NHMA 15th Annual Conference
Decreasing Infectious Diseases Among
Hispanics
Dr. Vargas-Jackson
March 2011
Hispanics/Latinos in the United States and
HIV/AIDS
 As
the largest minority group in the U.S., Hispanics are
disproportionately affected by HIV/AIDS. In 2006,
Hispanics comprised 15% of the U.S. population or 44.3
million people, yet represented 18% of the HIV/AIDS
cases that same year, among 33 states with name-based
reporting, excluding Puerto Rico. Among
Hispanics/Latinos, males had a higher AIDS rate (per
100,000) of 31.3, than females, 9.5.
Hispanic/Latina Women and
HIV/AIDS
For Hispanic/Latina women living with HIV/AIDS,
the most common methods of HIV transmission:
1) High-risk heterosexual contact and
2) Injection drug use (IDU)
In 2006, the majority of Latinas living with HIV/AIDS
were infected through heterosexual contactapproximately 70% of Latinas.
Hispanic/Latino Men who have sex
with men (MSM)
For Latino men living with HIV the most
common mode of transmission is sexual
contact with another man. At the end of 2005,
57% of all Hispanics living with HIV/AIDS in
the U.S reported male-to-male sexual contact
as the transmission category, compared to
49% among Blacks.
Hispanics/Latinos, Drug Use, and
HIV/AIDS
Communities of Color in the U.S. are most heavily
affected by AIDS associated with substance use. At
the end of 2006 in 33 states with confidential namebased reporting, 14,427 male adult or adolescent
Hispanics living with HIV/AIDS became infected
through injecting drugs with HIV contaminated
needles, representing 23% of Hispanic males living
with HIV/AIDS.
Hispanic/Latino Youth and HIV/AIDS
Hispanic/Latino adolescents in the U.S. face
unique obstacles that help account for their
disproportionately high rate of HIV infection.
Hispanic/Latino teens aged 13-19 accounted
for 19% of AIDS cases among U.S. teens in
2006 although they represented 17% of the
U.S. teen population that same year.
Cultural Barriers & Misunderstandings
Among the barriers preventing Hispanics/Latinos
from acquiring information, increasing knowledge
and accessing services, some of the most
important are:
 Lack of Health Literacy
 Health related Stigma
 Other Cultural Factors
Stigma Definition
Negative
feelings, beliefs and behaviors
directed toward an individual or group due to
a particular label or characteristics. Stigma
is the result of existing stereotypes,
prejudices, biases, and other forms of
oppression in our society, directed at
individuals and/or groups.
Health Related Stigma Definition
Stigma is a social opportunistic disease that
attaches to many illnesses, such as: HIV,
mental disorders, drug abuse, tuberculosis,
etc.
It Decreases prevention & access to care and
services success, and increases intolerance,
and mortality rates
The Attitude That Spreads HIV
Stigma
has become a major reason why
HIV epidemic continues and millions of
people are newly infected and dying with
HIV every year.
HIV Related Stigma
Using HIV as an Example:
a) Primary HIV Stigma is directed at those individuals who
are infected and/or those perceived as infected with the
virus
b) Secondary HIV Stigma is aimed at those individuals
and/or groups associated with those infected, such as:
partners, family members, friends, health care providers,
volunteers and agencies working with those infected
Health Literacy Definition
Is
the degree to which individuals have
the capacity to obtain, process and
understand health information and
services needed to make appropriate
health decisions, in a particular language
Health Literacy FACTS
 Low
health literacy is a major source of economic
inefficiency in the health care system

Magnitude of cost ranges from $106 billion to $238 billion
annually
 When one
accounts for the future cost of low literacy that
results from current actions (lack of action) cost of low
health literacy is closer to $1.6 trillion to $3.6 trillion
(Vernon, Trujillo,
Rosenbaum, DeBuono, 2007)
Culture
Culture refers
to integrated patterns of
human behavior that include the
language, thoughts, communications,
actions, customs, beliefs, values and
institutions of ethnic, religious or social
groups.
