typical of the program's monthly meetings. Rather than getting a drab course in what Uriburu calls "Prevention 101," participants are called upon to confront concepts such as guilt, familial bonds, and love and to realize how these things influence their behavior. He wants them to understand how, up to this point, the forces embedded in these concepts have helped lead each participant to engage in behavior which puts him in a high-risk category for HIV infection.

"We are basing our program on a few variables: That, at least for the Latino community, most of [the people engaging in high-risk behavior] are people that are very insecure. ... Their self-esteem is very low," says Uriburu. "We focus our intervention on these variables, not directly on the use of the condoms, because they already know that information. The problem is that they don't use it. That's why the focus of the group is to empower [participants] to think by themselves."

The program, which began last August, is a joint venture of La Clinica and Whitman-Walker's Office of Latino Services. It is operated with a $70,000 D.C. Administration for HIV/AIDS grant and, according to AHA's interim HIV prevention division head, Ivan Ortiz-Torres, the city couldn't be happier with how they've spent the money.

Psychologist Diego Uriburu's discussion groups examine why participants engage in risky behaviors. (by Clint Steib)

"They're really giving us a big bang for our buck," says Torres, one of the program's most vocal advocates. "It's not the traditional skills-building program. We needed to go beyond that, and La Clinica, to their credit, said, 'Well, we could do this.' ... If you cannot solve these issues [confronted in the program's sessions], then it's very difficult for us to tell you, 'Well, you should negotiate the use of the condom.' None of that, and we know this based on surveys, will stick with them. Because if you're thinking you're going to be deported 30 days from now, you're going to be thinking of that and that alone."

The program has three components: outreach, group sessions, and individual counseling.

The participants for the monthly group meetings are recruited through outreach done by La Clinica staffer Martin Vasquez. Vasquez, a Gay man living with HIV, goes out to bars and street corners popular with Latino Gay and bisexual men and transgender people. There, he says, his main goal is to develop a relationship with the men, to gain their trust. Vasquez, Uriburu, and the program's third facilitator, Gerardo Oliva, a Catholic missionary from Mexico City, all say the program turns upon developing this initial foundation of trust. Without it, they say, the often wrenching conversations could not take place.

And Vasquez, who moved to Washington from Mexico 10 years ago, says building that trust is no easy task. He jokes that, initially, most men he approaches think he is propositioning them for sex when he takes out his packet of condoms and prevention materials. But eventually, he says, they come to a meeting based on the personal invitation he extends.

Additional outreach is done through a regular column that La Clinica convinced the Spanish-language newspaper The Washington Hispanic to run. La Clinica's HIV prevention programs director, Candace Kattar, said the column's frequent focus on Gay issues is unprecedented in D.C.'s Spanish-language press. She said that the first time they submitted a Gay-themed column, the publication's administration called her to inquire, politely, exactly what the information had to do with HIV prevention. Kattar explained that the focus of the program is not on how to practice safer sex, but on the factors that lead people not to practice safer sex. She informed the paper that the column would continue to deal with Gay issues. Kattar said the paper seemed a little uncomfortable but has allowed the column to continue running with no further inquiries.

Once participants find their way into the group, they are confronted with Uriburu's themes. In a candlelit room with flowers (the facilitators say they constantly try new ways to disarm the participants), the men are encouraged to bring their personal experiences to bear upon the themes.

"We want them to use their experiences to talk about these issues," says Uriburu. "Each one, we saw, it triggered a different memory, a different wound that they have."

In the program's third phase, which the three facilitators stress is not necessarily the final step, some participants choose to move into one-on-one psycho-educational therapy with trained counselors.

"The agency's really satisfied," said AHA's Ortiz-Torres. He says that, while he understands the need for continued "skills-building" programs on safer sex, he wants to incorporate similarly styled programs into the grants for other community-based organizations serving minority populations.

"Not only do we intend to extend the life of the program, we intend to extend its prevalence," gushed Ortiz-Torres. "I hope it will become one of the flagships of our prevention efforts."

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