Oregon's HIV/AIDS caseload is atypical of the national trend. The HIV rate is very low -- about six-tenths of one percent -- and more than 78 percent of those cases are white, according to the Kaiser Family Foundation.
But if you look closer, you see some familiar trends. Blacks are barely two percent of the population, but accounted for six percent of all HIV cases in 2009. The Latino HIV/AIDS caseload is growing and the demographic is younger. Latinos account for about 12 percent of the state's population and also for about 12 percent of its HIV/AIDS caseload, according to Kaiser. Migrant workers, the undocumented, drug users and gay and bisexual men (men who have sex with men or "MSM") are disproportionately represented, too. Sixty-seven percent of all adult HIV cases in Oregon were transmitted by male-to-male sex.
"We're seeing younger MSM of color that are HIV positive here in Portland , especially Latino youth," says Ernesto Dominguez, the 23-year-old youth technology specialist at the Cascade AIDS Project and an online peer educator with Youth Resource. CAP is the largest HIV/AIDS service provider in the state. "It's my job to find them."
Explain the job of a "youth technology specialist."
My job is to help create an online hub of sexual health information for at-risk youth. Specifically LGBT youth -- and also African American, Latino and homeless youth. [Many youth] use a variety of social media platforms so we're there with prevention and testing information on Twitter, Facebook, YouTubes, blogs, etc..
Pivot is another program of Cascade AIDS Program. It's encourages better health for men who have sex with men in Portland. Pivot is a community space and a drop in space for people to hang out, use computers, and a safe space for young men to access testing for STDs. We also host programs throughout the year, such as on healthy relationships, dating, being HIV positive and other risk reduction programs.
Describe the HIV epidemic among Latino communities in Oregon.
Portland and Oregon are predominately white. But while we are seeing a disproportionate number of HIV cases in the Latino community, the numbers are not as large as in some of the states closer to the Mexican border, such as California. We do have a larger numbers of [Latino] HIV cases in rural areas, where there are many farm workers.
In Portland, just like many other large cities, people of color and young people are at highest risk for HIV and STDs. The numbers are not as high as Los Angeles or New York, but youth and Latino youth are at higher risk.
How do you conduct outreach to undocumented migrant workers?
We test in different places where we see many migrant workers. We'll use a van and pull up to where there are day laborers and migrant workers. We'll test right there while they are waiting for a job. Those are very powerful relationships because we show up where they are. We don't ask them to take a day off from work to get tested. The more you come to a community and provide services, the better those services are received.
It's the same with finding youth online. When we are on social media platforms, such as Facebook, Twitter, and creating YouTube videos, young people can access them immediately. That's opposed to coming to our website or offices. You have to meet people where they are.
The Centers for Disease Controls recently released data that show young MSM, specifically Black and Latino, are at highest risk for HIV. What are the challenges to working with Latino youth in Oregon?
With the Latino community, the [primary] challenges are access and language, and we are sometimes [limited] by immigration status. We also saw trust issues after SB 1070 passed in Arizona and some new laws were passed in Oregon around drivers licenses. Undocumented people were reluctant to come forward for HIV testing or access to care. It remains difficult to provide some services to many people who are undocumented, specifically around housing. So sometimes we just have to be creative when providing services to [HIV positive] clients. This is especially true with undocumented LGBT youth.
Talk about coming out and how that impacts risk behavior.
I came out when I was 14 and started [activism] in late middle school because of my own identity as a young gay Latino. Later, I worked in the Mayor's Office on youth policy.
Family is one of the most important things in a young Latino's life. But after you come out the closet, many people are pushed away and sometimes there is a huge amount of resentment. That resentment toward self and family creates risks for STDs and HIV.
The more you compound intersecting identities such as being a queer youth, youth of color, living in a rural community, having parents that did not graduate from college, the more it increases the likelihood that youth will engage in risky behavior. In my case, it wasn't the fact that I was queer and Latino ... it was just not having the same support system as my white, straight peers. I didn't have that family support system, so I looked for it online, in organizations, non-profits and volunteer capacities. But many other young Latino youth [may not] do the same thing. Mentoring becomes important, that's a big part of my job.
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.