Download this transcript (28KB)

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

[Dr. Antonia Novello] For example, La Clinica del Pueblo is an urban-based organization that provides integrated clinical and mental health services through community partnerships, linkages, and innovative venues. Here is what La Clinica del Pueblo is doing in the Washington, D.C. area, in collaboration with organizations, such as Casa de Maryland.

[Catalina Sol] La Clinica del Pueblo was founded in 1983 in Washington D.C. to serve Central American immigrants who were fleeing the wars at that time and were locating in this area. When we first started out, we were just a one-week clinic, one-room mental health services, and fortunately we've grown into a larger operation. We have a full range of clinical services - daily, evenings, and weekends - support services, social services, and quite a large number of community education activities. HIV testing is a very old part of our service; we've been providing testing and counseling since 1987, and our patients have access to testing through our prevention counselors who do educational sessions in the waiting room, as well as all of our providers and patient care coordinators offer it as part of the medical visit. The counselor will pick someone up, provide the risk assessment, risk reduction plan, test, and the results. The provider can also do that if there's a special circumstance, but the most important thing is that it's a well-established part of our service and that counseling is a very key, important part of our testing program.

As a Latino organization, we still need to work very hard to reach those who are must vulnerable and hard to reach within us. The most effective way to do that is to recruit members from those groups to work with us as peer educators. I'd like to speak a little bit about the Promotores model. “Los Promotores De Salud En Latino America” are people from communities who are trained as health workers where there is no doctor. And that has worked very well in the United States, as well. Places like Casa of Maryland, for example, that serve daily seen recent immigrants. If we were to take a van and just provide testing, nobody would come or we wouldn’t provide a good service. They use Promotores De Salud who are trained not only in HIV, but in other health areas to lay the groundwork, create trust, and then bring people into testing. We provide testing, so it’s something that’s also well known in the community, and it’s the type of partnership that really lets us be effective and provide quality service to hard-to-reach groups.

[Elisa Jaramillo] Here at Casa of Maryland, we provide services for the low income, immigrant community in Maryland, including legal, employment, education services. We have an excellent health program that provides education information, including HIV/AIDS prevention. Our health promoters go to different sites, such as laundromats, shopping centers, grocery stores, door to door, and our day labor sites to find individuals at high risk, provide the education, and refer them to HIV counseling and testing services. The health promoters not only do the referrals, but they are there to provide the support to clients to make sure they are getting the counseling and any other services, as required.

[Catalina Sol] Latinos are disproportionately represented among the uninsured and among the working poor, so access to health care is a real significant issue. It's why HIV testing only through health care settings won't reach a large number of people in our community. Also, people have limited time to be able to come for health services in general, let alone for HIV testing. They don't have sick leave, they don’t have benefits that would really make that easy for them to access. So, if we were just providing testing for our own patients, we wouldn't really be servicing all of the community that seeks us for services. So, the way that we get around that, is that we provide HIV testing on walk-in availability, no appointments necessary. All the hours that we provide clinical services, as well as weekends, and also offsite., you know, partnering with other community-based organizations. To do that is very important, but also making it as accessible and as easy and as linguistically accessible as possible. You know, it's not only important that we're open, but we have to be able to speak Spanish and other languages, if necessary, and to really be responsive to the cultural norms that people bring with them when they’re talking about sexuality or drug-using behavior or all of the things that come up with HIV testing. So, culture, language, access, and geography are all very important. Latinos, locally, get tested at places like ours and then they get care at places like ours. I think that many organizations that serve Latinos find themselves having to provide every service that a patient needs because, it’s either not available outside of your system or your patients need to be with you because they've established that link of trust. The adherence issues are a real problem for our patients, because they're isolated; the stigma of HIV is extremely high within the community. So something as simple as taking your medications at the hour that you're supposed to take them is complicated if there's other people around, if you don't have privacy, if there's no family members that are even in the area to support you because of the fragmentation that occurs in our immigrant families. So, acompanamiento, which is accompaning someone through their process physically, emotionally is a really important part of our model of care.

[Omar Reyes] My name is Omar Reyes. I'm the HIV Counselor and Testing Manager of La Clinica del Pueblo, and my job includes to coordinate all the HIV consulting and testing activities in the community. We do collaboration work with different organizations in the area, including Casa Maryland, Neighbors Consejo, which is an organization that provides services to the homeless population, Mary Center, which is an organization that provides service to pregnant women, Latin American Center that works with the youth population. We make sure that we serve all the segments in the community. Another part of my job is to make sure that my counselors take the necessary training to be good counselors and to provide good services to the Latino population.

[Catalina Sol] The one thing that I would say to any group that wants to work with Latinos in HIV prevention is that they really need to know the specific characteristics of their local Latino community. We're extremely diverse, not just in national origin, but in our rural or urban extractions, and the reasons that we migrated to this country, and the resources that are available to us. And even at Casa of Maryland where we provide services, we can't only offer services in Spanish. We have clients that speak Mam, which is an indigenous language in Guatemala and we have other immigrant groups that are seeking care in immigrant-friendly sites, so we have clients from Cameroon, other clients from West Africa. Here, we serve a number of clients from East Africa who speak Amharik, so we really have to practice our linguistic access. I think that the most important thing is to recruit people from the community to help you understand what it is that's needed to be able to access the community and what their real and true needs are so that you can make that link with HIV prevention and have it be relevant to them.

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