been involved in dealing with AIDS in children since 1986.

By Antonia Novello

Fonte--Special to the Los Angeles Times

As Surgeon General of the United States, I am concerned with the health ofall Americans. As a Hispanic woman, I have a special concern for the health ofmy own community. And as I look at the health of Hispanics in the United States

today, I see many signs of hope and progress. But I also see difficult problems

and challenges. The most worrisome is HIV infection and AIDS.

We have learned many things about AIDS in the more than 10 years since it

was first reported, but what the relentless increase in cases and deaths has

especially taught us is that HIV and AIDS infect and kill without discretion or

distinction.

So is AIDS a problem for Hispanic communities? ^Absolutamente si@.

As of November, more than 200,000 people had been been diagnosed with AIDS,

and more than 130,000 people had died. More than 33,000 of the diagnosed AIDS

cases were Hispanic. Hispanics are only 8 percent of the U.S. population, but

account for more than 16 percent of reported AIDS cases.

Certain kinds of behavior, including intravenous drug use and unprotected

sex, are known to spread HIV. Are they present in the Hispanic community?

Absolutamente si.

Transmission of the virus through heterosexual contact is three times more

common among Hispanics than among whites. Sexually transmitted diseases such as

syphilis and gonorrhea also occur disproportionately among Hispanics,

indicating a high rate of unprotected sex.

Similarly, according to the National Institute on Drug Abuse, while 22

percent of AIDS cases overall are attributable to injection drug use, the

percentage increases to 40 percent among Hispanics.

Why is this happening? The reasons are complex, but they include denial,

misconception, fear and a poor understanding of HIV. Many Hispanics lack even

the most basic information about the transmission of HIV. Some mistakenly

believe that a cure for AIDS is available, or that you can tell who has AIDS by

the way a person looks. In a recent survey of more than 1,000 minority women,

75 percent of Hispanic women felt they were at no risk of acquiring HIV; this

despite the fact that Hispanic women account for more than 20 percent of cases

among women. A recent study done in Los Angeles on low-income Hispanic males

infected with HIV found that more than half of those who were sexually active

kept their infection secret from their partners.

Our community also denies and rejects homosexuality. Whether we accept the

lifestyle or not, we cannot afford to turn our backs on these, our brothers and

sisters. We must also remember that 10 percent of reported heterosexual AIDS

cases have occurred among women who had sexual contact with a bisexual man.

If we are to stop this disease from killing more and more of our families,

friends and children, then we must break the bonds of denial, fear and

ignorance.

We cannot assume that all Hispanics can be reached in similar ways.

Knowledge gained among one group can and should be applied to others, but we

must have a clear and sensitive understanding of the history, cultural

traditions, religion and economic realities of each community in order to be

effective.

Hispanic women need information about how HIV infection is spread and how

they can protect themselves, but the information must reflect their realities.

For example, we have been telling sexually active women that abstinence works,

and for those who cannot abstain that they should change the rules and make

sure that their men wear condoms. But in our culture, is this a feasible

alternative? And women have been hearing that monogamous sex with one

uninfected partner is safe _ but will a Hispanic woman be able to demand and

receive from her partner a truly monogamous relationship?

The issue of women and AIDS goes to the heart of how we, as women, are going

to live our lives. Too many of us take care of our families and not ourselves.

We must do both.

We must start by persuading our communities that AIDS is a family issue _

and that difficult matters such as sexual behavior, the use of alcohol and

other drugs _ even homosexuality _ must be discussed in a family setting that

respects the values and traditions of our heritage.

The issue of AIDS in the Hispanic community is much broader than the

epidemic itself. If we are to stop it, then everyone in the community must see

a role for himself or herself in fighting the spread of the epidemic and caring

for those who are ill. It cannot be ``us versus them.'' We are all a family. We

are not here to judge, we are here to help.