program report 2011-2013 4 8 22 24 25 26 28

Welcome Program Expanded Your Looking Commission Spanish Overview Reach of the Feedback Forward Mission Statement Section Deep South The Future and Executive Goals Leadership

Leadership Unity Knowledge Action

The Commission on AIDS would especially like to acknowledge the Ford Foundation’s support since the beginning for the Latinos in the Deep South program, our groundbreaking initiative in the Southern region of the US. We would also like to recognize our national, regional and local partners and participants who contributed to our advocacy efforts, leadership development institutes, individual coaching sessions, awareness campaigns, media & visibility efforts, capacity building training sessions, and webinars. We would also like also to thank the Centers for Disease Control and Prevention (CDC), the Office of AIDS Research (OAR) at NIH and ViiV Healthcare for their contributions and guiding support.

If you wish to cite this report as a source, please use the following citation: Vega, M.Y., Klukas, E., Valera, E., & Montenegro, J. (2014). Latinos in the Deep South: Program Report 2011-2013. Latino Commission On AIDS: New York.

Produced by HEARD at the Latino Commission on AIDS THE “LATINOS IN THE Deep South” program works to advocate and mobilize communities, build healthcare infrastructure, address stigma, and nurture emerging leadership to help grow and sustain healthy Latino communities in Alabama, , , Mississippi, North Carolina, South Carolina and Tennessee. WELCOME

Dear Friend, Partner and Colleague: In such times, it is more important We are pleased to present the Latino than ever to not only take direct action Commission AIDS’ 2011-2013 activities but to build lasting and dynamic report for “Latinos in the Deep South.” partnerships with community- Our Deep South program works to members-at-large, service providers, advocate and mobilize communities, researchers, government administrators build healthcare infrastructure, address and community leaders. The Latino stigma, and nurture emerging leadership Commission on AIDS has been blessed to help grow and sustain healthy Latino with key partners, collaborators and communities in seven key states: Alabama, networks of committed individuals. Georgia, Louisiana, Mississippi, North Through these partnerships and Carolina, South Carolina and Tennessee. collaborations, the Commission has One of the programs primary goals continued to hone its Deep South efforts includes the commitment to implement through four key areas of strategic a unique community engagement model focus, which we refer to as the LUKA as well as the desire to help develop an Principles: Leadership, Unity, Knowledge informed public and media on particular and Action. health access issues for Latinos in the south in order to reduce health disparities and These principles serve as both a guiding promote policies that will produce better path and practical methodology for health outcomes. our continuous efforts in the Deep South to address the health disparities The last three years have seen significant many Latinos therein face. The 2010 shifts in the national discourse around US census, and the community survey healthcare, and HIV. data that has been released thereafter, Accordingly, there are three national issues point to a very strong growth in the requiring our joint attention: HIV remains population in the Deep South. a serious public health challenge across As a country overall, Latinos make up the nation and in particular the south; 17% of the US population. The largest health disparities in the US are widening Hispanic populations are in what we in general, and geographic disparities are refer to as traditional Hispanic places stark with 15 of the top 20 metropolitan like New York, , statistical areas (MSAs) for HIV incidence and . However, Alabama, South being in the south (Reif, et al., 2013); and Carolina, and Tennessee had the fastest lastly despite the Affordable Care Act’s growing Hispanic population from 2000 (ACA) aims to expand access to affordable to 2011. Out of the top ten fastest growing health coverage and reduce the number of Hispanic states, nine are from the south. uninsured , healthcare coverage Only South Dakota, which saw a Hispanic will continue to vary significantly across population growth of 129% in the past ten the country, with the south having grand years, was from outside the south. Because variance in the ACA implementation. of the immense rapid growth of the Furthermore, Hispanics remain one of the Hispanic population in the Deep South, largest groups of the uninsured. These there is a major need to nurture emerging challenges all impact the overall state of leaders, bring key collaborators together Latino health in the south. to leverage resources, enhance knowledge [4] capacity building sessions  community organizing  high poverty leadership development stigma  screening lgbtq discrimination networking initiatives testing immigration status  treatment lack of transportation research & dissemination supportive care

S IN THE DEEP SO LATINO UTH PRO GR AM

[5] “My organization was very fortunate to have worked with the Commission in 2013 on community and board development projects, helping my agency better serve the people of our

