By Priscilla Greear, Staff Writer

ATLANTA—Maria Rivas has a mission: to spread AIDS education to help the growing numbers of poor immigrant and other Hispanics in Atlanta with HIV or at risk to get it, who often battle additional linguistic, medical and cultural barriers to prevention and treatment.

Straddling those hurdles, she has served for almost 12 years as the first Hispanic outreach coordinator of El Programa de Alcance Hispano, or Hispanic Outreach Program, at AID Atlanta, the Southeast’s largest AIDS service provider. Seeing a way to serve Latinos, she took the job right after moving here from the Dominican Republic where she was a secretary for the Agency for International Development.

Barriers are broken through the program’s bilingual street outreach teams who meet Latinos where they’re at, going door-to-door visiting them at low-income apartment complexes and trailer parks in metro Atlanta and North Georgia. Teams meet every weekend with residents and ask permission to educate them on HIV/AIDS prevention. The method works because many don’t know English or have the money, transportation or information to access available educational, health and social services. Often over four people live in one apartment and many are transient, single men who move around looking for better work in jobs like construction or restaurants. Information is tailored for specific groups like gay men, drug addicts, youth and transients.

“We have found this is so effective because normally Hispanics will not come to where you are to get information. You have to go where they are,” said Rivas. “Because of that (we have) three people visiting in their own house that provide the family (information) to learn about HIV/AIDS in a very culturally sensitive manner in their own language in their own home by their own people, by culturally sensitive outreach workers. This is a program that doesn’t work for the Anglo community ... because you don’t open your doors.”

A goal is voluntary testing for those identifying themselves as at risk. “Ninety-nine percent of the time the receptivity is fantastic ... We are right there in the doors talking to them about education and at the same time telling them about how they’re going to be accessing services and offering the services,” Rivas said. “By doing this type of intervention in homes we are overcoming many obstacles that prevent Latinos from accessing education, social and health services about HIV and AIDS and other sexually transmitted diseases ... By giving that information and talking to them about risk factors ... They will do something about it, they will have enough material to process it once we are gone.”

A member of the Cathedral of Christ the King, Atlanta, Rivas is working to reduce deaths from AIDS, serving over 6,000 yearly. Over 300 Spanish-speakers come for testing yearly, largely poor immigrants. According to the national Centers for Disease Control and Prevention, of the estimated 40,000 new HIV infections occurring nationally in 1999, 15 percent were among Hispanic men and five percent were among Hispanic women. Since Hispanics make up only 12 percent of the population, they are disproportionately affected. The highest rates were among blacks, who make up 54 percent of new cases, although they are only 13 percent of the population.

The coordinator believes that churches are “excellent venues” to spread not only the light of faith but of AIDS education. AID Atlanta distributes materials and gives presentations in Spanish to Hispanics at churches, schools, recreational settings and elsewhere. Presentations are tailored to fit needs of specific audiences like youth, where abstinence is heavily promoted, and Catholic audiences. Talks have been given at about 12 parishes and at Catholic Social Services.

Peer counselors are another sharp prevention tool. Volunteers who are HIV positive and youth are trained to offer one-on-one education and empathy. Rivas also speaks on Spanish radio.

She thinks some congregations may not want to get involved because they “don’t want to hear about” the leading transmission methods of gay and heterosexual sex and drug use.

“There are many lives at stake. This issue has to be faced. We have to talk about it and find a solution and people should not be embarrassed to talk about HIV and AIDS ... There are some of the church members living with HIV and the community doesn’t know, but probably they’re afraid to talk about it,” she said. “The Hispanics, the majority of them are Catholic and when they come to Atlanta the first place they go to is the church. They really trust the church so the support of the Hispanics with HIV is really needed ... That’s why they have to get involved.”

Having served on the now inactive Archdiocesan AIDS Task Force, Rivas said St. Philip Benizi Church, Jonesboro, is one example of parish outreach where an Anglo parishioner fed and cared and advocated for a Hispanic man until he died. The archdiocesan Hispanic Apostolate doesn’t know of any Hispanic AIDS outreach in over 40 parishes with Hispanic ministries. Rivas recommended AIDS ministries get a Hispanic liaison and her program can aid parishes with training and resources. She also hopes the task force, which facilitated interaction with parishes, finds new life.

“We have to do more presentations at church settings. This is very important for them to know it’s not because I attend church I’m out of risk ... There is vulnerability, especially young people have to consider that. Anyone can get HIV and AIDS,” she said. “Peer counseling I think plays a very important role in reaching out to the faith community ... That would be a good tool to help young people get education with HIV and AIDS.”

AID Atlanta has free, anonymous HIV testing and an early intervention primary care clinic run by Saint Joseph’s Mercy Care Services. The HIV negative learn ways to modify and eventually eliminate at-risk behaviors and carriers are counseled on treatment options and get help as needed with interpretation and accessing early medical treatment and social services. The majority are referred to HIV clinics at county Health Departments and the Grady Infectious Disease Program. “As soon as they are diagnosed the first thing we do is educate the person about the virus and help connect the person with the health system so that the person can have early treatment for HIV.”

