AIDS Is Special Problem Within Latino Community : Health: O.C.’s Uno Plus Uno, other groups work to overcome cultural barriers, halt spread of the disease.

Mark Lambaren stood up at the meeting of Uno Plus Uno. It was his turn to speak. “When my family found out I was gay, my father kicked me out of the house,” Lambaren told the group.

Formed as a support group for Latinos, Uno Plus Uno aims to help stop the spread of AIDS in Orange County’s Latino community. Patterned after Alcoholics Anonymous, Uno is one of the county’s few support groups for Latinos who have contracted the AIDS virus.

As of Feb. 28, Santa Ana, which is 65% Latino, reported a total of 313 AIDS cases, more than any other city in the county. Laguna Beach, a city substantially smaller but recognized as having a large gay community, had 305 cases. In Laguna Beach, Latinos make up only 7% of the city’s population of 23,170, while Anglos make up 91%.

Three years ago, Latinos accounted for 48 AIDS cases, or about 13% of the total cases in Orange County. That percentage jumped to 20% with 94 cases in 1992. Meanwhile, Anglos accounted for 71% of AIDS cases in the county, dropping from 82%. Latinos make up 23% of the county’s 2.4 million population.

Advocates of Latinos who suffer from AIDS point to the new figures with concern because prevention and intervention in the disease are difficult. These experts say that a majority of the Latino AIDS caseload is made up of undocumented immigrants, typically speaking only Spanish. They have a high rate of illiteracy and generally low incomes, and in some cases are homeless.

“It’s a wake-up call,” said Linda Gomez, a benefits coordinator at the AIDS Services Foundation of Orange County in Irvine. “I believe the number of reported AIDS cases in Santa Ana is low because it represents only those that are reported--that is, those that have been tested and diagnosed. The figures only represent the cases that we know about.”

This year, the National Commission on AIDS urged the federal government in a report Jan. 11 to stop regarding AIDS as a disease of gay Anglo men and start treating it as a racial and ethnic issue.

African-Americans and Latinos in the United States accounted for 46% of AIDS cases last year although they make up just 21% of the population, the report said. African-Americans, it said, make up 12% of the population and represent 29% of the nation’s AIDS cases, while Latinos, who make up 9% of the population, account for 17%.

“The cumulative effects of racial discrimination, the chronic lack of access to resources and the resulting underdevelopment of community infrastructures have had lasting effects,” the commission said. “For communities of color, the sense of economic inequity, social distance, discrimination and social stratification--of not being accorded full equality--is undoubtedly strong and persistent.”

Raul Yzaguirre, president of the National Council of La Raza in Washington, praised the commission’s findings that complex factors are causing the spread of AIDS in minority communities across the country.

“Poverty, discrimination, limited educational attainment, limited access to health care, substance abuse and a lack of effective and culturally relevant health prevention and education all contribute to disproportionately high rates of HIV/AIDS among Hispanics,” Yzaguirre said.

In Orange County, Latino AIDS cases have gone up at a faster rate than Anglo cases, according to anthropologist Joseph Carrier, who co-authored a study of Spanish-speaking immigrant males for the Journal of Sex Research in 1991.

“The problem is that Latino men are a very difficult group to reach in terms of intervention” because some of them feel uncomfortable talking about sexual behavior, Carrier said. Denial of having AIDS or carrying the HIV virus is a typical reaction among Spanish-speaking AIDS patients from many Latin and South American countries, advocates said. According to these advocates, undocumented Latino immigrants, who traditionally shy away from a public agency for fear of detection by immigration authorities, also are less inclined to take a test for the AIDS virus.

“It’s when they get pneumonia, tuberculosis or an infection and wind up in a hospital having their blood tested that they discover they are HIV positive or have AIDS,” said Samuel Handman, an AIDS Foundation caseworker. “Unfortunately, it’s a hospital that calls us saying that ‘so-and-so has walked in with pneumonia and has tested positive for AIDS or the HIV. We’ll be referring him to you.’ ”

More common are scenarios in which heterosexual men become HIV positive and refuse to notify their wives or mates, said Jay Villarreal, a case monitor with the AIDS Foundation.

“When you come from the Latino community, there is a stigma attached to having AIDS,” Villarreal said. “In Mexico and other Latin countries, there is a double stigma. One for AIDS and another because you may be gay.”

Gomez said: “That’s why many of (the heterosexual men) don’t want others to know they have contracted the virus. Instead, they tell people they’re dying of cancer. It’s easier.”

Yolanda Padilla is a 32-year-old mother of five who came from Guatemala and has AIDS. While Padilla suspects that her husband gave her the virus, he has so far tested negative.

Padilla’s real name is not being used because she is living in the United States illegally, fears immigration officials and doesn’t want people to know that she has AIDS.

Padilla said that because she is Catholic, she is so shamed by having the disease that she has not told her sister or members of her extended family.