Michael Murphree, LCSW 23 county service area.” CEO/Executive Director Medical AIDS Outreach of Alabama and skill sets to provide culturally competent services, and to spur action for continued policies with a positive impact on the daily lives of Latinos. 2000 2010 We feel it is important to continue to share the program’s major activities, initiatives Georgia and accomplishments during the last few years, as well as it vision going forward. In the last three years we have: 435,227 853,689 • Increased the capacity of local leadership to affect policy change • Increased resources for local advocacy and community building • Supported local voices to national platforms North Carolina • Documented needs of Latinos in the 378,963

deep south 800,120

Going forward in 2014, our goal is to Tennessee continue to enhance knowledge, unite

and develop leaders and build momentum 123,838 290,059 towards an increased consciousness of the emerging Latino population in the Deep South. In the summer of 2014, we will be 95,076 235,682 South releasing The Current State of Latinos Carolina in the Deep South, which will serve as a follow-up to our seminal 2008 regional 107,738 192,560 Louisiana assessment report. We invite each of you

to actively participate in events that will 75,830 185,602 Alabama prevent the spread of HIV, address health Growth of disparities that impact our communities, 39,569 81,481 Mississippi Latino population and impact the implementation of health 2000-2010 in care reform and the new National AIDS 7 states of the Strategy. Ultimately, it comes down to the deep south relationships. It’s your support that makes 1’256,241 in 2000 us strong and we thank you. It means 2’639,193 in 2010 the world to not only us, but also to a region attempting to address the needs of a rapidly emerging Hispanic population. Let’s work together to save lives, mitigate barriers to health care and support healthy communities. Together we can make a difference. [7] PROGRAM OVERVIEW

Health disparities across racial and outlets, local businesses, and AIDS ethnic lines persist in the US. In the US Service Organizations (ASOs) to reduce Deep South – consisting of states that health disparities, especially around HIV/ share a common history and geography AIDS. – this is exacerbated by overall lower levels of investment in health care. Through these last three years, there have Specifically, there are structural barriers been five key goals for the Latinos in the that impact the availability, affordability Deep South program: and acceptability of screening, testing, treatment and supportive care; such 1. Heighten awareness of the barriers include high poverty (Fox, 2010), emerging Latino population in the stigma (Mahajan, et al., 2008), LGBTQ south discrimination (Grant, et al, 2010), 2. Increase awareness of the needs of immigration status (Bustamante, 2012), the Latino population and lack of transportation (Heckman, et al., 1998). 3. Enhance the ability of communities to meet these needs The lack of health care infrastructure 4. Support enfranchise and empower makes emerging populations particularly Latino communities to address vulnerable, as they may have difficulty local needs accessing services due to linguistic or cultural differences, lack of familiarity 5. Assist create overall healthier with the systems, and little to no communities awareness of the health conditions present in the region. In the last ten years, the Thus, we hope to have the following long- Latino/Hispanic population has seen the term program impact: fastest population growth in seven of the eight Deep South states (North Carolina, • Create environments where barriers South Carolina, Louisiana, Tennessee, to Latino health care become a topic Georgia, Alabama and Mississippi). This of conversation and an opportunity is the result of three major factors: a for advocacy work slightly higher Latino birthrate which puts the Latino population at a younger • Increase Latino leadership at health median age than other groups; increase service policy and stakeholder tables in migrant populations – characterized by the pursuit of cyclical agricultural, As such, the Latinos in the Deep South meat farms, construction industry and program is a regionally focused program service jobs – and in-migration as Latinos coordinated by the Latino Commission from other parts of the US relocate to on AIDS (the Commission). The program the southern states to follow family or aims to build local leadership, support employment in other industries. The networks and coalitions, enhance Latino Commission on AIDS’ Latinos knowledge and cultural competency, in the Deep South program works with and spur actions to address the needs Latinos, Latino-serving organizations, of the emerging Latino populations local health departments, regional media in the Deep South, specifically in the [8]

