Transcript for the Piece Audio version of Part One: HIV PREVENTION IS LOSING GROUND

HOST: ACROSS THE NATION, THE HIV/AIDS EPIDEMIC HAS HIT LATINOS DISPROPORTIONATELY HARD. VOICES OF HIV LOOKS AT HOW HIV AND AIDS ARE AFFECTING LATINOS IN WESTERN NEW ENGLAND. WE?LL HEAR ABOUT WHAT?S BEING DONE TO PREVENT THE SPREAD OF HIV AND WHAT STILL NEEDS TO BE DONE. IN THE FIRST PART OF VOICES OF HIV, FRANCESCA RHEANNON REPORTS ON WHY MANY EFFORTS TO PREVENT THE VIRUS? SPREAD SEEM TO BE FAILING.

The HIV epidemic is one of the deadliest challenges facing Latino communities in western New England. The toll is heavy and ongoing. In Holyoke, more than three quarters of those living with the virus are Latino, while in Springfield and Hartford, this figure is more than half ? some twenty eight thousand people in all.,Jeff Scavron has been dealing with the epidemic since the beginning. He?s the director of Brightwood Community Health Center in Springfield?s predominantly Latino North End:

SCAVRON: We hardly know any families that haven?t been affected in one way or another.

Scavron and his colleagues treat most of the families who need primary care in the North End. He says that while Brightwood has made progress in treating HIV, it hasn?t been able to slow its spread. The reported rate of new infections has remained steady ? and Scavron is afraid that reported cases are just the tip of the iceberg:

SCAVRON: We probably report forty or fifty percent of all actual new cases of HIV.

Scavron says prevention is up against some tough barriers:

SCAVRON: It requires people to change the way they have their most intimate relationships; the way they look at their medical problems and their health problems, and their use of substances. And it?s hard to get people to do that.

And even more so now, because of new medical treatments that have lowered the death rate. People are living longer with AIDS, and being HIV positive has become more of a chronic disease. As people with HIV live more normal lives, they still have to practice life-long prevention to avoid infecting others. Healthy people have to practice prevention too, says Dr. Claudia Martorell. She heads up the Springfield branch of Community Research Initiative of New England, an organization that conducts HIV clinical trials and treats many low-income HIV patients. Martorell says she?s afraid those without the virus are getting complacent:

MARTORELL: At the beginning of this epidemic, you would see people wasted, and they would die from these fatal AIDS diseases. And people were very scared. Now you don?t see that anymore because of the drugs. People are not seeing their friends die and they do not realize the vulnerabilities that they have. That means that the focus on prevention is not there anymore.

Poverty can also make it hard for people to focus on prevention. Eddie Salinas from Hartford's Hispanic Health Council works with young gay men who are HIV positive:

SALINAS: [Spanish under] I can't tell somebody, "Why don't you put on a condom," if they don't know where they are going to sleep that night, if they don't know where they're going to get their next meal, if they don't know how to use transportation. There are a lot of problems that are more primordial, and this is mainly the case with our Latino and African-American clients.

Claudia Martorell also sees this among her patients. And, she adds, the continuing shame and stigma attached to HIV is making it difficult for those who are HIV positive to disclose their status to their loved ones:

MARTORELL: When someone gets to the hospital and they are diagnosed with a pneumonia that is because of AIDS, but the family does not know that the person has AIDS, and of course because of confidentiality issues I cannot disclose.

In the Latino community injection drug use is the major way HIV is spreading. It?s fueling a breakout of the virus into groups in the community who don?t use drugs themselves. That?s especially true of Latina women, who are getting infected primarily through heterosexual sex. Martorell says many women don?t know that their male partners are infected ? or even using drugs. That?s what happened to Rosie, a soft-spoken Latina mother of three from Springfield. She only found out that she?d been infected by her partner when her youngest child came up positive for HIV:

ROSIE: When my son was diagnosed, he had came over, because we were broken up by then, and he came by to see the baby, and I said to him, if there?s anything you need to tell me, I suggest you say it now, and at that he confessed he had been positive for eight years.

Rosie's son died of AIDS at age sixteen months. She now teaches others how to keep from getting infected. But not as much anymore. Money for HIV youth education programs has been slashed. In Massachusetts, the budget for all HIV and AIDS services is down a third over the past five years, from $50 million dollars at its peak down to $32 million dollars in 2005. Many of those cuts happened under Jean Flately Maguire?s watch. But in 2001, she was head of the Massachusetts HIV/AIDS Bureau, when the word came down that she had to slash twenty million dollars out of her budget:

Maguire: There are many organizations that were devastated in the course of those cuts and some that actually closed. So we haven't just diminished the resources that are out there for prevention. We've literally diminished the people and the groups that are doing the work.

Maguire says that with the success of new HIV treatment, the need for prevention has actually increased.

Maguire: Because of the good effects of the drugs, we've expanded the number of people who are actually living with HIV and therefore the pool of potential people that could transmit the virus to others.

When dollars are scarce, they go first to treating those who are sick. But with the estimated lifetime cost of care and treatment for just one HIV positive person at about one hundred and ninety five thousand dollars and with forty thousand new infections per year nation-wide, that strategy will end up being more costly in the long run.

For Voices of HIV, I'm Francesca Rheannon.

HOST: VOICES OF HIV WAS PRODUCED WITH 88.5 WFCR IN AMHERST, MASSACHSUETTS. NEXT ON VOICES OF HIV, FRANCESCA RHEANNON REPORTS ON HOW THE VIRUS IS AFFECTING LATINA WOMEN.