Talking Prevention

MCAP goes out to the fields to teach farm workers about AIDS.

The Monterey County AIDS Project (MCAP) has launched a revolutionary outreach program--the second such program in the state--to teach about HIV and AIDS to the county''s Spanish-speaking farm workers, a population traditionally underserved in the area of AIDS prevention education.

The Rural Latino Farm Worker Outreach program, or "La Raza Campesina Monterey," is headed by Eugenio Garcia, Jr., a young man who grew up in the migrant labor camps of Southern California and Watsonville, and is himself the son of a Hispanic farm worker family.

This February, armed with a B.A. in sociology from U.C. Santa Cruz, Garcia returned to the fields of the Salinas Valley, but not to pick or pack vegetables. Now he''s there to spread the word about HIV and AIDS, in Spanish, to his own people.

Garcia''s target population is the county''s Spanish-speaking farm workers, the 20,000 year-round workers and the additional 20,000 who come through during the high season. He goes out into the fields to talk to farm workers on their lunch breaks. He walks the streets of East Salinas, talking to people in laundromats, men standing on corners, homeboys and homegirls hanging out with their buddies. He works with the big growers and packers, to organize presentations before groups of Spanish-speaking employees. So far, he''s spread the word about AIDS prevention in 15 of South County''s 50 or so migrant labor camps.

"This program is important because it targets a population that has not received education about HIV and AIDS in a culturally appropriate way," Garcia explains. "A lot of them still don''t know what HIV is. Living in America, we assume everyone knows by now. But these people, many from small towns in Mexico, never got the message. Or they didn''t get it in Spanish."

MCAP''s Hispanic outreach program, funded by the state Office on AIDS, is based on a pilot project MCAP''s new executive director Cajetan Luna ran last year in the San Joaquin Valley. When Luna took the helm at MCAP last November, improving the organization''s outreach into the county''s Spanish-speaking community was one of his top priorities.

The changing face of AIDS statistics, nationally and in Monterey County, bears out Luna''s choice. As the number of new AIDS cases among white homosexual men decreases, the largest increase in new cases reported is among heterosexual women of color--Hispanics and African-Americans.

The Hispanic population is traditionally underserved by health care agencies, particularly when it comes to AIDS education, Luna says. "There are language and access barriers, fear of the Immigration and Naturalization Service, lack of culturally appropriate materials, and culturally, the Hispanic population doesn''t like to talk about sexuality," he says. That''s why Garcia speaks to men and women separately, and doesn''t talk about sex to children in front of their parents.

Among Hispanics, Luna says, wives are being infected by husbands who have been unfaithful. "That happens in other cultures, but in the Spanish-speaking family, you tend to take care of these problems ''within the family,''" Luna points out.

AIDS education outreach campaigns designed for other high-risk groups don''t reach the Hispanic population, or may actually have a negative impact, say Luna and Garcia. "They may say, ''I''m not homosexual, I''m not at risk,''" Garcia says. "But when I tell them it''s about protecting their families, then they listen. And they thank me afterwards."

Handing out brochures about AIDS doesn''t work in the fields, Garcia says, because many of the farm workers are illiterate. So he talks, and shows specially prepared picture flashcards. And handing out coupons for free testing at MCAP offices may be a waste of time. It''s hard to get to town when you don''t have a car, little free time, and are already distrustful of offices and bureaucracies.

So Garcia is trained to do HIV testing right there in the fields, using OraSure, a sponge-like material placed in the mouth between the gums and the cheek until moistened. He takes the swabs with him when he leaves, and returns with the results two weeks later. It''s not quite as accurate as a blood test, so positive results have to be reconfirmed, but so far, according to MCAP officials, no local farmworkers have tested positive using OraSure.

"It''s a great tool," says Luna. "It''s not invasive, and people can do it themselves, in a public place. They can''t say they can''t come in for testing, because we say, let''s do it right now."

For Garcia, his new job is a kind of homecoming, although not perhaps the one his family would have chosen. His father is still a farmworker for Dole in the Salinas Valley, and when Garcia is doing his outreach presentations, he often comes across people who know him or his father. When they hear he''s working for MCAP, they usually assume he''s gay, or HIV positive. The fact that he''s straight and not affected by AIDS makes his message more palatable, he believes. His audience sees that if he''s concerned, maybe this is a problem that could touch them, too. "They sit up and listen," he says. "I have a sense that I''m helping my own community."

He''s had to sit down with his 12-year-old brother, to explain what he does, and that he''s not gay or HIV positive. "I talked to him about tolerance," Garcia says. "I grew up in a homophobic environment, the Latino community. Gay kids were bashed in my school. I don''t want my brother to see that happen to someone."

Garcia uses his position to educate local farm workers about health care in general, not just AIDS prevention. When he shows up to make a presentation in the field, he may bring Mexican sweets, or long-sleeved shirts and pants to hand out, clothing the workers need to protect themselves from pesticides. It''s a matter of respect--he gives the people something, and asks for their attention in return.

Sometimes, he admits, the farm workers don''t want to hear about AIDS. "Maybe they''re married, maybe they just don''t feel like listening, but after a while, when they see I don''t push my information on them, they listen," Garcia says. "Overall, I''ve had a great response."

Garcia''s next step, he says, is talking to the Alisal and Salinas High school administrations about giving Spanish presentations to their students. There''s lots of outreach on the Peninsula, "in mostly white school districts," but the message isn''t getting through to Hispanic kids as well as it could, Garcia says.

"When I went out to the field today, I talked to people who didn''t know anything about HIV or AIDS at all," he says. "It was a reality check for me. Because not knowing means they''re at risk." cw

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