“Do you believe that God will find a remedy for AIDS?” Padilla asked. “You see, I do. For those who are down here, I don’t think he would abandon us without a miracle.”

During a recent interview, Padilla was fighting a cold. An ear infection left her temporarily deaf. The once-robust woman, who weighed 159 pounds and could easily lift her 3-year-old son with one arm, now has trouble just sitting up. She weighs about 115 pounds and stays in a rear bedroom most of the day, beneath a vanilla-colored blanket.

Little things now mean a lot to her. If she can lift her head to hear a visitor’s voice, her weak neck muscles lose their energy after a few seconds. When she lowers her head back to the pillow, her lungs heave a long sigh.

Asked about her future, Padilla said, “I made my husband promise that he will take care of our 4-year-old daughter and 3-year-old son. The children from my first marriage, who are 14, 12 and 8, my mother said she would care for them.”

At county-sponsored AIDS events, advocates of Latino AIDS patients said that Latinos, many of whom are Catholics, do not want to be confronted in public with sexually oriented subjects or literature.

Last Halloween, for example, the county sponsored an informal AIDS clinic, including prevention education at El Toro Market in the heart of the Latino community in Santa Ana.

“We did AIDS prevention and also some testing. But we couldn’t distribute (free) condoms. That was part of the agreement. It was, we were told, out of respect to their family-oriented clients,” said Abe Sanchez, a county AIDS counselor.

Caseworker Handman and other advocates point to cultural attitudes that also may hinder AIDS prevention. Many Latino males, he said, arrive in Orange County from countries that are culturally “male-dominated” and where Spanish-speaking AIDS information fails to stress sufficiently that the virus also jeopardizes the heterosexual population.

“We get a lot of our male patients telling us that no one tells them what to do; that they can come and go as they wish. Even if they’re in a high-risk group, they feel that they don’t have to get tested (for AIDS/HIV),” Handman said. People in high-risk groups are homosexuals, drug abusers and hemophiliacs.

AIDS educational materials need to be modified to take into account some of these cultural differences and the high level of illiteracy. To this end, fotonovelas, in which stories are told using photographs in a comic-strip format, have been created in English and Spanish, said Carrier.

As for Mark Lambaren, helping other Latinos has become his role and serves as a catharsis, he said.

After leaving his overbearing father, Lambaren moved to the United States when he was 20. Now, 40, he tested positive for the HIV virus five years ago, when he was applying for legal residency and took a required blood test.

Lambaren said his father once called him podrido, which means rotten.

As for Lambaren’s father, if there has been any progress, it has been glacial.

“My father still doesn’t support me,” Lambaren said. “I’ve spoken to him on the telephone and have explained to him about homosexuality and the way I felt growing up and everything. But it doesn’t do any good. He’s still Dad.”

AIDS Help

Free confidential information, support and HIV testing are offered in Spanish at a number of Orange County agencies, including:

* Orange County Center for Health, 503 N. Anaheim Blvd., Anaheim. Call (714) 956-9541.

* Orange County Health Care Agency, 1725 W. 17th St., Santa Ana. For Spanish, call (714) 834-8700; for English, (714) 834-8129.

* AIDS Services Foundation, 17982 Sky Park Circle, Suite J, Irvine. Call (714) 852-1010.

* AIDS Response Program, Gay and Lesbian Community Center of Orange County, 12832 Garden Grove Blvd., Suite A, Garden Grove. Call (714) 534-0961.

Latino AIDS Cases Increasing

Before 1989, about one of every nine AIDS cases in Orange County was a Latino. That proportion increased to about one in every four by the end of February. Cases among whites have dropped from 85% to 63% of the total during the same period.

A Shared Problem

Although the trend among Latinos as a percentage of all AIDS cases is rising, the nearly 2,500 cases that have been recorded in Orange County have occurred mostly among whites. White: 77% Latino: 16% Black: 3% Asian: 2% Other/unknown: 2% What’s Behind the Rates

A recent study conducted by two local anthropologists at the Orange County Health Care Agency illustrated that Latino male illegal immigrants were at a particularly high risk of contracting the HIV virus. Some study conclusions:

* Most male immigrant workers arrive alone or with other single men. They have little opportunity to socialize and meet women.

* Major sexual outlets for Spanish-speaking illegal male workers are prostitutes. Some prostitutes cater only to immigrant Latino males.

* Condoms are infrequently used by male immigrants.

* AIDS educational materials need to be modified and take into account cultural differences and high-level illiteracy.

* Latino men involved in bisexual behavior may not consider themselves homosexual or bisexual and could be difficult to reach with educational messages.

* Educational intervention originally was slanted toward the white gay community and did not effectively reach homosexual Latinos.

Source: The Journal of Sex Research, Orange County Health Care Agency, 1990 U.S. census

Researched by DAVID REYES / Los Angeles Times