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"Down low" is a term coined by African-American men who have sex with other men but don't consider themselves gay. Delgado believes that attitude has also contributed to many of his clients not returning to learn test results. "It's their baggage -- they don't want to identify with the homosexual community," he says. "Haitians are even more closeted. I've been trying to start a Haitian gay men's support group but it's impossible."
Delgado says another problem is undocumented immigrants who are afraid the government will find them if their infection is confirmed; they also mistakenly believe they won't be able to receive medical services because of their illegal status. "There's still a lot of ignorance," he notes. The clinic is now trying to induce more people to return for results by testing for HIV, hepatitis, and syphilis in one session (syphilis infection has increased exponentially in South Florida over the past couple of years).
Another problematic issue for Delgado is age. Although much of the focus of AIDS prevention is on young people, the actual statistics show that older individuals are more likely to carry the disease. According to county health department statistics (October 2003), people under 30 make up less than 17 percent of AIDS cases in Miami-Dade County, and about 24 percent of HIV cases. People between the ages of 30 and 60 account for 78 percent of AIDS cases and 71 percent of HIV cases. "I feel like we neglect those people," he says. "We don't identify them as a risk group and so we don't pay as much attention to them." www.dadehealth.org/hiv/HIVservices.asp