Perceived Barriers to Treatment for the Latino HIV+ Community
Barriers to HIV treatment can come in two forms: actual and perceived.
While actual barriers to treatment may be more easily solved due to their objective nature, perceived barriers to treatment are much harder to identify, let alone solve, due to their cultural and subjective nature.
Cultural implications may increase the complexity of perceived barriers to care.
The Latino community is particularly impacted by perceived access to care on many levels.
The first barrier to treatment would be getting testing for HIV.
To start with, most individuals (whether of Latino descent or not) carry with them a false sense of invulnerability and/or a perpetual sense of denial, manifested by such thought processes as: "It can't happen to me.
" Additionally, HIV related stigma in the Latino community runs rampant.
The abject fear stemming from HIV related stigma and having to get tested may prevent many from taking this crucial first step.
HIV related stigma is further impacted by cultural norms in the Latino community.
Many "old school" Latinos continue to associate HIV as "the gay disease" or a death sentence.
These norms, passed over from one generation to another, could likely prevent someone from accessing testing, and subsequent medical care, if needed.
Internalized homophobia, which continues to affect the Latino community, may also have an adverse impact on individuals getting tested and/or accessing care.
Once the individual is tested and should the results come back positive, then another interesting Latino phenomenon comes into play: Fatalismo.
This is a concept in the Latino community which basically states "God has ordained death.
" This could manifest in the newly diagnosed individual as a sense of "I'm going to die anyway so why bother getting treatment.
" If proper medical care (and possibly even mental health services) are not in place immediately after a positive result, the Latino individual may forgo treatment until it's too late.
It is also not uncommon for Latinos, particularly men, to not seek and/or participate in treatment until it's absolutely necessary.
Traditional folk remedies and spiritual practices that are common in the Latino community can also prevent a newly diagnosed Latino individual from seeking appropriate medical care.
Religious practices such as Santeria and folk remedies may be the first line of defense for some Latino families.
While respectful of religious practices and folk remedies, none of these have shown to have much efficacy in treating HIV.
However, staunch believers of such practices poses a significant barrier to accessing care for the newly diagnosed Latino.
So where does the Latino new poz individual go to seek treatment? The initial shame of being diagnosed with HIV will likely prevent the individual from reaching out to family and loved ones.
This individual would have to resort to internet research, which can bring its own share of problems.
Let's assume that the individual does find an appropriate medical provider to seek treatment.
Fears of being seen by known associates at a medical office could increase apprehension towards treatment.
Additionally, in cities were bilingual staff and forms are not available, how does the Latino individual fill out any paperwork upon their initial visit.
If the individual is lucky to arrive at a facility with bilingual staff and paperwork, educational and literacy levels may also provide a perceived barrier to treatment.
Beliefs about accessing care may become another perceived barrier to treatment.
For anyone of a lower socioeconomic status, which is not limited to the Latino community, costs of medical services and medications can be mind-boggling.
Many individuals are not knowledgeable regarding programs such as ADAP, which covers the costs of medical services and medications for most individuals who meet the criteria, even those who are undocumented.
Individuals who may work long hours and have lack of transportation could potentially not access treatment.
We as providers need to look beyond traditional measures of treatment for the HIV+ community, particularly for the Latino community, and think outside the box.
Perhaps services such as intensive case management from the onset of diagnosis, mobile testing centers and mobile medical centers, as well as providing bilingual staff and forms for patients may be a place to start.
Additionally, educational services such as life skills training, literacy programs and patient advocacy groups (to teach folks about the plethora of resources in the community) could broaden treatment for the Latino community and break down perceived barriers to care.
While actual barriers to treatment may be more easily solved due to their objective nature, perceived barriers to treatment are much harder to identify, let alone solve, due to their cultural and subjective nature.
Cultural implications may increase the complexity of perceived barriers to care.
The Latino community is particularly impacted by perceived access to care on many levels.
The first barrier to treatment would be getting testing for HIV.
To start with, most individuals (whether of Latino descent or not) carry with them a false sense of invulnerability and/or a perpetual sense of denial, manifested by such thought processes as: "It can't happen to me.
" Additionally, HIV related stigma in the Latino community runs rampant.
The abject fear stemming from HIV related stigma and having to get tested may prevent many from taking this crucial first step.
HIV related stigma is further impacted by cultural norms in the Latino community.
Many "old school" Latinos continue to associate HIV as "the gay disease" or a death sentence.
These norms, passed over from one generation to another, could likely prevent someone from accessing testing, and subsequent medical care, if needed.
Internalized homophobia, which continues to affect the Latino community, may also have an adverse impact on individuals getting tested and/or accessing care.
Once the individual is tested and should the results come back positive, then another interesting Latino phenomenon comes into play: Fatalismo.
This is a concept in the Latino community which basically states "God has ordained death.
" This could manifest in the newly diagnosed individual as a sense of "I'm going to die anyway so why bother getting treatment.
" If proper medical care (and possibly even mental health services) are not in place immediately after a positive result, the Latino individual may forgo treatment until it's too late.
It is also not uncommon for Latinos, particularly men, to not seek and/or participate in treatment until it's absolutely necessary.
Traditional folk remedies and spiritual practices that are common in the Latino community can also prevent a newly diagnosed Latino individual from seeking appropriate medical care.
Religious practices such as Santeria and folk remedies may be the first line of defense for some Latino families.
While respectful of religious practices and folk remedies, none of these have shown to have much efficacy in treating HIV.
However, staunch believers of such practices poses a significant barrier to accessing care for the newly diagnosed Latino.
So where does the Latino new poz individual go to seek treatment? The initial shame of being diagnosed with HIV will likely prevent the individual from reaching out to family and loved ones.
This individual would have to resort to internet research, which can bring its own share of problems.
Let's assume that the individual does find an appropriate medical provider to seek treatment.
Fears of being seen by known associates at a medical office could increase apprehension towards treatment.
Additionally, in cities were bilingual staff and forms are not available, how does the Latino individual fill out any paperwork upon their initial visit.
If the individual is lucky to arrive at a facility with bilingual staff and paperwork, educational and literacy levels may also provide a perceived barrier to treatment.
Beliefs about accessing care may become another perceived barrier to treatment.
For anyone of a lower socioeconomic status, which is not limited to the Latino community, costs of medical services and medications can be mind-boggling.
Many individuals are not knowledgeable regarding programs such as ADAP, which covers the costs of medical services and medications for most individuals who meet the criteria, even those who are undocumented.
Individuals who may work long hours and have lack of transportation could potentially not access treatment.
We as providers need to look beyond traditional measures of treatment for the HIV+ community, particularly for the Latino community, and think outside the box.
Perhaps services such as intensive case management from the onset of diagnosis, mobile testing centers and mobile medical centers, as well as providing bilingual staff and forms for patients may be a place to start.
Additionally, educational services such as life skills training, literacy programs and patient advocacy groups (to teach folks about the plethora of resources in the community) could broaden treatment for the Latino community and break down perceived barriers to care.
