ANDROMEDA TRANSCULTURAL HEALTH RICARDO GALBIS, M.D. Executive Director MAY 20, Decatur Street NW Washington, DC 20011

HIV in the District 12,428 persons living with HIV/AIDS DC has the highest rate of new reports of AIDS nationally DC has ten times the mortality rate than the national rate 0.2% of those infected are Hispanic

Challenges with HIV Patients Co-morbidities  Mental Illness  Substance Abuse  Diabetes  Hepatitis C Adherence  Medication resistance  Non-compliance Risky Behavior  Unprotected sex  Drug use Stigmas towards illness

Challenges to delivery of evidence based care to patients in DC  Uninsured, underinsured, barriers to access to care  Compliance and Adherence to treatment  Ability of community based organizations to effectively operate without funding or donations, e.g. children’s mental health  Not all Insurance plans cover mental health services or psychiatric medications

Demographics of Latinos in the Nation and the District Approximately 35.3 million Latinos in the US Expected increase to 97 million by 2050 DC Total Population: 572,059 DC Hispanic/Latino: 44,953 (7.9%) This does not include undocumented persons

Need for mental health services Latino youths experience more anxiety related issues, depression and drug use than non-Hispanic white youth Older Latinos experience more depression related to physical health issues and environmental change  Language barriers  Immigration

Need for mental health services Latino adolescents report more suicidal ideations compared to non-Hispanic white adolescents Recombined families Higher incidence of alcoholism Higher incidence of anomie Precursors to gang activity e.g. non peer group acceptance and desire to belong Nonfunctional families Latchkey children

Access Mental Health Care 39% of Hispanics have no health insurance  Only 41% of those who are health insured have coverage for mental health treatment, compared to 65% of whites, and 63% of African-Americans According to surveys  22% of Hispanics are open to seeking professional mental health care compared to 15% of the general population. Hispanic PR wire: National Survey Reveals Hispanics Engage In Healthy Behaviors to Manage Stress More Than General Population Concern about Family Health Leading Source of Stress Women as Family Health Managers More Stressed than M

Barriers to Mental Health Care Lack of funding Educational Disparity Mental illness stigmas Insufficient Cultural Competency

Breaking the barriers Educational Disparity Addressing the language barrier Cultural competency Health Education  Decreasing stigmas Access to Care Reaching out to Patients in their community

Antares and participant