states of: Alabama, Georgia, Louisiana, strategies to address these barriers at the Mississippi, North Carolina, South local and regional level were introduced Carolina and Tennessee. We aim and practiced such as media relations, to accomplish these goals through message framing, policy analyses and Specifically, we provide trainings, toolkits, advocacy 101. regional institutes and webinars on the latest state of the science biomedical The Institute helped participants get information and reported Hispanic needs. comfortable and develop expertise with web-based learning environments, Below we highlight the activities, events develop collaborative activities on a range and overall efforts in the four key of policy-issues locally, and serve as a strategic areas of focus: Leadership, Unity, sounding board amongst peers to share Knowledge and Action. lessons learned. Following this distance- learning period, each cohort was brought together for a Summit in which they Local Leadership further solidified their leadership, as well Throughout our regional assessment as shared purpose in addressing health process from 2007-2008, we found disparities in the south. As of December that leadership development was a key 2013, we have conducted three cohorts of component of the addressing the needs of Dennis Deleon participants. As a result Latinos in the Deep South. In particular, of our success with these three cohorts, many of our partners have noted that we also created a Georgia-specific there is a need for leaders to spring component of the Institute in partnership forward and help create a sense of shared with the state health department - the purpose amongst the various stakeholders Georgia Latino Leadership Initiative. that are working towards alleviating the The Georgia cohort developed as its health disparities faced by Latinos in the capstone project, a website for the Latino south. There was also a noted to need to community called informatemejor. help identify community resources and wordpress.com to help keep the emerging strengths as well as gaps. This concern local Georgia Latino population informed resonates within the National HIV/ regarding the latest HIV information. AIDS Strategy in which there is a call for leadership development. Unity As such, as we created The Dennis The second strategic area of focus of deLeon Sustainable Leadership Institute the model is to unite communities for a in 2011, posthumously honoring our SHARED PURPOSE through coalitions visionary founding leader. The Institute or other venues of unifying possibilities. consisted of a 6-month webinar- Coalitions are diverse groups that based series that met bi-monthly, with combine their resources to create change homework assignments related to the by setting goals, jointly raising their session topic. There were sessions on: voices and garnering attention. As a Medicaid redesign, Affordable Care Act result, coalitions can be powerful catalysts implementation, HIV criminalization, within communities to achieve desired and anti-immigrant policies. Specific outcomes. Based on previous work in [10] The LATINOS IN THE DEEP SOUTH PROVIDES TRAININGS, TOOLKITS, REGIONAL INSTITUTES, AND WEBINARS ON THE LATEST BIOMEDICAL INFORMATION AND HISPANIC NEEDS. the region, the Latino Commission on partners), in over 30 roundtables and AIDS recognizes that different states in community forums in the south from the Deep South have different levels of 2011-2013. For instance, in January of community readiness to include diverse 2012, the Commission facilitated a live stakeholders, be it organizational type, forum entitled A Response to HIV in the race/ethnicity, sexual orientation, or HIV Latino Community in North Carolina, status to name a few. This being the case, bringing together both service providers we see different levels of community and community members to discuss readiness around coalition building. To community concerns and need around increase community readiness (which is implementing and operationalizing a long-term process), the Latinos in the biomedical prevention on the ground. Deep South program has partnered with and remains committed to partnering with other national and regional HIV organizations doing longtime work in Enhance Knowledge the South: Southern AIDS Coalition, The third strategic area of focus has been ACRIA, AIDS United, Delta AETC (AIDS to enhance and increase n ot only the Education and Training Center), North knowledge of key stakeholders (policy Carolina Harm Reduction Coalition, makers, service providers, academics) of American Institutes for Research, Human the needs of Latinos but to also enhance Rights Watch, American Civil Liberties the corresponding supporting skills Union of Mississippi and A Brave New sets needed to address those identified Day; to name a few. needs. During the period of 2011 to 2013, we honed in on three components: 1) In February 2011, in collaboration with workforce/service provider development; the Office of AIDS Research, we held 2) research and 3) community a Deep South Regional Summit in assessments. Below we review each of Memphis, Tennessee where the focus was these sub-components. on biomedical updates and community- based participatory research (CBPR). The goal of said summit was to increase 1) Workforce/service provider knowledge of clinical trials and their development: Because of the continuous recent findings, to increase awareness of shifts in community needs, funding CBPR tenets, to increase understanding streams and workforce staffing, there of CBPR as a mobilization tool that has been a noted need for workforce/ empowers community members, and to service provider development. As a long- increase collaborations across diverse standing provider of capacity building stakeholders. Participants worked assistance, the Commission took to heart together to arrive at shared CBPR said needs and implemented a focused purpose and goals. capacity building initiative directed at the As part of helping to nurture the south that included trainings, webinars evolvement of coalitions and groups and workshops both locally in the dedicated to addressing the needs of south and at national levels. Workforce Latinos in the south, we participated development also included our signature in, as well as co-facilitated (with local organizational assessments consisting of [12] three stages: organizational assessment help organizations pivot in this changing (assessment, feedback, action planning), landscape. Below are two series examples. action plan implementation (coaching, training & TA) and evaluation. We • Program Sustainability: have developed and utilize instruments • Organizational Readiness to assess organizational, regional and & Partnership under the cultural competency needs of agencies. changing landscape in HIV These assessments provide organizational • Grant Writing under the baseline data, as well as identify and guidance of NHAS & ACA prioritize specific capacity building needs. • Monitoring & Evaluation in From 2011-2013, we conducted over the time of High Impact HIV 15 organizational assessments in the Prevention south. Below we provide a synopsis of our • Hepatitis and Disease Integration: training and webinar activities. • Federal updates on hepatitis • Hepatitis and Latinos Trainings. From 2011 to 2013 we • Hepatitis and vulnerable conducted more than 20 trainings populations throughout the Deep South in the following core areas: 2) Research: In our 2009 regional Deep • Testing, linkages to care and South meeting held in collaboration with treatment the Office of AIDS Research in North • Interventions for emerging Carolina, participants from across all 7 populations Deep South states noted that there was • Community mobilization a huge research gap on Latinos, Latinos • Organizational development and HIV and Latinos in the south. As one of our goals is to increase knowledge These four core training areas were and address those knowledge gaps, delivered to help ASOs, CBOs, health we partnered with local and national departments and other key stakeholders academics to both increase the number shift or further enhance their services of research projects that are relevant to to align with the National HIV/AIDS Latinos in the south and to disseminate Strategy and/or Healthcare reform. said the latest research findings.

