LATINO AIDS CASES RISING MANY STAY IN DENIAL, DELAYING TREATMENT.

Byline: Rachel Uranga Staff Writer

Enyavil watched grown men die alone on the streets of Lima, Peru, and vowed never to return to his homeland after he learned that, like those outcast men, he was HIV-positive.

Today, he lives in the San Fernando Valley in a house he shares with his sister and her husband. He is a victim not just of disease but of deep-seated cultural beliefs that make his illness a taboo subject among many Latinos and often keep some with HIV or AIDS - or at risk - in denial.

``The culture is reigned by machismo. We have our own customs and taboos. It's a scandal in our culture if you have HIV,'' Enyavil, 39, said, sitting in a Van Nuys health clinic. ``People think the worst of you. It's as if you are a leper.''

The proportion of Latinos with new AIDS cases in Los Angeles County has surpassed that of any other ethnic group. Clinics in the Valley have watched their client base dramatically shift over the past few years from mostly white males increasingly to monolingual Spanish-speakers like Enyavil.

The nonprofit El Proyecto del Barrio has seen the caseload of HIV and AIDS patients in the West San Fernando Valley double in the last four years. About 84 percent of those patients are Latino, and a growing share of them are women.

The county reports that Latinos accounted for one-third of those living with AIDS - 14,879 cases - but they made up 43 percent of new cases as of 2003.

Whites continue to make up the majority of the county's AIDS cases, according to the 2003 statistics. The number of new cases among whites continues to decline while African-Americans still have the county's highest per capita rate of AIDS.

Still, recent studies project a 31.5 percent rise in the number of Latinos with HIV or AIDS by 2015 if nothing is done to stem the epidemic.

``The stigma continues to contribute to the fact that the community doesn't own up to this,'' said Oscar De La O, president and CEO of Bienestar. The nonprofit operates 11 Southern California community clinics catering to Latinos with HIV and AIDS.

``Countering the effects of stigma requires families to be aware of the realities of HIV/AIDs. It does not discriminate; it is not a gay disease. Education and awareness are key.''

Enyavil, who asked that his full name not be revealed for fear of discrimination, said he suffers from hemophilia and believes he contracted HIV through a blood transfusion. He has lost many of his friends and has found it difficult to make new ones.

``A lot of my clients are isolated after finding out and lose what little support they did have,'' said Deboara Kerimer, a bilingual mental health therapist at the Northeast Valley Health Corp.'s early-intervention program in Panorama City. ``It's extremely taboo and a hidden secret.''

Making matters worse is a conservative religious culture that often frowns upon birth control such as condoms. Women using condoms are often viewed as promiscuous. And men remain closeted for fear of being alienated from family and friends.

Wilma Mendoza, a mother of seven, discovered she was HIV-positive only after her longtime boyfriend was arrested and forced to be tested.

``We never talked directly about it. He was having sex with other men and I didn't know anything,'' said Mendoza, who is now a counselor at Bienestar in Hollywood and East Los Angeles.

``Most of the problem with Latinos and a lot of men is they don't accept themselves as gay. In the (Latino) community you don't talk about sex. Even as couples or with your kids.''

Because many Latinos are secretive about their sexual behavior, they don't talk about the prevention of sexual transmission. They often brush aside the virus as one belonging to morally corrupt individuals and will not be tested.

Most disturbing is recent data showing Latinos with HIV or AIDS are more likely to detect the virus later than members of other racial groups. They often wind up at the doctor's office only after they have become sick. Latinos often put aside testing because of the stigma attached to it, and many have little access to health care.

``It means if they don't seek testing they are not getting the benefits of treatment,'' said Gordon Bunch, director of the Los Angeles County Department of Health Services HIV Epidemiology program. ``And if they don't know they have HIV, they are more likely to engage in risky behavior.''

Mona, a mother of three children, including a 16-year-old with HIV, said she would never have been tested had she not started work at a community clinic, where she learned about the virus.

``I really feel there is a lack of education. A fear of the unknown of what could be, what could happen to you,'' said the 42-year-old Canoga Park resident, who did not want to use her full name.

A former IV drug user, she was diagnosed in 1989 with HIV. Friends became cold toward her. Neighbors served her food on paper plates. Her children's friends were prohibited by their parents from visiting her home.

``Every race there is some kind of discrimination, but I feel that in my own community, in dealing with HIV and AIDS, the discrimination is overwhelming. It's sad to see that my people are like that with each other. They are afraid what I have they might get.''

Rachel Uranga, [phone]

rachel.uranga(at)dailynews.com

CAPTION(S):

photo, 2 charts

Photo:

Enyavil, who believes he contracted HIV through a blood transfusion for hemophilia, holds up the pills he must take.

Evan Yee/Staff Photographer

Chart:

(1) L.A. AIDS CASES BY RACE

SOURCE: County of Los Angeles Department of Health Services-Public Health

(2) AIDS CAUSES AMONG LATINOS IN L.A.

Source: HIV/AIDS Surveillance Summary