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In the rural county of Chatham, N.C., soccer is one of the few sources of entertainment for Latino men; for the last three years it turned into a channel to distribute information about HIV and sexually transmitted diseases (STDs).

"Soccer leagues are the only way to gather the majority of Latino men living in this area," said Jaime Montano, coordinator of the Hombres program for the Chatham Social Health Council (CSHC), a community-based organization that provides education, prevention and HIV testing services to the local Latino community.

"This is a rural area and there are only few options available for Latino men to have fun during the weekends when they are not working," said Montano.

The Council works in collaboration with researchers from the University of North Carolina School of Public Health and the Wake Forest University School of Medicine.

According to focus group results with Latino soccer players, sexual health issues were among their major concerns. As a result, they identified a leader from each of the soccer teams and trained him in Spanish on sexual health issues to become health educators (navigators) for their teammates.

Navigators received incentives and were responsible for talking to their teammates about how to prevent infection from sexually transmitted diseases, asking them if they had any symptoms and giving them condoms. Monthly progress reports and final results showed an increase in condom use among soccer players and in willingness to be tested for HIV.

"In the beginning, talking about condom use was a little bit awkward for the navigators," Montano said. But things changed when they realized how widespread the HIV epidemic was in the area.

Loneliness, nostalgia and alcohol could be a dangerous cocktail that promotes engaging in risky sexual behaviors with sex workers without any protection, Montano said.

Montano, also a substance abuse counselor, recalled that he had two patients who got infected with HIV while intoxicated. When they found out about their HIV status they reacted in completely opposite ways.

"We Latinos are usually fatalists," he said. "We think that getting infected with HIV means we are going to die, but it doesn't have to be like that."

One of his patients refused to take the HIV medication and, as he was devastated with his diagnosis, he decided to go back to Mexico to die. Meanwhile, the other one still lives in the United States, takes his medication and tries to have a normal life.

Immersed in "disenfranchised communities" and being deprived of family ties, the immigration journey in isolated areas might cause immigrants to experience a cultural identity crisis and develop a "sense of hopelessness," said Dr. Jesus Felizzola, coordinator of the Latino HIV/AIDS initiative in the Division of Public Health at the North Carolina Department of Health and Human Services.

"People are at higher risk when they lose their identity and they respond to their environment depending on how they are treated."

One of the biggest barriers in raising awareness about HIV/AIDS is the language issue, and that's why Felizzola believes that HIV prevention messages and intervention strategies tailored to the needs of the different Latino subpopulations are crucial to achieve substantial results.

"We need a national comprehensive strategy," he said. "We need to increase education in order to get Latinos tested and increase the number and proportion of Latinos who receive medical care after infected."

According to a 2007 Henry J. Kaiser Family Foundation report, Latinos represent 14 percent of the United States population but accounted for 19 percent of the AIDS cases diagnosed in 2005. In the United States there are 1.2 million people living with HIV/AIDS, and 200,000 of them are Latinos.

Latinas are also severely affected by HIV, said Ramon Soto, program director of Union Positiva, a community-based-nonprofit organization located in Miami, Fla., which provides bilingual education, prevention and HIV/AIDS support services and testing for the local Latino community.

Talking about condom use entails talking about trust and monogamy, Soto said. Latinas believe they are not at risk because they are monogamous.

"Bringing the subject of using protection is very hard because there is a perception of condom use as equivalent to being unfaithful," Soto said, and added that regardless of gender, Latinos think that asking to use a condom means they are promiscuous.

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Links

Chatham Social Health Council
http://www.chathamcouncil.org/

Union Positiva
http://www.unionpositiva.org/

North Carolina Department of Health and Human Services
http://www.ncdhhs.gov/

HIV/AIDS among Latino women
http://www.4women.gov/minority/hispanicamerican/hiv.cfm

Centro Latino de Chelsea
http://www.centrolatino.org/hivaids.php

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