Webinars. From 2011 through 2013, Since 2012, we have been working the Commission conducted over 100 with the Center for AIDS Research at webinars that were open to individuals the Medical College of Wisconsin (in from all states. During this time we have particular, Dr. Carol Galletly and her had over 3500 webinar registrants across colleagues) on a study that aims to all sessions. The Deep South relevant understand how HIV criminalization topics ranged from cultural competency and immigrants laws impact the health regarding Latinos to addressing job seeking behaviors of Latino immigrants in burnout to how to work with traditional Tennessee and North Carolina, including and social media. We also produced HIV testing, access to treatment, and several webinar series that were meant to utilization of health and supportive [13] services. With the dearth of research coalitions would not amount to much. In on Latinos living with HIV and those at order to meet the needs of the emerging risk, particularly in the South, this study Latino population in the Deep South will help answer questions needed for action-oriented steps with concrete end informed policy advocacy around HIV goals must always be at the forefront. criminalization and immigration laws in As part of our National Latino AIDS the South. Awareness Day observation, we held Congressional Briefings in both In 2012, in partnership with the Office of September 2011 and 2012 in collaboration AIDS Research, Social Scientific Systems with a diverse set of partners. Due to and the National Council of , the government shutdown, we were the Commission also developed and unfortunately, able to hold our annual implemented the first Latino-focused briefing in 2013. The briefings served to Community Research Forum at the highlight the needs of Latinos in terms of International AIDS Conference, held in healthcare, Insurance, HIV and Hepatitis. Washington, DC. The forum focused on At both of the briefings, there was bi- the latest research regarding Latinos, HIV partisan support and sponsorship. In and access to care. There were more than the 2012 briefing, our Commission staff ten panelists who brought a wide array of spoke specifically to the need of Latinos perspective, including that of migrants in in the Deep South and that there needs to the Deep South. be a sense of urgency to addressing these needs. 3) Regional Assessments: The Commission has both undertaken, at the At the state level, the Latinos in the request of local stakeholders, individual Deep South program supported its organizational assessments as well as partners on their various legislative regional assessments. We have provided day visits. In particular, we had a very guidance to key southern partners on how active presence in the Mississippi and to do community assessments, including North Carolina legislative action days. utilizing the method of community In 2012, we provided several workshops mapping. Over 15 organizational on “how to tell your story” as part of assessments were conducted in the South community mobilization efforts. The to enhance organizational readiness in Deep South staff were able to in April the face of a changing landscape. We also 2013, participate in three advocacy helped conduct four large-scale regional days in North Carolina: HIV Advocacy assessments in the south. The resulting Day, LGBT Legislative Day and Latino findings of these assessments will be Advocacy Day where we promoted incorporated into our upcoming regional restoration of AIDS Drug Assistance report. Program funding in the budget proposal, thanked legislators for introducing a Syringe Decriminalization bill, promoted Action higher education for undocumented The fourth strategic area of focus is that students, and opposed anti-immigrant of Action. Without taking action, the bills including the Reclaim North development of leaders, knowledge and Carolina Act. The Commission [14] UNITY

DEEP SOUTH REGIONAL SUMMIT

RESPONSE TO HIV IN THE LATINO COMMUNITY IN TRAINING ON HIV EDUCA PREVENTION AND NORTH CAROLINA CAPA KNOWLEDGE

CIT WEBINARS,THROUGH

Y BUILDING ASSIST

15 ORGANIZA

ASSESSMENT

TRAININGS, TREA WORKSHOP

TMENT TION LUKA TIONAL STRATEGIC AREA S ANCE OF FOCUS S NORTH CAROLINA CAROLINANORTH LEGISLA LOCAL POLICY UNITY KNOWLEDGE LEGISLATIVE AC LEGISLA Y ISSUES ACTION TION DA DAY MISSISSIPPI TIVE DEEP SOUTH TRAINING ON HIV EDUCATION TIVE AC TIVE C Y TINO GEORGIA LATINO REGIONAL SUMMIT PREVENTION AND TREATMENT BRIEFINGSONGRESSIONAL IN D.C. ISSUES LOCAL POLIC LEADERSHIP MISSISSIPPI TION DA AINABLE LEGISLATIVE 2011, 2012 INITIATIVE RESPONSE TO HIV CAPACITY BUILDING ASSISTANCE ACTION DAY GEORGIA LA ACTION Y P IN THE LATINO THROUGH TRAININGS, LEADERSHIP INITIA DENNIS DELEONN SUSTS AINABLE COMMUNITY IN WEBINARS, WORKSHOPS LEADERSHIP SUMMITUM NORTH CAROLINA COCONGRESSIONAL BRIEFINGS IN D.C. LEADERSHIP SUMMIT DENNIS DELEON SUST 15 ORGANIZATIONAALL 2011, 2012 LEADERSHI LEADERSHIP ASSESSMENTMENTS ACTION

