FIU Researcher Helps Prevent HIV And AIDS In Rural South Florida

By: Valentina Palm / Asst. News Director

 

Dr. Patria Rojas assigned Latina farmworkers in Homestead to examine their naked bodies in the mirror for homework. Three years later, her HIV and sexual education intervention proved to be successful and will be replicated for males.

“Some of these women, didn’t know they had a urethra and a vagina, ”said Rojas, who is Puerto Rican. “They didn’t know their bodies.”

Rojas earned a $1.5 million grant from the National Health Institute to develop the HIV intervention for Latina farmworkers in Miami-Dade County who work in fields, plant nurseries and packing facilities, growing vegetables like peppers, tomatoes, and salads in Homestead supplying Florida and the whole country.

Rojas, who is a research associate professor at the Center for Research on US Latino HIV/AIDS and Drug Abuse at FIU applied for the five-year grant in 2014.

The intervention Rojas applied, SEPA, stands for Salud, Educacion, Prevención y Autoayuda, which translates to Health, Education, Prevention and Self-help. 

It was designed by Nilda Peragallo, former University of Miami Dean of Nursing and Health Studies, and approved by the Centers for Diseases and Prevention.

“I wanted to test if it was going to be effective with women from Mexican and Central American descent,” said Rojas.

Miami Dade County is number one in the country for HIV diagnosis per capita with around 26,632 people living with the disease, according to the CDP.

SEPA is a series of “platicas” or “charlas”, Spanish for groups talks or conversations between scientists like Rojas and the women in vulnerable communities. The three-class series on anatomy, HIV and AIDS and assertive communication are two hours long and held for groups of eight to 10 women.

More than 250 women participated.

“It’s not teaching them by lecturing but just ‘charlando’,” said Rojas “Also using an empowerment theory, that by teaching people, you also empower them to advocate for themselves.”

Rojas aimed to tackle five social determinants of health that make Latina farmworkers more vulnerable to contracting HIV: poverty, low academic achievement, limited access to health care and high rates of domestic violence and alcohol use in their community.

“Now, imagine women who live in semi-rural areas, they are even at higher risk,” said Rojas.

Latina farmworkers in Homestead make, on average, $10,000-15,000 working in fields and nurseries. Also, their highest level of education is high-school or less, according to Rojas.

“We found out through our studies, the higher level of education, the more educated women are, the less likely she is to engage in sex that will put her at risk,” said Rojas.

But sociocultural factors in the Latin community such as “machismo” and “marianismo” exacerbate the risk of contracting sexually transmitted diseases.

According to Rojas, “machismo” values make a men’s hypersexual behavior acceptable even if its outside of marriage or a relationship. On the other hand, “marianismo” makes women see that behavior as normal, exclusively for men.

“Women are expected to be submissive to their partners,” said Rojas. “Not be too knowledgeable about sexual matters, they are very ashamed to carry condoms because they’re afraid that they’re going to be stigmatized as sluts or that they are “mujeres de la calle” (women of the streets) or easy and they’re having sex with multiple men.”

Another factor increasing the vulnerability of the Latin community is low condom usage rate, said Rojas. Only around 25 percent of Latinos use condoms, according to a study she conducted prior to the intervention.

For their second assignment, women learned how to put on a male and female condom and the benefits of using protection.

“Most Latinas use condoms to prevent pregnancy, not to prevent diseases,” said Rojas. “Some don’t want their men to use condoms because they are related to sex outside of the relationship.”

But, alcohol and domestic abuse are also barriers for Latina farmworker in Homestead to negotiating safer sex with their partners.

Daily, women fear domestic violence from their partners due to alcohol abuse so they are even more scared to ask for condom usage, said Rojas. 

“They’re afraid to be beaten up and asked, ‘why do you want me to use a condom? Are you cheating on me? you think I’m cheating on you? Or, do you think I have something?’,” said Rojas. “If you’ve been in an established relationship without using condoms and then you bring it in, It’s hard, really hard.”

The third and last session focused on assertive communication exercises to help women tell their partner things they feel comfortable or ashamed of saying.

Rojas taught them the power of body language, “I statements” and the sandwich technique: starting with a flattering statement, following it with the critique and finishing on a positive note.

Most women engaged in role-plays involving safe sex and it’s the relation to alcohol or domestic violence.

“Amor, I love when you come home but I want to tell you I don’t like it when you come drunk and it’s hard for us to do it and use preservatives,” said Rojas, remembering her student in a class. 

The student, she said, had to start her statement over and over to finish it.

Lack of sexual education in Latino communities is a generational problem because the topic is seen as taboo, Rojas believes.

“Mothers don’t have the skills, they don’t know how to talk about sex because nobody taught them how to do it,” said Rojas. “Your mother cannot teach you something that she doesn’t know.”

Rojas and the FIU Stemple College concluded over 75 percent of the women improved on their sex education test and were also practicing safer sex with their partners. 

But Rojas was surprised by the impact the intervention had on the community.

“Some of the women threw parties on their homes, they invited friends and they showed them how to use condoms,” said Rojas. “Educating a few women, you create this impact coming close to the family and into their community so they became our ‘promotoras de salud’ or ‘health promoters’.”

Following the success of her SEPA intervention, Rojas will launch the same class series for Latino farmworkers in Homestead with another $1.5 million grant from the National Health Institute.

She hopes the program will encourage men to have safe sex.

“If they don’t want to use condoms, In reality, it’s their decision and if they don’t want to use them how can you force them?,” said Rojas.

Rojas, who works in the HIV field since 1993, learned from the intervention, that a lot more has more work needs to be done to improve sexual education in Latino communities.

“For me, seeing the lack of knowledge among these women was heartbreaking,” said Rojas. “They thought that you could get HIV from sharing the toilet, from going to the bathroom, going to a restaurant, from going to the pool or even form a mosquito bite.”

In the future, Rojas hopes to focus on educating mothers on how to talk about sex with their daughters. 

“These are very intelligent women, to be an immigrant and survive without speaking the language, without having any academic knowledge, you develop certain life skills,” said Rojas. “Some of these women have three, four, five or eight kids, so the lesson I took home is: there is still this vulnerable population, there is a lack of information education doesn’t get to them.”

 

assistant professor in the Robert Stempel College of Public Health & Social Work

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