The number of AIDS cases among Latinos, mostly illegal aliens, jumped sharply in Orange County last month, prompting concern among health officials who expressed fear that it is just the first sign of an "alarming" spread of the disease within that community.
And the Latino patients now coming forward, they said, have waited until their illness reached an advanced state because they didn't want anyone to know that they had contracted AIDS, a disease spread most often through sexual contact.
"This increase in AIDS among non-English-speaking (Latinos) is truly alarming," said Parrie Graham, the executive director of the AIDS Services Foundation of Orange County. "We haven't seen anything like this before, and their problems are so great."
"I'm afraid things will continue to get worse, what with the kinds of numbers we're seeing now," she added.
Graham said these men have told counselors that they delayed seeking help until now because they did not want friends and family to know they had acquired immune deficiency syndrome.
"They also didn't want to have to admit to themselves, or to others, that they got it through sex with other men," Graham said.
"Since they waited so long before seeking help," she said, "they are physically very sick by the time we see them--much sicker than our typical client."
Six new AIDS cases were reported among Orange County Latinos last month, bringing to 65 the number who had contracted the disease as of Nov. 30, according to county health officials.
While based on small numbers, the increase represented nearly a full percentage-point increase in just one month, health officials said.
And they said they believe the number of reported AIDS cases among Latinos will begin multiplying rapidly in coming months.
Moreover, Latinos made up about one-third of the 20 new cases reported in Orange County last month, health officials said. This increase brings to 582 the total number of cases of AIDS reported in Orange County since the compilation of figures began in 1980, they said.
Most of the new Latino cases were non-English-speaking men who are illegal immigrants and who were believed to have contracted AIDS through homosexual activities, not by using non-sterilized needles while injecting drugs or through heterosexual contact, county health officials said.
The findings were presented Wednesday in Santa Ana at the monthly meeting of the AIDS Coalition to Identify Orange County Needs, a 30-member group that consists of AIDS educators, health professionals and others concerned about the spread of AIDS in the county.
"We're concerned about this increase, because we think it's a trend," said a county health official who requested anonymity to preserve a confidential working relationship with AIDS patients.
"We just don't know how big a trend it will be. But we think (there are) several more men who are still hiding how they got AIDS."
Health officials said Wednesday that they have encountered difficulties in interviewing Latino illegal immigrants with AIDS because they come from a culture in which it is difficult for them to acknowledge to themselves, or to others, that they engage in homosexual activities.
Problems such as these in educating the Latino community about AIDS and how it is transmitted prompted county health officials to commission a pamphlet directed to Spanish speakers, and it specifically addresses men who do not consider themselves homosexual but who occasionally have sexual relations with men.
"There is a kind of homosexual behavior--highly closeted and very difficult to discuss--in which a hyper-masculine type of man can have relationships with men and women but clearly does not see himself as homosexual," according to Raul Magana, an AIDS community education supervisor in Orange County.
Magana and county health officials plan more interviews with the Latino men who have newly reported cases of AIDS. They hope that ultimately the patients will explain how they contracted the disease.
"Even when they talk to (Magana), who speaks Spanish and is male, they feel they are taking a risk by telling the truth," a health official said. "It is culturally acceptable for them to say that they got AIDS from a prostitute. It's not OK for them to say they're gay."
Graham, the executive director of the AIDS Services Foundation, said she believes that more Latinos will be coming forward as their health deteriorates to such a degree that they can no longer hide that they have AIDS.
ASF, a nonprofit organization founded 2 1/2 years ago to provide free counseling and support services to people in the county with AIDS, did not have an illegal immigrant seek assistance at its Costa Mesa office until two months ago, Graham said.
"Then, in the first week of October, we had five non-English-speaking (Latinos) come in," Graham said. "Now, two to three a week come in." Today, they make up 15 of ASF's 156 clients.
Graham said these men are only now seeking help from government and volunteer agencies--and therefore are showing up in county statistics on the incidence of AIDS--because "they have no money, no place to live, and have psychological problems."
She said her organization is struggling to provide that help because their illegal status in this country makes it difficult for them to get government-subsidized medical care or disability payments.
"They can't speak English, they can't get Medi-Cal, and they're the least likely to have a home environment," Graham said. "They're the most in need, but nobody seems to want to help them."