New faces of AIDS: Minority numbers grow


The young Venezuelan thought he had received a death sentence simply for loving another man.

He was waiting for the results of an AIDS test he took after learning his lover of four years carried the virus and could have infected him. The possibility of having to cope with the disease had not hit him, but a health care worker suggested he needed help, so he wandered into the support group at Hispanic Unity in Hollywood.

He felt uncomfortable talking, but said he feared he was infected. He still loved his boyfriend and told the group he accepted his fate because he believed getting AIDS is expected when you're gay.

A chorus of voices rose up in Spanish, explaining to him that AIDS does not come from being gay. The group offered to be a family he could turn to for comfort in a culture that often stigmatizes gays and people with AIDS.

The young man is part of the changing face of AIDS that Broward County health care workers are still struggling to tackle five years after they first noticed that the disease was striking minorities in ever-increasing numbers.

With blacks and Hispanics now making up more than two-thirds of new infections, the county is redirecting the $50 million it spends each year on AIDS programs to focus more on minority groups fighting the disease. They hope the change will break down the cultural barriers that have hampered efforts to treat and prevent the disease among minorities.

"There are a lot of people who are lost and don't know where to go for help when there is a lot of help out there," said Saul Cruz, 52, a Fort Lauderdale resident who helped start the support group at Hispanic Unity. "They don't know how much is out there."

Some minority AIDS activists worry that the county still is not doing enough, but the new push has others concerned about the impact on traditional AIDS organizations that began when the disease was viewed mainly as a problem for middle-class, white gay men.

"You keep spreading the money out thinner and thinner, and pretty soon the people who need help aren't going to get anything," said Robert Goerlich, a volunteer at the Poverello food bank, where government funding has been cut to boost minority programs elsewhere. "They ought to be ashamed."

The steps health care administrators have taken over the past six months include:

Directing $265,000 in federal funding to minority groups to start programs offering food to low-income people with AIDS. The programs are the first based in the minority community and will be run by Hispanic Unity and Trinity Ministries.

Giving Miami-based Christ Crusaders $47,000 to pay for a project providing care and counseling to blacks and Caribbean-Americans in south Broward who are infected with HIV, the virus that causes AIDS.

Giving $275,000 to New Directions Institute and the Broward County Family Health Center to expand their work in minority communities to include HIV prevention, testing and counseling.

Hiring a coordinator to supervise the AIDS work in minority communities across the region.

Holding conferences with local black pastors and leaders of the Seminole and Miccosukee Indians to discuss AIDS prevention efforts.

Launching FIU's $4 million project to fight the spread of AIDS in minority neighborhoods in Broward that have been the most affected.

The changes have meant assistance to minority organizations fighting AIDS has increased between 10 percent and 15 percent since last fall, when Clinton administration Surgeon General David Satcher declared a "crisis" existed in metro areas like Broward.

Broward ranks behind only New York and Miami as the urban area most heavily hit by the disease. The Florida Department of Health estimates that 18,600 area residents are infected with HIV.

State health data show Hispanics and blacks are disproportionately affected, with an estimated 1 in 50 blacks infected compared with 1 in 286 whites. Blacks surpassed whites in the number of AIDS cases and in deaths from the disease in Broward in 1995.

The new priorities are a striking change from the situation two years ago, when four black members of the county AIDS advisory council walked out of a meeting to protest the lack of services directed to minorities.

Health officials and minority activists argue programs should be specially tailored because years of AIDS work have missed large swaths of minority communities.

"Information has been out there about AIDS for 20 years, but we know a sizable part of the population is not responding in the way we would like," said Bill Darrow, a professor running a new minority AIDS outreach program at Florida International University. "We need to tailor messages to them."

AIDS efforts have been hindered because of the stigma about the disease and homosexuality among minorities, and because the groups hardest to reach, such as high school dropouts and the homeless, are disproportionately black or Hispanic. Also, some ignored the disease while gay white men organized to educate themselves about what was happening.

But many of the problems in reaching minorities come down to basic issues of access and cultural sensitivity, according to health professionals and minority activists.

Traditional programs have been based in Fort Lauderdale and Wilton Manors and have been hard for minorities in other areas to reach. Minorities also argue the programs have not been as sensitive to their special needs as organizations based in the minority community would be.

Hispanic Unity staffs its AIDS program with bilingual, bicultural workers and promises its food program will offer more choices of cultural foods than traditional programs have. Workers with Christ Crusaders visit minority areas late at night to offer care programs and HIV testing.

"We can reach the people better because we understand the problem," said the Rev. Juanita Mincey of Christ Crusaders. "We are minority like they are. We can speak their language. This is not a gay white disease. This is hitting blacks and Hispanics more than anyone, and we need to stop thinking this isn't going to hit our house."

Mincey said she expanded her program from Miami to south Broward because she saw a troubling lack of AIDS outreach there. She now serves about 400 to 500 people from the Miami-Dade County line through Hollywood.

"I had a feeling, and we started scouting it out," she said. "We thought, Oh, my God, what a need.'"

The premise guiding the push by Broward health officials is that the new demographics of AIDS require making every effort to provide people access to programs within their own communities.

Some immigrants are suspicious of government-run programs, while minorities from cultures that stigmatize AIDS fear being seen going into a place that focuses solely on AIDS work. Leaders of minority-run programs argue they also are better able to deal with cultural issues that prevent some from talking about sexuality and safe sex or from seeking medical care quickly.

"I don't think it is intentional on the part of mainstream organizations, but they are not as attentive to these needs," said County Commissioner Josephus Eggelletion, who supported the commission's decision to shift more of its AIDS funding to minority groups last month. "It's very difficult to know what needs are there if you are not connected to the community."

Some question the decision to focus more on minority organizations. Supporters of the Poverello food bank in Wilton Manors, for example, are concerned cuts in aid will harm their work of feeding low-income people who have AIDS or HIV.

The food bank was unprepared when county commissioners cut funding last month from the $925,000 received last year to $753,000. Poverello has since shut its doors on Saturdays, no longer gives more food to parents with children than to others and has stopped offering non-food items like laundry detergent and soap.

Ken Fontaine, who helps run the food bank, said the organization tried to take steps that minority groups are now doing. Poverello wanted to open a satellite in Hollywood two years ago but met resistance. It also has tried to offer ethnic food among its selections.

"I'm supportive of any agency that will support a person with HIV, but what I've seen is a lot of people get into it and get out of it," Fontaine said.

Minority AIDS activists argue that not only are those concerns misplaced, but that the county still is not putting enough money into their communities.

Ann Cardenas, who helps run the AIDS care work at Hispanic Unity, said her program went four years without any assistance and now is receiving enough money for one case manager when several are needed.

"We've started to see small shifts in money, but we haven't seen the major shifts we need," she said. "The money for minority communities is simply not adequate."


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