Los Angeles Times - November 25, 2009
Alexandra Zavis

The findings underscore the need for more targeted education and prevention programs within the diverse Latino community, which accounts for a disproportionate number of new HIV and AIDS cases in the U.S., said Janni Kinsler, one of six UCLA researchers who conducted the study.

"HIV is not declining, and it should be," Kinsler said. "If you don't know that you have it, God only knows who you are transmitting it to."

Latinos made up 14% of the population in 2006, according to the Census Bureau. But they accounted for 22% of new HIV and AIDS cases that year, the Centers for Disease Control and Prevention found.

They also tended to be tested for HIV later than other ethnic groups and to be more likely than whites to also have hepatitis C, which can be associated with a more rapid progression to full-blown AIDS, according to studies.

Researchers at UCLA's Division of General Internal Medicine and Health Services Research surveyed 600 Latinos recruited from Los Angeles County sexually transmitted disease clinics, needle-exchange programs and community-based organizations that provide HIV-prevention services.

The researchers measured their level of acculturation -- how well adapted they are to their new culture -- by asking them where they were born, how long they had lived in the U.S., the primary language spoken at home and their current immigration status.

Those with lower levels of acculturation were more than twice as likely to have had no more than one HIV test and to have tested positive for the virus that causes AIDS, the study said. Doctors recommend that those at risk of infection be tested every six months.

Those with lower levels of acculturation were also more than twice as likely never to have been tested for hepatitis C and a third less likely to test positive for the disease.

Legal immigrants, who made up 76% of the total, were twice as likely as their undocumented counterparts to receive HIV and hepatitis C tests.

And for every one of the characteristics that were measured for acculturation, participants were found to have a 6% less chance of having access to healthcare, said Dr. William Cunningham, who co-authored the report.

Cunningham said the findings supported the hypothesis that low levels of acculturation are a significant barrier to the use of HIV-related prevention services and access to medical care.

"The question is how do we reach those populations and what kind of education do we do," he said. "We know that simply giving people facts is not enough to change their behavior, so we really need to understand what their motivating barriers and facilitators are."

Further research is being done to answer those questions, he said.

Suggestions mentioned in the study included setting up Spanish-language hotlines and confidential HIV testing and counseling sites. The researchers also said that healthcare providers should be educated about the need to tailor HIV-prevention services to Latinos based on acculturation levels.

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