One of the difficulties that exist within the Puerto Rican (and possibly Hispanic) population is that women are born into a power structure where they may feel like they have no control in their relationship (31). Another problem with these tricky relationships is that at times the woman feels that if she speaks up about safer sex, her partner may leave especially when there is already suspicion involved (31). These women value their relationship more than their personal safety (31). In another study performed in 1988, Latina women believed AIDS to be a white problem (32).
A major factor that complicates the situation is that Hispanic women are expected to rely on their husbands for sexual knowledge (32). The problem is that in general women are the ones with the positive attitudes about condom use and in Hispanic society, that concern is mitigated by their being a male dominated culture (33). The cause for concern is heightened by the results that showed Hispanics as having the lowest belief that they could actually avoid AIDS (33). An interesting detail that another study found was that Hispanics women who come to the United States acculturate to the less traditional sexual norms (34). Consequently, because these women come from other countries the immigrant population should be noted in any prevention plan (34).
The culture for Hispanic men translates to more than one third of Spanish-speaking Hispanic men having multiple partners in a study (33). Almost half of English-speaking Hispanic men reported having multiple partners (33). It is safe to assume that as a Hispanic becomes more acculturated, they will be more open to having more partners. The women in the other half of these relationships get the short end of the stick because they use condoms less assuming that they are the sole partner, while in actuality, their male counterparts reported high rates of multiple partners (33). As mentioned before the women are in a bind because they may suspect infidelity, but if they value their relationship, they may not want to risk damaging their relationship (35). Due to these concerns, women at times avoid the issue of condom use. The numbers for married men are promising either. 18% of married Hispanic men and 9% of married white men reported having multiple partners (35). The cause for concern still exists since Hispanic men are twice as likely to be sleeping around and thus are at higher risk for AIDS.
Another difficulty lies in the fact that at times Hispanic women as well as black women are unaware that their partners may see themselves as heterosexuals who have occasional homosexual partners (36). It does not help that women born in Puerto Rico/the Dominican Republic were less like to utilize condoms (37). Each of these problems build on each other and make AIDS prevention that much more difficult. Even in a public health campaign that was implemented for 2 years, the Hispanic population in the survey continued demonstrating a lack of knowledge about AIDS (38). The lack of knowledge was evident when some in the sample thought that teenagers could not get AIDS and that a vaccine existed (38).
The other population to target is adolescents and they face more problems than their adult counterparts. Not only are the minorities still the ones facing the bulk of the problem, reaching out to them is difficult. Some parents may question the readiness of their children to learning about sexual diseases because indirectly they will be exposed to sex. Yet studies have shown that the younger adolescents were the more they delayed condom use (39). This just shows the need for earlier education so as to protect the population that is the future. Other studies have also mentioned the need for the younger generation to make an impact (40). If the younger generation can change then in a few decades, those new behaviors will stick.
Regardless of the subgroup, minorities in general face stigma and there has always been some level of mistrust of the government. In the African American populations, participants in a study did not trust medical research because of Tuskegee (41). Another study echoed similar sentiments regarding dealing with the medical system or government agencies (42). Though the Hispanic population was not directly affected by Tuskegee, they feel the same ways about the government and its representatives (43). All these barriers make are up and thus there is still room to improve programs to more effectively target the at-risk populations. Realistically, we can never get rid of AIDS without confronting IV drug abuse, STDs, and teenage pregnancy (43). It would be difficult for a program to simultaneously target all those groups and thus a real solution may not exist for fifty or more years.