A Ventura County clinic has received a state grant to spread the word about AIDS to one of the few groups in the United States that hasn't been inundated with information about the incurable virus--migrant workers.
Clinicas del Camino Real, which operates nonprofit health facilities in Fillmore, Saticoy and Oxnard, has been given a $51,000 grant from the state Department of Health Service's office of AIDS for the program, which has been dubbed Uno a Uno, or One on One.
The program, which will be one of 25 throughout the state, will send health educators to farm labor camps and other housing for farm workers to make the case for safe sex. The program will start in late August or early September.
"Our concern is that there's still a lot of ignorance," said Camino Real's health education director, Bertha Felix-Mata, who said Uno a Uno is the first such program in Ventura County.
"In the general population, it's been hard enough to get out the word that it's not just a disease that affects homosexuals," she said. "But with migrant workers, the case is even harder to make. There are even greater cultural barriers."
At the same time, farm workers are at high risk for all sexually transmitted diseases, spread largely by the prostitutes who migrate on weekends from larger cities to the areas surrounding farm labor camps.
Some of the workers, separated from wives and girlfriends, also indulge in homosexual behavior, and some, following customary practice in Mexico, medicate themselves through hypodermic injections administered at home, according to Teresa Macias, director of community service for the Sequoia Community Health Foundation, a Fresno agency that began a similarly funded program for farm workers last year. AIDS can be transmitted by sharing hypodermic needles that have not been properly disinfected.
"They are disproportionately at risk," Macias said.
No data has been collected yet on the incidence of AIDS among farm workers, epidemiologists say. But Macias's group, while testing farm workers applying for the Immigration and Naturalization Service's amnesty program, found only three cases of AIDS among 6,000 people, a figure Macias called "insignificant."
Nevertheless, she said, the potential for a problem is there. She said there is a scarcity of information in Spanish about AIDS, or acquired immune deficiency syndrome.
'The AIDS Lady'
"We always assume that there are thousands of things coming out in the media but there is very little coming out in their language and in a way that is acceptable to them," said Macias, whose appearances on Spanish radio and television have earned her the nickname of "la Senora de SIDA --the AIDS Lady" among farm workers in the San Joaquin Valley.
Macias, herself the daughter of migrant workers, visits labor camps, fiestas and community meetings, and frequently encounters men and women unaware of the AIDS threat.
"I usually ask how many people have heard of AIDS," she said. "Three out of 10 people won't have heard anything."
Richard Perugorria, a health educator with Community Health Centers of Kern County, said the farm workers that he has addressed in small gatherings in the Bakersfield area have usually heard of AIDS. Still, they have considerable misconceptions about how the virus is contracted.
He said many farm workers believe AIDS is transmitted only among clearly effeminate men who display a lifelong penchant for homosexual sex. They sometimes do not associate an occasional homosexual act with being a homosexual--or with placing themselves at risk for AIDS, he said.
Compounding problems, Latinos are reluctant to use condoms, widely regarded as a means of protection against the AIDS virus, because of a cultural bias against them.
Condoms an Insult
"They don't practice sex with condoms," Macias said. "It's culturally unacceptable. Catholicism is opposed to any contraception. I can give a woman condoms and say, 'This is how you protect yourself,' but she'll go and throw them away because she doesn't want to insult her husband."
A Mexican study bears that out, Perugorria said. It found that only 8.5 million condoms were sold in that country in 1981, when the population of men between 14 and 45 years old was 14.5 million. "That means almost half a condom per man per year," he said.
The reluctance to talk about sex, meanwhile, can further deepen confusion about AIDS and other venereal diseases. Perugorria recalled the time a woman called a Spanish-language radio program on which he was discussing AIDS. She was concerned about a rash on her husband, but when Perugorria asked her which part of the body it covered, she would only respond, "There."
By the time Perugorria had questioned her enough to determine that she was referring to the man's penis, he had lost her.
"She hung up," he said. "She was that embarrassed to use the word for a sexual organ when talking to a man."