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Stigma Remains an Obstacle to Treatment
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District health officials, meanwhile, are trying to reassure Latino patients.
"In D.C. we try to send the message that those fears [of arrest for seeking health services] are unfounded. Our health response has nothing to do with immigration," said Shannon Hader, director of HIV/AIDS Administration for the D.C. Department of Health.
But health experts say fear perpetuates a dangerous culture of silence.
According to the D.C. health department, Latinos make up 8 percent of the District's population and 5 percent of all diagnosed AIDS cases -- a rate Hader suspects would be higher if more Latinos were tested. Nationwide, Latinos make up 15 percent of the population and 19 percent of diagnosed AIDS cases, according to the Kaiser Family Foundation.
Goforth said the taboo against discussing STDs is also costly.
"I have seen clients die from full-blown AIDS in a house full of their entire family and no one knew they were positive," Goforth said.
His job is to incorporate patients' treatment plans into their daily lives, which can be a challenge. Many who test positive are unlikely to take their medicine as prescribed or keep doctors' appointments because they are trying to hide their HIV from their families, he said. Many immigrants, he said, still consider HIV/AIDS a death sentence. Without medication, it can be.
"They don't know about modern treatment," Goforth said. "If you don't know that, you're back to the beginning of the epidemic when people thought, 'Why should we get tested if we are just going to get sick and die?' "
To give hope to his most vulnerable clients, Goforth tells his story.
"I tell them I have been HIV-positive for 16 years," he said. "They look at me and say, 'He looks like a normal healthy guy. He's got a good job and is just living a life.' "
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