A majority of Los Angeles County primary care practitioners are failing to advise their Latino patients -- who are at high risk for HIV infection -- to get tested, according to a UCLA study released Thursday.
Only 41% of the 85 surveyed primary care providers -- including doctors, nurses and physician assistants -- had regularly offered advice about sexually transmitted diseases during the six-month period covered in the study, which was conducted in 2004 by the UCLA AIDS Institute.
The lack of HIV testing is one reason most Latinos who become ill find out they are HIV-positive less than a year before developing AIDS, researchers said.
The percentage of AIDS cases for Latinos in the county has increased, from 20% of all new cases in the 1980s, when the epidemic began, to 43% in 2002, according to the latest figures available from the county Department of Public Health.
"There are two issues here: a lack of healthcare access for Latinos in general and the cultural stigma attached to HIV/AIDS," said Rosa Solorio, assistant professor of family medicine at UCLA's School of Medicine who co-wrote the study. "But this study shows how Latinos already in primary care aren't getting the advice they need."
All UCLA survey respondents served in areas where the population was at least 50% Latino. More than half of the practitioners primarily spoke Spanish with their patients.
A vast majority of the surveyed practitioners offered fewer than 20 HIV tests each during the six-month study period, despite recommendations by the Centers for Disease Control and Prevention that physicians in high-HIV risk areas offer testing to every patient.
Solorio said that many practitioners were uncomfortable asking patients about their sexual histories and that this might explain their reluctance to suggest HIV testing.
"There are still many cultural taboos in Latino culture about sex," Solorio said. "We just don't talk about it publicly."
Solorio said another factor might be a patient's fear about the cost of a test and subsequent counseling. She said patients should be referred to agencies that offer free testing.
For example, the Los Angeles County office of AIDS programs and policy offers free HIV testing and counseling. Appointments can made by calling (800) 367-AIDS or visiting www.hivla.org.
Another agency recommended by the county is Bienestar, a nonprofit that offers bilingual HIV/AIDS services.
Victor Martinez, Bienestar's metro regional director, agreed with the study's findings. Latinos in general tend to avoid regular medical care until it's too late, and that is why early HIV testing is so crucial, he said.
"For Latinos, we can joke about sex, but it's much more intimidating discussing it seriously in front of others, even our doctors," he said. "So testing is the most important factor in fighting the epidemic because once we know, we can treat it and protect others from contracting it."
Bienestar can be reached at (323) 727-7896 or www.bienestar.org.