[15] The Dennis Deleon Sustainable Leadership Institute is a space for emerging community leaders to enhance and develop leadership skills in order to impact HIV/AIDS local, state and federal health policy affecting Latinos in the Deep South. As of December 2013, we have conducted three cohorts of Dennis Deleon participants. each cohort was brought together for a Summit in which they further solidified their leadership, as well as shared purpose in addressing health disparities in the south. participated as an organizer for the group of individuals is that of media. Latino Advocacy Day through the NC Below are some of our media appearances Latino Coalition and served as a panelist from the last three years. at the HIV Advocacy Day through the NC AIDS Action Network. The Radio Interview: How has the Latino Commission recruited NC community Community Changed in North members to participate in the legislative Carolina?, Latina 102.3 FM with Dennis visits including: Equality NC, LGBT Escobar, Charlotte, NC June 2013 Center of Raleigh, El Centro Hispano and Youth Leadership in Action. We Television Interview: Promoting National also participated in the South Carolina Hispanic Hepatitis Awareness Day, Hola Hispanic Roundtable in 2011; as well North Carolina, WRAZ-TV, Raleigh, NC, as the South Carolina “Be the Change” May 2013 session in December 2013. Television Interview: HIV in the Latino While at the 2012 International AIDS Community, Get Tested, Hola North Conference (IAC) in DC, we used our Carolina, WRAZ-TV, Raleigh, NC, April presence to raise our voice on behalf 2013 of the Deep South in order to make more readily visible its needs; including Radio Interview: Promoting National participating on the panel for the Latino AIDS Awareness Day, La Mega documentary deepsouth premiere at the 97.9 FM with Alex Sensation, Charlotte, IAC. We went on to do several more NC October 2012 panel appearances on behalf of the deepsouth documentary that serves to Radio Interview: Promoting National highlight structural system level barriers Latino AIDS Awareness Day, Latina that many on the margins face in the 102.3 FM with Dennis Escobar, Charlotte, south. Furthermore, we participated NC October 2012 in the Shine the Light workgroup that has been assembled to bring a national Newspaper Interview: Latino Memphis, spotlight to the needs of those that are March 2011. marginalized in the south and to also highlight the health care (especially HIV) infrastructural needs in the south. Additionally, in 2013, as an invited speaker to PACHA’s annual meeting, the Commission presented a major focus on Latinos in the Deep South highlighting the needs of Latinos in terms of the intersection of healthcare reform and Ryan White.

Lastly, a major goal of the program is to make Latinos in the Deep South be visible to a wider group of individuals. One key [18] “It’s important to promote hiv testing as a part of a health screening. knowing your status is key. i urge you all to take control of your health and get tested.”

Erik Valera, Latinos in the Deep South Radio Interview: Promoting National Latino AIDS Awareness Day La Raza 106.1 with Alex Ruiz Charlotte, NC - October 2012 From 2011 the latinos in the deep south program has conducted more than 20 trainings the areas of Testing, linkages to care and treatment; Interventions for emerging populations; Community mobilization; and Organizational development

Expanded reach of the deep south proGRAM

When first developed in 2007, the Latinos Furthermore, due to the success of in the Deep South program specifically the regional summits that had been focused on the states of North Carolina, previously held in North Carolina, South Carolina, Louisiana, Georgia, Alabama and Tennessee, we were able Alabama, Tennessee And Mississippi. to, in collaboration with the Office of In the last three years, because in part AIDS Research, hold a regional summit of numerous requests to implement the in (, and Arizona LUKA principle model in new regions, we participants) and in Missouri (Illinois, have expanded our mobilization efforts Kentucky and Missouri participants). to the states of Texas, Florida, Kentucky Like the Deep South, these are all states and Arkansas. Both Texas and Florida that have seen an influx of Latinos, as well are seen as traditionally Hispanic states; as a need for infrastructure development while Arkansas and Kentucky are seen as particularly in terms of helping Latinos emerging Latino states. access care. While in Kentucky in 2012, we had the great pleasure to As such, we were able to do extensive participate in their local National Latino regional Training Institutes in the states of AIDS Awareness Day events and met Texas and Florida in close collaboration very committed service providers and with the local health departments. In advocates. 2012, we provided day-long institutes in San Antonio, Dallas and Houston where the focus was on community mobilization, organizational sustainability, staff development (addressing specifically burnout) and the use of social media. In Austin, we convened a community forum to discuss and action plan around structural level barriers towards HIV prevention and care, which was attended by community members, service providers, health department staff and elected officials across the state. In Florida, we helped facilitate the first ever Latino Summit in 2010 as spearheaded by local partners and we have also been recently supporting in the implementation of town halls focusing on the needs of Latino men who have sex with men. Meanwhile, from 2012-2013, in both Arkansas and Kentucky, in close collaboration with the health departments, we have been helping conduct regional assessments to identity the needs of the community as well as the needs of non- traditional service providers. [22] Reach of the Latinos in the Deep South Program

KY TN NC AR SC MS GA AL TX LA FL

Latinos in the Deep South Program since 2007 Latinos in the Deep South Program expanded reach from 2011-2013 Latinos in the Deep South Program home since 2012

HIV Diagnosis among Latino Adults and Adolescents in 2011 (rate per 100,000) 18.7 25.8 12.2 KY NC 19.5 TN AR SC 28.4 AL GA MS 26.0 TX LA 34.1 FL 23.9 14.8 52.7 33.7