Cultural & Linguistic Competence
Cultural & linguistic competence is a set
of congruent behaviors, attitudes, and
policies that come together in a system,
agency, or among professionals that
enables effective work in cross-cultural
situations.
Cultural & Linguistic Competence
Implies having the capacity to function
effectively as an individual and an
organization within the context of the
cultural beliefs, behaviors, and needs
presented by patients/families, and their
communities
In summary, IT IS A SKILL
Cultural & Linguistic Competence in
Health Care
National
Standards for Culturally and
Linguistically Appropriate Services in Health
Care: March 2001
14 Standards
Standards currently being revised/updated
Global Center for Stigma & Health Literacy
“Cultural Competence in Health Care”
“The Center”
The primary motivation for Howard University and its
Partners to launch “The Center” is:
To practice and teach Cultural Competence in Health Care,
increase Health Literacy skills and eliminate STIGMA
The Center: Is not the expression of any specific Culture;
It is the acceptance of our own Humanity;
“that we are ONE despite our differences”
Why a Center: Health Care is a Cultural Construct
Culture: particularly Health Literacy, & Stigma defines:
-how health care information is received
-how rights and protections are exercised
-what is considered to be a health problem
-how symptoms/concerns about the problem are expressed
-who is stigmatized, stereotyped, & discriminated against
-who should provide treatment for the problem
-what type of treatment should be given, among other things
1- Why a Center?
•
•
•
•
•
Because we need to become a Forum for a network of
agencies, organizations & participants working on: HL/S
We need to establish a Global Knowledge Network on
Stigma Reduction & increased Health Literacy skills
We need to Develop a Society-wide Health Response to
eliminate Health Disparities
Because we need to fight for Health as a Human Right
Because Stigma is the attitude that spreads HIV
2- Why a Center ?
•
•
•
We need to bring together diverse stakeholders to
share experiences, knowledge, tools & research around
Stigma & Health Literacy
We need to foster innovative solutions & expand the
reach of existing ways to reduce Stigma & Increase
Health Literacy
We need to facilitate research across disciplines to
expand evidence–based impact of Stigma and Health
Literacy intervention efforts
Howard University and Partners
Launched the:
Global Center for Stigma and Health Literacy
“Cultural Competence in Health Care”
December 1, 2010
Global Center for Stigma & Health Literacy
“Cultural Competence in Health Care”
“The Center” Vision is:
A Culturally Competent, Health Literate world free of
health related Stigma
The Center: Is not the expression of any specific culture;
It is the acceptance of our own Humanity;
“that we are ONE despite our differences”
Global Center for Stigma & Health Literacy
“Cultural Competence in Health Care”
Mission
To improve health outcomes and decrease
health disparities by eliminating health-related
Stigma; promoting cultural competence in
health care with emphasis on health literacy at
providers and populations ends
Center’s Main Areas





Conduct Assessments and Research at providers and
community ends
Development of Culturally appropriate Markers, Tools
and Interventions
Provide Training, Technical Assistance & Capacity
Building
Monitor & Evaluate all programmatic aspects on
constant basis
Develop Publications & Disseminate best practices &
other relevant Information
The Center Summary
In summary, “The Center” will continue the development of a
Culturally Competent, Society-Wide Health
Response
&
Fight for Health as a Human RIGHT
Rebecca Vargas-Jackson, M.D.
2011 International Stigma Conference
Info: wwwwWhoCanYouTell.com
 December
1 & 2, 2011
 Broadcasted worldwide by WHO/PAHO
 Free for live and web participants
 Bi-lingual, English/Spanish
 Some partners are: GWU, Georgetown, Catholic
University, Universidad del Caribe, UDC, University of
California San Diego, several CBOs and FBOs, HRSA,
CDC, National Hispanic Health Professional Schools,
NAPWA, Congressional Black Caucus, NHMA
2011 International Stigma Conference
WWW.WhoCanYouTell.com
(202) 865-7262
Rebecca Vargas-Jackson, M.D.