Transitions: Serving Youth of Color
Volume 15, No. 3, January 2004

This Transitions is also available in [PDF] format.

By Romàn Cruz, Director of Community Action, National Latino Children's Institute, and Carolina Godínez, Senior Program Coordinator, Institute for Hispanic Health, NCLR

Latino Youth Are at Risk

• The Latino population is the youngest and fastest growing ethnic minority group in the United States. The U.S. Census Bureau estimates that nearly 39 million Latinos live in the United States.¹
• Many Latino youth are sexually active. According to 2001 data from the CDC's Youth Risk Behavior Surveillance System (YRBSS), 46 percent of all U.S. high school students have had sexual intercourse, compared to 48 percent of Latino youth.²
• Among sexually active students in 2001, 58 percent reported using a condom at most recent sex. Latino students (54 percent) were less likely than white or black students (57 and 67 percent, respectively) to report using a condom.²
• HIV/AIDS has disproportionately affected Latinos. Although, Latinos represent 13 percent of the U.S. population, they account for 20 percent of persons living with AIDS as well as 19 percent of cases first reported in 2001.³

Studies consistently show that Latinos receive less preventive care than non-Latinos.^4,5 Moreover, preventive care may not be an immediate priority for individuals worrying about how to meet the basic survival needs of their families, and Latinos have less access to health education, health care, or culturally and linguistically competent health care providers than do whites or African Americans. ^4,5 Thus, it is imperative to find ways to reach Latino youth with information and services to promote responsible sexual decisions.

Two projects addressing HIV prevention among Latino youth provide examples of key strategies. They are Charlas Entre Nosotros from the National Council of La Raza (NCLR), and Onda Sana from the National Latino Children's Institute (NLCI). These projects use different approaches and have been implemented in different geographical areas.

Charlas Entre Nosotros

Charlas Entre Nosotros (CEN), a peer-to-peer HIV/STI prevention program implemented by NCLR, is a five-year pilot project involving charter schools and community-based organizations in developing and providing peer-to-peer HIV/STI prevention for Latino youth, ages 13 to 19. CEN's goal is to reduce the incidence of HIV/STIs among Latino youth through education, using effective and culturally appropriate prevention strategies, and reinforcing responsible sexual behavior. CEN works to strengthen 1) youth's ability to resist peer/societal pressures and 2) young people's self-concept, cultural values, and sexual health beliefs. Currently CEN is in its fifth and final year.

Through Charlas Entre Nosotros, four community-based organizations were selected to partner with NCLR. Hispanic Health Council in Hartford, Connecticut, offers a comprehensive, community-based approach to serving the Latino community on issues such as maternal and child health, family health promotion, and youth development. Centro Hispano de Hawaii in Honolulu, Hawaii, focuses on community advocacy, arts, and culture. As part of its arts and culture programming, Centro Hispano de Hawaii operates a radio program to reach out to youth, including Asian and Pacific Islander youth. NCLR also partners with a charter school, Calli Ollin Academy in Tucson, Arizona, and with a community clinic, Salud Para La Gente in Watsonville, California, that provides health education and services. Most CEN partners link with local schools, and many youth receive school credit for their CEN community service hours. At every site, youth participate in a Charla, consisting of four consecutive sessions involving 15 to 20 youth. The four, two-hour sessions are led by youth facilitators who are trained to lead on basic concepts regarding HIV/ AIDS and STI prevention, using an adapted version of Be Proud! Be Responsible! Charlas are formed with two different age groups: 13- to 15-year-old youth and 16- to 19-year-olds.

Youth and youth leaders have provided evaluation data, indicating that they have enjoyed being part of CEN, being leaders, and having the chance to do something of value for their community. To better meet the needs of Latino youth participating in Charlas, NCLR has updated the curriculum to include a module on values, while a module on sexual orientation and gender identity is currently under development.

Onda Sana

Onda Sana uses cultural values and novel strategies to help young Latinos ages nine to 15 to create una onda sana—a "healthy wave"—in their community. Onda Sana builds on culture and tradition to emphasize the importance of young people's making healthy choices and creating a cadre of like-minded peers. The goal of the program is to reduce behaviors that put young Latinos at risk for HIV infection and to develop strong community leaders.

Several community-based organizations serving Latinos throughout the United States served as pilot sites for the development of program materials and strategies. The Onda Sana materials are flexible and can be used in a variety of settings from schools to clinics. Materials developed by youth—such as stickers, posters, sample Web pages, and a tee shirt—provide visual reminders to young people to choose una onda sana. In addition, the program sponsors special events to provide community groups the opportunity to discuss HIV/AIDS issues.

One of the strategies of Onda Sana is group discussion. The program creates a safe space for young people, as well as their parents, to discuss topics that are generally taboo in the Latino family, including sex, sexuality, substance abuse, and other behaviors that put youth at risk for HIV infection. Some Latino parents may avoid conversations about sexuality issues, saying De eso no se habla. (We don't talk about those things.) The parent stance, the look, the pointing finger, the What will your grandparents think? and other similar gestures and rhetorical questions are not unusual when Latino parents attempt to communicate with their teens. Most of the time, such conversations end up with raised voices and accusations. You never listen! Or, You are grounded!

Helping parents and youth communicate can be difficult; but, with activities like "What were you thinking?" the facilitator helps break the ice among parents and they begin to recognize the similarities between their teens and themselves at that age. The facilitator starts by sharing a story of his/her own youth. Most people have memories of actions that they realize could have hurt others or themselves. After a few such stories, parents start to understand how their children, who may now be engaging in similar behaviors, are not very different from themselves at the same age. This exercise levels the playing field. Parents are able to talk more calmly as they begin to open communication with their child. Onda Sana provides these and many other activities to help Latino youth and their parents develop and open communication. The activities are designed with Latino traditions and customs to help Latino youth make healthy and wise choices for life.

References

1. U.S. Census Bureau. Hispanic Population reaches All-Time High of 38.8 Million, New Census Bureau Estimates Show. [Press release] Washington, DC: The Bureau, June 18, 2003.
2. Centers for Disease Control & Prevention. Youth risk behavior surveillance, United States, 2001. Morbidity & Mortality Weekly Report, Surveillance Summaries 2002; 51(SS-4):1-64.
3. Centers for Disease Control & Prevention. HIV/AIDS Surveillance Report 2001;13(2).
4. Centers for Disease Control & Prevention, National Center for HIV, STD and TB Prevention. Protecting the Health of Latino Communities. Atlanta, GA: Author, 2000.
5. Kates J. Latinos and HIV/AIDS. Menlo Park, CA: Kaiser Family Foundation, 2001.