Source: Centers for Disease Control

[23] 73% YOUR FEEDBACK developed partnerships 64% conducted a 61% community went on to develop assessment service protocols In a recently conducted evaluation with past consumers of the Commission’s training and mobilization services (N=148), 70% noted they regularly or always use their new skill sets and 89% found our services were useful in the field. Further, 61% noted they went on to develop service protocols; 73% developed partnerships and 64% conducted a community assessment as a result of our services. Respondents noted key high-impact prevention outcomes as a result of our services: 52% noted an increase in their HIV testing positivity rate; 75% note an increase in linkages to care; and 66% noted an increase in client medical adherence. This could be due in part to the fact that 80% noted we successfully incorporated local concepts. ACTION OF CLIENTS Furthermore, over 94% of Deep South AS A RESULT OF OUR SERVICES participants noted being satisfied with HIGH-IMPACT PREVENTION OUTCOMES our services. AS A RESULT OF OUR SERVICES

In terms of what topics for future trainings, Deep South participants noted that going forward they would like to learn more about how to do prevention with HIV positive individuals and more tactics for community mobilization.

52% noted an increase in their HIV testing positivity rate

66% noted an increase in client medical adherence 75% noted an increase [24] in linkages to care looking towards the future

During this coming year of 2014, the Latinos in the Deep South program will help position the agenda of Latino HIV issues in North Carolina, South Carolina, Tennessee, Louisiana, Georgia, Alabama and Mississippi on structural aspects and barriers to healthcare. The Latinos in the Deep South program will accomplish this by utilizing resources developed by the Commission in each region since 2007, developing opportunities for the Latino community voice to be heard at stakeholder tables, and enhance visibility of Latino issues on barriers. The Latinos in the Deep South program will continue to develop partnerships and nurture the growth of emerging leaders in order to have an expanded pool of Latinos and Latino-serving organizations and their leaders involved in HIV care discussions. Here at the Commission we are committed to renewing, refocusing and reengaging our commitment, energy and passion towards reaching an AIDS-free generation, recognizing that such a path must go through, as well as address the challenging realities of, the Deep South of the . Commission Mission Statement and Executive Leadership

The Latino Commission on AIDS including Puerto Rico and the U.S. Virgin (Commission) is a nonprofit organization Islands. The Commission’s innovative founded in 1990 dedicated to addressing public health model encompasses the health challenges and responding five core and complementary service to the impact of HIV & AIDS in our divisions, which include: communities. The Latino Commission is the leading organization coordinating • Capacity building assistance; National Hispanic Hepatitis Awareness • HIV testing and linkages to care; Day (May 15), National Latino AIDS • HIV prevention education and health Awareness Day (October 15) and other promotion; prevention, research, capacity building • Community mobilization; and and advocacy programs across the • Hispanic Health Behavioral Research United States and its territories. Today, Center. we operate 20 programs ranging widely in target population, focus and scope – Executive Management: from direct client service to community [1] Guillermo Chacon; mobilization to training to research President projects. The Commission has expanded [email protected] its services outside New York to meet the [2] Miriam Vega, PhD challenge health needs of communities Vice President in more than 45 States and territories, [email protected] [3] Leandro Rodriguez, MA Director of Programs [email protected] [4] Karan Itwaru Director of Finances [email protected]

Latinos in the Deep South Program 5 [5] Erik Valera 1 Program Director [email protected] [6] Judith Montenegro Director of Community Organizing [email protected]

6

3

4

2 1 “The Commission’s commitment to address the health challenges of Latinos in the South is firm. We will advocate to overcome all the barriers to access health care, prevention, and education.” — Guillermo Chacon 2 “Much research needs to be done on creative models for prevention and care for this very mobile 3 population.” Going forward in 2014, our goal is — Miriam Vega, PhD to continue to enhance knowledge,

unite and develop leaders, and “We are commited to mobilize communities 4 and nurture emerging leadership to help build momentum towards an grow a healthy generation of Latinos/ Hispanics in the south” increased consciousness of the HIV — Karan Itwaru and health care needs — Leandro Rodriguez, MA

5 “The lack of health care infrastructure makes emerging populations particularly vulnerable. Our program will work with partners to address those challenges” — Erik Valera

6 “Our leadership Institute provides participants the opportunity to develop expertise with web-based learning environments, develop collaborative activities on a range of community-issues locally, and serve as a sounding board amongst peers to share lessons learned to further solidify their leadership.” — Judith Montenegro [27] BIENVENIDOS