The road Rivas travels with clients is rocky and lined with roadblocks, but also clear directions and rest stops with heavenly views. She recalled helping very sick immigrants coming to Atlanta with nowhere to turn to access medical services and medicines. “If a person is going to die he doesn’t die alone” but with support, Rivas said. She recalled another woman with HIV who “cried and cried because she was scared. This is why we really worked with her. (I say,) ‘If you weep, I weep with you.’”

Rivas keeps her pace, fueled by faith, particularly when she helps a newly diagnosed person in despair regain some control.

“I am an instrument of God to help them on their way ... I try to take that person by the hand to find his way out of this to better cope and lead a healthier life ... By doing this I feel my personal life as well as my spiritual life has been enriched,” she said.

“This is the thing that really gives me more satisfaction in my work, bringing light to people who are in the darkness. I’m not only helping the person to live longer and healthier, I’m also saving other lives. You’ve got to protect yourself and others from getting infected. I’m not only working with this person here but with those in the rest of my community. It’s a double mission.”

Volunteers, who help with interpretation, transportation and home and hospital visitation, are also healing medicine.

“We need people from the churches to volunteer with us, provide hospital visits to Latinos who are living with AIDS,” Rivas said. “They don’t have the support. They’re lonely because they don’t have their families here and some of them are lonely and very sick and they need people to visit and talk to them.”

Many immigrants served come from rural areas in Mexico and Central America. There are an estimated half million Hispanics living in the archdiocese and when they come here, they don’t receive sufficient health care. The Center for Immigration Studies reported recently that a third of immigrants nationally don’t have health insurance.

While three times as many men are infected, AID Atlanta is seeing increasing numbers of infected Hispanic women and youth. And in 1999 the CDC reported more pediatric HIV cases for Hispanics than Anglos. Gender roles are deeply embedded in some Hispanic cultures; women traditionally are completely monogamous, more submissive and have difficulty confronting men who may be promiscuous. “We have to empower Latino women to really get assertive and discuss these issues because this is a health issue,” Rivas said. In addition, some people are “so afraid to seek help because they’re going to be stigmatized. They are so ashamed to be found living with HIV.”

“We have to understand where they come from, their (religious and cultural) beliefs, and we have to present our message according to their beliefs, never forgetting we have to get the facts to them about HIV and AIDS,” she said. “The epidemic is hitting really hard the Latino and black community and this is why we have to get out there and educate our community because the rate is increasing every day with Latinos, especially with women and young people.”

Clients are referred for food, clothing and other needs to the St. Vincent de Paul Society. A small number of clients are sent to counselor Eglee Treber, a Venezuelan immigrant, at CSS Counseling Services.

Treber noted immigrants already have lives of pain and stress, struggling with cultural adaptations and separated from their families. An HIV diagnosis dissolves dreams of a better life and forces them to cope with another system.

“They’re having to deal with the denial of the disease, the grief process, the anxiety, depression and having to let the family members know about the illness,” she said. “The most immediate (goal) is to ... help them work through the denial and accept the illness and help them go through the grieving process ... I give them stress management techniques that they can use, thinking restructuring, to have a fuller life in the present, to appreciate more the present, the here and now.”

Hispanics traditionally “go to Hispanic family members for help, advice, referrals, and it makes it very difficult for them because most of them don’t have their families of origin here with them,” she said. “They need to know more about ... what counseling is and what it could do for them.”

While she works in a secular setting, Rivas also promotes spirituality as a resource for those with HIV/AIDS.

“They are dealing with different types of crises, this is why God has to be present,” she said. “We ask them to embrace the future and get close to God because that will comfort them. And Hispanics, they’re very religious. They believe a lot in spirituality. They’ve got great faith.”

For Saul Vargas, a Catholic from Panama who is HIV positive and volunteers at AID Atlanta, the relationship between Hispanics and their faith is a reason for priests and parishes to offer more spiritual support to those with HIV, particularly homosexuals.

“You need to get support. That’s why faith and the church (are) so important,” said Vargas, who attends San Felipe de Jesus Mission in Atlanta. “Things are leading me to go out and speak more directly to the Catholic community because ... according to the pope, it’s their duty, getting the Catholic church more involved with us and other AIDS service agencies.”

“The purpose of the church is to help everybody to achieve a moment in faith. Although certain lifestyles aren’t approved of, God is merciful and the church directs us. Everyone has sin and will continue doing so and the church just points in the right direction.”

Whatever their health, AID Atlanta clients find ways to keep focused and moving forward. “We have people here who are doing wonderful. They know about HIV. They are very compliant. Their health has improved, not only their physical health but emotional. But these are people who came in and knew nothing about HIV. We help them to get empowered,” Rivas said. “These are wonderful cases and wonderful people and I really admire them a lot. I see how they were and how they are, how this is like going from poor to rich. Once they are empowered they got on their feet in the struggle against HIV.”

For information in Spanish, call Rivas at (404) 870-7767 or the bilingual Georgia AIDS information line at AID Atlanta at (800) 551-2728.