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[Announcer] This podcast is presented by the Centers for Disease Control and Prevention. CDC - safer, healthier people.

[Dr. Antonia Novello] Hello. Hola. Welcome Y Bienvendos to "Current Challenges and Successes in HIV Prevention with Hispanics and Latinos." I'm Dr. Antonia Novello, the former Surgeon General of the United States and the former Health Commissioner of the State of New York.

[Dr. Raul Romaguera] And I am Dr. Raul Romaguera, Associate Director for Prevention in Care in CDC’s Division of HIV/AIDS Prevention. Dr. Novello and I will be your hosts and moderators for today's program, coming to you from the Centers for Disease Control and Prevention in Atlanta. Thank you for joining us.

[Dr. Antonio Novello] Our goals for today's broadcast are, first, to raise awareness about the disproportionate impact of HIV and AIDS on Hispanics and Latinos in the United States and Puerto Rico. Our second goal is to promote greater understanding of the current issues that affect HIV/AIDS risk among this group. And our third goal is to encourage all organizations who work with Hispanics and Latinos to implement effective interventions and strategies to reduce HIV transmission.

We will hear from CDC staff and colleagues from across the country, including Puerto Rico, regarding research and evidence-based interventions, and near the end of today's broadcast, we will take you – the audience - questions. We will provide a fax number and email address for those questions in a few moments.

Also, mark your calendar and inform colleagues soon about the upcoming webcast. Beginning on May 15, 2008, CDC will present a webcast titled "Update on the Heightened National Response to the HIV/AIDS Crisis among African Americans.” And this will be a 90-minute webcast available for viewing at any time at your convenience, beginning May 15 and thereafter, at www.cdcnpin-broadcast.org. More information about this webcast will be provided after February 15th at the same website.

We have five key objectives for today's broadcast, and after viewing this forum, participants should be able to:

1. Describe the diversity of Hispanics and Latinos and the impact of HIV/AIDS on this population group.

2. Describe current issues that cause Hispanics and Latinos to be at an increased risk for HIV.

3. Identify behavioral interventions and prevention strategies to reduce HIV among Hispanics and Latinos.

4. Discuss the importance of re-evaluating local strategies for all organizations to proactively bring HIV testing and prevention services to Hispanics and Latinos in various settings, and

5. Access CDC-supported training and technical assistance for interventions and strategies to increase HIV testing and modify behavior to reduce HIV risk among Hispanics and Latinos.

[Dr. Raul Romaguera] At times during today's program, we will use the words "Hispanic" and "Latino" interchangeably for the purposes of being inclusive, regardless of how persons identify themselves as either Hispanic or Latino, for example. To understand the disproportionate impact of HIV/AIDS among Hispanics and Latinos, we need to discuss the growth and diversity of this population group. Hispanics and Latinos account for almost 15% of the U.S. population and are the fastest growing ethnic group in this country. The Latino population grew 9.8% between the years 2000 and 2002, whereas the U.S. population increased only 2.5%.and by the year 2050, this group is expected to be 25% of the nation's total population.

This population group is also now the largest and youngest minority group, with one in three Latinos under age 18. One of the most important issues to consider for HIV prevention though, is that this group is highly diverse, which is due to many factors, such as country of origin and ancestry, language, cultural differences, religions, level of acculturation, and socioeconomic situations.

In the 2000 U.S. census, 35.3 million persons in the United States and 3.8 million persons in the U.S. Commonwealth of Puerto Rico identified themselves as Hispanic. Among the total U.S. population, they identified themselves, by subpopulation, as Mexican (7.3%), Puerto Rican (1.2%), Cuban (0.4%), and other Hispanic (3.6%).

Some estimates are that roughly two-thirds of Hispanics are of Mexican descent and, even though Hispanics or Latinos have a long history in the United States, more than two-thirds are either immigrants or first-generation Americans. The countries and continents of origin are also very diverse with ancestry that covers several continents, including areas of South America, Central America, Mexico, the Caribbean, Europe, and Asia. This diversity impacts many factors important for HIV prevention, including language; differences; cultural perspectives, such as gender roles and gender decision-making; and education. Also, diversity affects stigma about sexual orientation and negative perceptions of government authorities, including healthcare providers. When designing programs for Latino groups, we should keep in mind that some participants may only speak English, Spanish, or an indigenous language. Some immigrants from Central America may understand Spanish but prefer to communicate in their indigenous language. Presentations and materials need to be customized to the particular audience. Some organizations are still providing HIV brochures in English only, to all audiences, and some organizations are merely providing literal translations of English materials. However, literal translations can be culturally inappropriate.

Clearly, socioeconomic factors, social environment, and limited access to preventive healthcare services and health information all contribute to racial and ethnic health disparities. These factors can influence quality of life, economic opportunities, and access to healthcare services. All these factors impact risk of HIV and AIDS.

Recent immigrants face additional challenges, such as social isolation, lack of information about HIV/AIDS, which can further increase their risk for HIV. Not only do we need to reach out to these recent immigrants in our outreach efforts, but we also need to provide linguistically and culturally appropriate HIV prevention services.

Although Hispanics and Latinos account for less than 15% of the U.S. population, they account for almost 19% of persons who receive an AIDS diagnosis. In 2005, for example, the annual rate for HIV diagnosis among Latinos was three times that of non-Hispanic whites, and by the end of 2005, an estimated 77,000 Hispanics and Latinos with AIDS had died.

Among persons living with HIV or AIDS in this population group, the most common exposures for HIV for men were sexual contact with other men, injection drug use, and high-risk heterosexual contact. And for women, the most common exposures for HIV were high-risk heterosexual contact and injection drug use.

A number of factors contribute to the HIV epidemic in the U.S. Hispanic population. For example, behavioral risk factors for HIV differ by country of birth. Hispanics born in Puerto Rico are more likely than other Hispanics to contract HIV as a result of injection drug use and high-risk heterosexual contact. By contrast, sexual contact with other men is the primary cause of HIV infections among Hispanic men born in central or South America, Cuba, Mexico, or the United States.

Hispanic/Latina women are most likely to be infected with HIV as a result of sex with men. Some women, including those who suspect that their partners are at risk for HIV infection, may be reluctant to discuss condom use with their partners because they fear emotional or physical abuse or the withdrawal of financial support.

We hope that this brief summary of the diversity of the Hispanic and Latino population and the impact of HIV/AIDS on this group will help in your local HIV prevention efforts.

[Announcer] To access the most accurate and relevant health information that affects you, your family and your community, please visit www.cdc.gov.