Estimados amigos, socios y colegas: cobertura de salud y reducir el número Tenemos el placer de presentarles las de estadounidenses sin seguro médico, actividades de la Comisión Latina sobre la cobertura de salud seguirá variando el SIDA 2011-2013 referente al programa significativamente en todo el país, con una regional “Latinos en el Sur del Sur de los gran diferencia muy clara en el aplicación Estados Unidos.” Nuestro programa “En ACA en el sur de la nación. Además, el Sur” trabaja para defender y movilizar los hispanos siguen siendo uno de los a las comunidades, apoyar el desarrollo segmentos mayores de la población que no de infraestructura a la salud, abordando cuentan con seguro de salud. Todos estos el estigma, y fomentando el liderazgo retos, afectan en su totalidad el estado emergente para ayudar a crecer y lograr general de salud de los latinos en el sur. sostener comunidades latinas saludables en siete Estados claves: Alabama, Georgia, En estos momentos es más importante Louisiana, Mississippi, Carolina del que nunca, no solo el tomar acción Norte, Carolina del Sur y Tennessee. Uno directa, sino crear asociaciones más de los objetivos del programa incluye el dinámicas y duraderas, con miembros de compromiso de implementar un modelo la población general, con los proveedores único de participación comunitaria, así de servicios, investigadores, funcionarios como el deseo de contribuir al desarrollo gubernamentales y líderes de la de un público y medios de comunicación comunidad. La Comisión Latina sobre informados, en cuestiones particulares el SIDA es afortunada de contar con los sobre el acceso a la salud que beneficien principales socios, colaboradores y redes a la población latina que vive en los de personas comprometidas. A través Estados Sureños , con el fin de reducir de estas asociaciones y colaboraciones, las disparidades de salud y promover la Comisión ha continuado afinando políticas que produzcan mejores resultados sus esfuerzos en el “Sur del Sur” a relacionados a la Salud. través de cuatro áreas clave con enfoque estratégico, a las cuales nos referimos En los últimos tres años se han visto como los “Principios LUKA” (por sus cambios significantes en el debate siglas en inglés): Liderazgo, Unidad, nacional en torno al acceso a la salud, Conocimiento y Acción. los hispanos y el VIH. En este sentido, hay tres cuestiones nacionales que exigen Estos principios sirven tanto como un guía nuestra atención conjunta: El VIH sigue y como una metodología práctica para siendo un grave problema de salud pública nuestros continuos esfuerzos en el sur del en todo el país y en particular el sur; las sur de los Estados Unidos para abordar disparidades de salud en los EE.UU. están las disparidades de salud que muchos aumentando en general, y las disparidades latinos ahí enfrentan. El censo de 2010 en geográficas son muy marcadas, con 15 de EE.UU, así como los datos de encuesta de las 20 áreas estadísticas metropolitanas la comunidad que se ha implementado a (MSA) de la incidencia del VIH ubicadas partir de entonces, apuntan un crecimiento en el sur (Reif, et al, 2013.) y por último, muy fuerte de la población hispana en a pesar de que la Ley de Reforma de el sur de nuestra nación. Como país en Salud (ACA por sus siglas en Ingles) general, los latinos representan el 17% de la tiene como objetivo ampliar el acceso en población de los EE.UU. [28] Las poblaciones hispanas más grandes se En el 2014, nuestro objetivo es seguir encuentran en lo que nos referimos como mejorando el conocimiento, unir y lugares tradicionalmente hispanos como: desarrollar líderes y crear un impulso Nueva York, Nuevo México, California y hacia una mayor conciencia de la Texas. población latina emergente en el sur de nuestra nación. En el verano de 2014, Sin embargo, Alabama, Carolina del Sur publicaremos un informe llamado “El y Tennessee han tenido el crecimiento estado actual de Latinos en el Sur del más rápido de la población hispana Sur de los Estados Unidos”, el cual desde 2000 hasta 2011. De los diez servirá como un seguimiento a nuestro principales Estados hispanos de más informe seminal de evaluación regional rápido crecimiento, nueve son del sur. del 2008. Invitamos a cada uno de ustedes Sólo Dakota del Sur, vio un crecimiento a que participen activamente en eventos de la población hispana de 129% en los que prevengan la propagación del VIH, últimos diez años. Debido al inmenso afrontando las disparidades en la salud y rápido crecimiento de la población que impactan a nuestras comunidades hispana en el sur, hay una gran necesidad y que repercuten en la aplicación de la de apoyar líderes emergentes, unir a los reforma de salud y de la nueva Estrategia colaboradores claves para aprovechar Nacional sobre el SIDA. Ultimadamente, los recursos, realzar el conocimiento todo se reduce a las relaciones para poder y habilidades para ofrecer servicios avanzar. El contar con su apoyo, nos culturalmente competentes, estimular la hace más fuertes y por ello les damos acción y abogar por políticas que tengan las gracias. Esto afecta a todo el mundo, un impacto positivo en la vida cotidiana no sólo para nosotros, pero también de los latinos y la población en general. a una región que intenta afrontar las Creemos que es importante continuar necesidades de una población hispana que compartiendo las principales actividades, emerge rápidamente. Trabajemos juntos iniciativas y logros del programa en los para salvar vidas, mitigar las barreras últimos años, así como la visión hacia el en el acceso para recibir servicios de futuro. salud y apoyar para avanzar y así lograr comunidades saludables. Ya que juntos En los últimos tres años hemos logrado: podemos lograr nuestra metas.

