As you are well aware, getting clients tested, linked to care, and into ongoing treatment for their HIV can be a difficult challenge. This challenge becomes even more urgent in communities of color, which are disproportionately affected by HIV in terms of new infections, proportion of people living with HIV, and in some cases rate of undiagnosed infection.1 For example:
- African Americans represent approximately 14% of the US population, but accounted for 44% of new HIV infections in 20101
- Young black males aged 13 to 24 are 11 times more likely than young white males and more than 3 times as likely as young Hispanic males to have HIV2 —
- Young black females aged 13 to 24 are 5 times more likely than young white or Hispanic women to have HIV2
- Latinos represent approximately 16% of the total US population, but accounted for 21% of new HIV infections in 20103
Cultural issues can overlap socio-economic and other factors when working with HIV in communities of color.1 Cultural competence is critical, and can impact your ability to function effectively as a service provider. "When working with Latinos who are born in Los Angeles," observes Natalie, an experienced HIV prevention manager in Los Angeles, California, "it's important to address the differences that they have in their culture between the first generation, second generation, and so forth...as a third-generation Latino, you're more connected somewhat to the American culture...so you can talk about sex and sexuality a little bit more openly than you could have with their parents."
HIV and Youth Culture
Youth culture can add another layer of complexity to working with people living with HIV in communities of color.2 "Young people are one of the hardest demographics to keep in care, to actually get into care, or even to get tested," reports Jason, an HIV case manager who works with youth in Charlotte, North Carolina. "It's really important to develop a great rapport, a great connection with them so you can keep them engaged." That connection may help at-risk youth get tested as early as possible.
AIDS Service Organizations (ASOs) working in a community of color know that developing cultural competence takes time; it doesn't happen overnight.4 It's an ongoing process of learning, experimenting with different approaches, and finding what works. Many ASOs offer cultural competence training, which can be supplemented by your own online research. For example, the AIDS Education and Training Center–National Multicultural Center (AETC-NMC) at Howard University provides insightful Case Studies in Cultural Competency (http://www.aetcnmc.org/studies/index.html) that allow you to explore a broad range of scenarios, organized by cultural community.
As you know, engagement is the other key piece. Take advantage of every chance to open a dialogue about HIV with your clients and community. Likewise, encourage your clients and others to talk about HIV with friends, family, and peers.4 Finally, National HIV Awareness Days provide the perfect opportunity to broadcast and amplify your message—for example, by posting an online article or planning a local event.
- 1. Centers for Disease Control and Prevention (CDC). CDC Fact Sheet: New HIV Infections in the United States.
http://www.cdc.gov/nchhstp/newsroom/FactSheets.html. Accessed December 2012.
- 2. CDC. CDC Fact Sheet: HIV and AIDS Among African American Youth. http://www.cdc.gov/nchhstp/newsroom/FactSheets.html. Accessed May 2013.
- 3. CDC. CDC Fact Sheet: HIV and AIDS Among Latinos. http://www.cdc.gov/nchhstp/newsroom/FactSheets.html. Accessed May 2013.
- 4. Tomaszewski EP. Understanding HIV/AIDS stigma and discrimination. National Association of Social Workers.
http://www.socialworkers.org/practice/hiv_aids/AIDS_Day2012.pdf. Accessed March 2012.