Linking East Los Angeles' HIV Positive Latino Youth to Medical Care
Q&A With Arlene Martínez, Youth Transitional Manager, AltaMed Health Services
September 15, 2011
Los Angeles is the epicenter of the Latino HIV/AIDS epidemic in California. The county has the majority of the state's HIV/AIDS caseload and Latinos comprise a plurality of Los Angeles County's HIV/AIDS cases -- at least 43 percent of all new diagnoses in 2010.
"We're definitely seeing an epidemic of HIV infection among Latino youth," says Arlene Martínez, youth transitional case manager at AltaMed Health Services in East Los Angeles, the largest network of community-based health clinics in Southern California. Martínez is a Los Angeles native born to Salvadoran parents, and has worked in HIV/AIDS and youth services for more than a decade.
A "higher percentage of male and female Latinos are diagnosed with HIV before the age of 30" than for any other ethnicity, notes the LA County Public Health's 2010 HIV Surveillance Report. A higher number of Latino youth 13-19 are also sero-converting. "Once they learn their diagnosis, one of our biggest problems is getting them to adhere to the medication," says Martínez.
Tell me about AltaMed's HIV/AIDS services.
AltaMed's Daniel V. Lara Clinic is full-service and specific to HIV and AIDS. Our headquarters are in East Los Angeles, and we have two satellite DVL Clinics in El Monte and Pico Rivera. We provide a full suite of programming and services. There are about four or five medical doctors that are HIV specialists.
We operate an on-site pharmacy and enroll clients in the AIDS Drug Assistance Program (ADAP), Housing Opportunities for Persons with AIDS (HOPWA) and Ryan White. We also conduct free rapid HIV testing as well. And of course there is a youth program, where I work.
How young are the clients?
We're definitely seeing an epidemic of HIV infection among Latino youth. About 88 percent of our youth clients are Latino men -- a smaller percentage are Latinas, Caucasian and African American. Most of my clients are aged 20 to 24, a few are under 20. My youngest client was 16, she is 18 now.
The youngest age that we can see clients is 13 years. Younger than 13, we want them to go to Children's Hospital because they will need parental consent to receive medication.
Working with HIV positive youth must be challenging.
Where do we begin? [Laughs] My job is work with all the youth that come through the clinic and make sure they are linked to care. I also conduct home visits -- those are needed often in some cases -- and handle referrals.
The biggest issue is teens telling their parents and coming out about their serostatus, because they don't want their parents to know. Or if they are guys, they don't want their family to know they are gay or bisexual. This happens very often. And many young people are still living with their parents.
Once they learn their diagnosis, getting them to become adherent to their HIV medication is a big challenge too. Many teens will not adhere to treatment medications because they won't take their medications home and never have their medication with them. There is always an excuse because so many are more afraid of what will happen if their friends or family learn their status. They're terrified of the stigma and being rejected, or even losing a roof over their head.
In one of my recent reports on Black MSM youth, a 23-year-old told me that he learned his diagnosis at 19-years-old, but waited two years until he was off his parents insurance to take any medication or see a doctor.
Because he didn't want his family to know, right? We've seen that as well. It's so unfortunate but that often happens. Just recently, we actually had to turn down two youth who had insurance through their parents but were too afraid to file claims. They could always close their insurance, but insurance takes care of so many other things that public programs will not.
The situation must be even more precarious for Latino youth who are undocumented.
Oh yes. That's a major problem here, too. Many clients become freaked out about being deported if they test positive. Or if they are in the process of being deported, they don't know that they have the right to tell authorities, "I'm HIV positive. I have the right to at least get my medication before I am deported.
That has happened many times when undocumented HIV positive clients were being deported. They are too afraid to speak up, because of the stigma of being identified as HIV positive to authorities and in their homeland. I try to educate them about what rights they have. Luckily, most of my clients are younger, so they tend not to be undocumented.
Rod McCullom has written and produced for ABC News and NBC, and his reporting and analysis have appeared in Ebony, The Advocate, ColorLines and other media.
This article was provided by TheBody.
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