• Aumentar la capacidad en los líderes locales para influir en el cambio de políticas públicas. • Aumentar los recursos para la movilización y capacidad organizativa comunitaria a nivel local. • Apoyar a que voces locales comuniquen sus temas a nivel nacionales • Documentar las necesidades de los latinos en el “sur del sur”

[29] DESCRIPCIÓN DEL PROGRAMA

Las disparidades de salud a través de ligeramente más alta, que pone a la líneas raciales y étnicas persisten en población latina en una media de edad toda la nación. En el sur del sur de los más joven que otros grupos, el aumento EE.UU. son Estados que comparten de las poblaciones migrantes - que se una historia y geografía en común, caracterizan por la búsqueda de puestos esto se ve agravado por los bajos de trabajo en la agricultura cíclica, en niveles de inversión en el cuidado granjas de carne, en la industria de la de salud. Específicamente, existen construcción y en servicios, sumado barreras estructurales que afectan a la migración interna, como los la disponibilidad, accesibilidad y latinos de otras partes de los EE.UU. aceptabilidad del acceso a estudios para trasladarse a Estados del sur con relacionados a la salud pública, pruebas la finalidad de seguir a su familia o o exámenes clínicos, tratamiento y algún empleo en otras industrias. El atención para la salud; (Mahajan, programa “Latinos del Sur del Sur de los et al, 2008) estas barreras incluyen Estados Unidos” de La Comisión Latina altos niveles de pobreza (Fox, 2010), sobre el SIDA, trabaja con los latinos, el estigma, la discriminación hacia organizaciones que atienden a latinos, la población Lesbiana, Gay, Bisexual, departamentos de salud locales, medios Transgénero y Queer (LGBTQ, por sus de comunicación regionales, empresas siglas en inglés) (Grant , et al, 2010), locales, y organizaciones que brindan el estatus ó condición migratoria atención en SIDA (ASO, siglas en ingles) (Bustamante, 2012), y la falta de para reducir las disparidades de salud, transporte (Heckman, et al., 1998) sobre todo en torno al VIH y el SIDA. agravan muchos más los retos para nuestra gente. Durante estos tres últimos años, ha habido cinco objetivos clave del programa La falta de infraestructura de salud “Latinos en el Sur del Sur de los Estados hace a las poblaciones emergentes Unidos”: particularmente vulnerables, ya que pueden tener dificultades para acceder 1. Aumentar la concientización de la a los servicios relacionados a la salud población latina emergente en el sur asociado a las diferencias lingüísticas 2. Aumentar la concientización sobre las o culturales, la falta de familiaridad necesidades de la población latina con los sistemas de salud, y poco o nulo conocimiento de las condiciones 3. Mejorar la capacidad de la comunidad de salud presentes en la región. En los para responder a estas necesidades últimos diez años, la población latina 4. Ayuda a garantizar la capacitación en / hispana ha presentado el crecimiento comunidades latinas para afrontar las demográfico más rápido en siete de necesidades locales los ocho Estados en el Sur del Sur de Estados Unidos (Carolina del Norte, 5. Ayudar a crear comunidades más Carolina del Sur, Louisiana, Tennessee, saludables en general. Georgia, Alabama y Mississippi). Este es el resultado de tres factores principales: una tasa de natalidad latina [30] Por lo tanto, esperamos lograr un impacto Todas nuestras actividades en la región a largo plazo a través de: del sur que incluyen, eventos y esfuerzos generales se basan en las cuatro áreas • Crear entornos en los que las barreras estratégicas de nuestra labor: Liderazgo, a la atención de salud que enfrentan Unidad, Conocimiento y Acción. los latinos se conviertan en un tema de conversación y una oportunidad para el trabajo de incidencia que cambie dichas realidades.

• Incrementar el liderazgo latino en los espacios donde se discuten políticas y decisiones que impactan los servicios de salud.

Como tal, el programa “Latinos en el Sur del Sur de los Estados Unidos” está enfocado regionalmente y coordinado por la Comisión Latina sobre el SIDA (la Comisión). El programa tiene por objeto desarrollar el liderazgo local, apoyar las redes de colaboración y coaliciones, para aumentar el conocimiento y competencia cultural, y estimular acciones para abordar las necesidades de las poblaciones latinas emergentes en el Sur del Sur de los Estados Unidos, específicamente en los Estados de: Alabama, Georgia, Luisiana, Mississippi, Carolina del Norte, Carolina del Sur y Tennessee. Nuestro propósito es alcanzar estos objetivos a través de las sesiones de capacitación, organización comunitaria, el desarrollo de liderazgo, la mejorar las iniciativas de creación de redes de colaboración, y poniendo como prioridad un enfoque comunitario basado en la investigación y la difusión participativa. En concreto, ofrecemos entrenamientos, herramientas, conferencias regionales y seminarios, información sobre los últimos avances de la ciencia biomédica, así como información sobre las necesidades relacionadas o que impactan la salud de la población hispana. [31] Latinos in the Deep South is a program of the Latino Commission on AIDS www.latinoaids.org