Fellowship Story Showcase
Latinas and Reproductive Health in Georgia
A look into what makes Latinas avoid regular check-ups and how this affects their health, particularly when it comes to sexually-transmitted diseases like human papillomavirus.
The anti-immigrant sentiment that some Latinas in Georgia are experiencing has led some women to refrain from scheduling routine medical exams that could save their lives, according to Dr. Lisa Flowers, a physician who treats Latina patients at various Grady Health System's clinics.
"We used to have more Latino patients at our primary care clinics. But the state no longer supports us. The number of patients who come for routine visits has dropped," said Flowers.
Flowers is worried about Hispanic women, who, she said, are not scheduling their annual pap-smear, a test that helps doctors find abnormalities that could turn into cervical cancer.
"At this time where immigrants are not valued, it's even more difficult to have women come for their routine tests. They end up going to the emergency room to get treated," said Flowers.
Flowers suggested that this fear could be partly blamed for a raise in the number of cases of cervical cancer among Latinas in the nation.
This type of cancer is mainly caused by the human papillomavirus (HPV). HPV is transmitted through sexual contact and may cause an infection in the cervix.
Every year around 10,000 Latinas are diagnosed with cervical cancer, but this number could be higher, according to the American Cancer Society. Of them, around 3,700 lose the battle with cancer.
Latinas are twice as likely as non-Hispanic White women to be diagnosed with this type of cancer, according to the Office of Minority Health (OMH), a division of the U.S. Department of Health & Human Services.
"Hispanic women are diagnosed with cervical cancer at later stages because many of them do not have access to medical care", said Flowers. According to her, women who haven't had a pap smear in a three to five year lapse are more at risk of getting cervical cancer.
Although Flowers admitted that Latinas are not an homogeneous group –those who are second generation or have higher education levels are more prone to have check-ups regularly- most of them do not seek preventive care often.
But the lack of preventive care is not the only problem Latinas face. There's an increasing number of women without health insurance and Hispanics are not likely to have a medical home. Moreover, Latinas are twice as likely to live in poverty, according to Flowers.
An initiative is born
On the other hand, there's a lack of knowledge and ignorance among Hispanic women in regards to the risks of not seeking preventive care, said Flowers.
"It would normally take me 15 to 20 minutes to discuss a diagnosis with a patient. But with Hispanic women it was taking me up to 45 minutes," said Flowers, whose mother is Cuban.
Being aware of these conditions, Dr. Flowers approached the American Cancer Society (ACS) to see if they could develop a program to educate Hispanic women.
Along with Olga Lucia Jimenez, BTM State Public Education Senior Manager-SAD for the ACS, Flowers created a program to educate Hispanic women and their partners.
"We decided to include men because usually they only get second-hand information," said Jimenez.
Con Amor Aprendemos started on 2008, with the objective of educating couples in a comfortable, confidential setting where they feel can ask questions. During the sessions couples participate in different activities and exercises.
"We talk about basic issues and also explain many things in detail. We explain them that someone could have caught the virus many years ago, and not necessarily because they were unfaithful", said Jimenez.
The program is implemented by "promotoras de salud" (health promoters) that are trained by the ACS to teach the content. The seven-session workshops are usually taught at churches or through local groups.
Through its evaluation system, the ACS has determined that among Con Amor Aprendemos participants the levels of awareness about the importance of preventive care have raised.
But probably what motivates the creators of the program the most are the changes they're seeing in the couples that participate in the workshops.
"We have received very positive comments, specially from men. They are thankful that we included them and they appreciate what this course means for them as a couple," said Jimenez.
Uriel de Jesús Adame and Rosalinda Carrizales support Jimenez's claims. The couple took the class in Dalton, Georgia.
"We really liked the program and it has been very helpful," said Carrizales, from Mexico. According to her what they learned has been useful in raising their daughter.
Besides, she has shared what she has learned. "One day I started talking to my sister and my niece, and my sisters in law, and they all started to ask questions," she said. "We have never talked about this before and this helped us to have my nieces vaccinated and now I want to vaccinate my girl when it's time," she added.
Adame couldn't be happier. "I recommend this program. You learn a lot, meet new people and are more confident when asking questions to the doctor," said Adame, from Mexico.
For him this type of workshops are important. "Men want to be ‘machos' and they don't want to learn about illnesses. You are ashamed of talking about this," he said.
What we don't know
These are some of the misconceptions that Hispanics have about cervical cancer and HPV, according to Olga Lucia Jimenez:
- They don't know that Human Papillomavirus is transmited thorug sexual contact.
- They don't know that the virus can live their bodies for years without them even knowing,
- They don't have enough knowledge about the vaccine against this virus.
- They don't want to vaccinate their daughters because they think they're giving them permission to have sexual relationships.
- They don't know that HPV is a virus like any other and that it can infect young people as well.
- They don't know that the pap smear exam is used to screen for cervical cancer.
- They don't know the different parts of the female reproductive system.