The Protection Racket

And the band plays on

Darrow's job on the task force had been primarily researching the spread of the disease. But as the '80s ebbed on, the sociologist became impatient with the CDC's approach. Darrow implored his superiors for an aggressive approach to prevention. "I said, 'I'm glad to help you guys out, but there's a time when we're going to have to do something. We need to intervene. We need programs to discourage high-risk behavior.' The CDC people, they'd say, it's our job to do the research. It's up to someone else to do interventions and develop the public health programs."

The CDC did launch a series of public service announcements called America Responds to AIDS in 1987, but Darrow recalls arguing with CDC officials. "It's not for gay men, and it's gay men you have to worry about."

It wouldn't be until after Darrow got to FIU in 1994, however, that he'd actually get a crack at ground-level intervention.

Twelve women and three men sit around the horseshoe shape of dark brown folding tables in one of several English-language classes sponsored by Hispanic Unity, a Hollywood agency that aids Spanish-speaking immigrants. It's a Wednesday morning, and Spanish chatter from adjoining rooms seeps easily through the thin sliding doors that partition them off.

Lining the walls are charts chock full of pronouns, adjectives, conjunctions, and every other part of speech you can throw at English-language neophytes.

But for about an hour this morning, they won't be thinking about subject-verb agreement and the like as the instructor turns the class over to Magaly Alvarado, who, until funding cuts, was part of the Reach 2010 project. Dressed in a light-blue pants suit, Alvarado is in charge of the organization's HIV/AIDS education outreach program. She's accompanied by Teresa Hidalgo, a medical doctor with a stocky build and serious demeanor, who also works for Hispanic Unity.

Alvarado jots down the category, Origen, on the whiteboard in front of the class. "Where does HIV come from?" she asks in Spanish. The group quickly identifies homosexuals as the originators of the disease, and several argue that it all started when some men had sex with monkeys. As Alvarado gently dissects this myth, one student finally admits that, yes, the idea is fairly ridiculous once you really think about it. But that's what she's heard, she reiterates.

Origins of the disease aside, Alvarado learns that most students here, some middle-aged, don't understand the basics of how HIV is transmitted, that it is spread only by contact with infected blood, semen, breast milk, or vaginal secretions.

As she continues to talk about transmission of the virus, she sees panic in some faces over a subject they perhaps had given little thought to before.

"Calm down," she coos. "I know it sounds like I'm creating a crisis in your lives, but there are solutions. You have to be conscious about what you're doing. It's not who you are; it's what you're doing."

Still, the mention of abstinence as one possible means to prevent infection prompts a 40-something woman with short hair and a husky build to sputter. "No, impossible," she declares. "There's no way to be abstinent, no, no, no."

Shortly after the presentation is done, Alvarado and Hidalgo walk across Johnson Street back to their office.

"When we first ask what they know, we look for the level of the people in the room," Alvarado says from the small cubicle space she shares next to Hidalgo. "That way, we can approach them in a different way. If they have no knowledge, you have to speak in a much simpler language. This was a medium-level group."

Hidalgo interjects: "We never, in my experience, have found a high level. Low to medium, that's it."

Preventing HIV anywhere in America is a tough task, and tackling the job in a place as diverse as South Florida is even harder. Here, the challenges in reaching immigrant communities are layered: language and cultural barriers that are divided yet again by country of origin, family makeup, and plain personality.

"When we talk about preventing HIV in Hispanics, I don't think there's one program that works across the board for all Hispanics," says Guillermo Prado, an assistant professor at FIU's public health school who specializes in HIV prevention in minority families. Baby-faced with a dark goatee, Prado is young and energetic. He's currently involved in a project looking at the most effective ways to prevent Hispanic adolescents from engaging in risky sex and using drugs, the two greatest risk factors in infection.

"The research out there shows that HIV rates and drug-use rates are not the same for all Hispanics," he says. "We know that certain Hispanic subgroups are at risk. Puerto Ricans tend to use intravenous drugs at higher rates, so they're at higher risk of HIV. Hispanics are a very heterogeneous group."

Research has consistently shown that enculturation, which is the process of an immigrant's assuming the values of his new country, plays an important role in HIV and drug use. Ironically, in South Florida in particular, the more encultured a teenager becomes, the greater his chance of risky behavior.

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