It wasn’t until recently that the U.S. government began to collect data on Latina health, according to the Hispanic Health National Alliance. In fact, before 1989 there weren’t any government statistics about the causes of death among Hispanics in general, much less about the undocumented.

And although it implied researching a topic with little to no precedent studies, Dominican University student Fanny Martinez chose to study the healthcare experiences of local undocumented Latinas over the span of two years, for a research methods class thesis.

Martinez, who is now a recipient of a full-tuition scholarship to the University of Chicago’s The Harris School of Public Policy, conducted lengthy interviews with twelve local undocumented Latinas of Mexican descent between the ages of 19 and 53.

She questioned their experience of immigration, family and intimate relationships, employment, education and reproductive health and evaluated the barriers and opportunities they face when using reproductive healthcare services in the Chicago metropolitan area.

The concept behind the study began as a personal matter for Martinez.

“My husband is a U.S. citizen and he lost his job. So we didn’t have insurance anymore about two years ago. I was worried because I didn’t know what I was gonna do in terms of birth control. I wondered how other women dealt with the same situation,” said Martinez who had to get permission from the Institutional Review Board for her study.

“It was a long process because it was research on a population that is doing something illegal and because I was dealing with a lot of intimate questions,” said Martinez. “One of the questions was “How do you feel after you had sex for the first time?”

She explained that usually to conduct a study the researcher needs to get permission from human subjects through a waiver that they sign.

“But I couldn’t do that because I couldn’t have any documentation of the women. An agent might recognize a name or the location of where they live and find them,” said Martinez. She used codes for names and took oral consent from the women instead.

Her findings show that barriers like cultural norms; lack of employment and economic instability, inadequate communication, lack of support from relatives and legal barriers because of their undocumented status prevented the women from addressing their personal healthcare needs. In many instances the women had access to affordable healthcare but were misinformed or uninformed about mainstream health topics.

“A lot of them got a mammogram or a Pap smear because ‘la comadre’ or a friend got one and told them about it,” said Martinez. “One of them was not even sexually active and she got HIV exams every year. If they saw ads on TV or the news about getting tested they will go ahead and do it.”

Another question Martinez asked the women in the studywas – “When you think about reproductive health, what comes to your mind?”

She said many had no idea what it was - including herself before she conducted the study - and the rest thought about pregnancy, but none of them thought of birth control, HIV, Pap smears, sexual education or sexual activity.

Martinez asked the women questions about their sexual experiences like the first time they had sex, their use of birth control, pap smears and mammograms in the past. She tried to use a lot of questions that would encourage them to talk about how they felt about the services and why they didn’t use the services.

Lack of time, shame in getting undressed in front of doctors and guilt from family were some of the reason the women cited for not acquiring medical treatment.

“Some mentioned that they couldn’t get reproductive services when they went with their mom. Whatever they do has to be behind their back. One of the women in the study stopped taking The Pill because she was afraid that her mom would find out,” said Martinez.

At the end of her report, Martinez also offered policymakers and community healthcare providers recommendations to help undocumented Latinas and Latinas in general, to gain better understanding and access to proper healthcare.

“If other counties can do something like Access DuPage [a local program that offers low-income, medically uninsured residents healthcare services] that would be great,” said Martinez. “Community-based organizations should develop free workshops too and healthcare providers should continue to have bilingual staff because this would really help the women.”

Breast Exams

Breast cancer is the most common non-skin cancer in women and the second leading cause of cancer death in women in the United States. Every woman is at risk, and this risk increases with age. Breast cancer can usually be successfully treated when found early. 

- A mammogram is a low dose X-ray that shows the inside of your breasts. During a mammogram, two smooth, flat plastic plates are placed around one of your breasts to flatten your breast tissue. Flattening your breast provides the best exam using the lowest dose X-ray. If you have menstrual periods, have your mammogram during the week after your period when your breasts are less tender. 

- Women age 40 and older are eligible for a screening mammogram every 12 months through Medicare. Tests are free. 

- If you have a lump in your breast, a normal mammogram is not enough testing to make sure the lump is not cancer. 

- Your risk of developing breast cancer increases if any of the following are true: You had breast cancer in the past,have a family history of breast cancer, had your first baby after age 30, have never had a baby. 

HIV Screening 

AIDS is a disease that causes the body to lose its natural protection against infection. AIDS is caused by a virus called HIV, or Human Immunodeficiency Virus, which attacks certain white blood cells that protect the body. 

-The HIV virus is found in the blood, semen and vaginal secretions of infected persons and can be spread in the following ways:Having vaginal, anal or oral sex with an HIV-infected person, sharing drug needles or syringes with an HIV-infected person,from an HIV-infected woman to her baby during pregnancy or during birth, or from an infected mother to her baby during pregnancy or when breastfeeding. 

-An HIV antibody test is a blood or oral test that can determine whether antibodies to HIV are present in a person’s body. Antibodies are produced after infection with HIV. There is no test for AIDS itself. 

- A positive result means you have HIV infection. You are infected for life and can spread HIV to others. You are likely to develop AIDS, but no one can know when you will get sick. 

-Medicare covers free HIV screening for pregnant women and anyone who asks for the test. They cover the test once every 12 months, or up to 3 times during a pregnancy. 

- Anonymous or confidential counseling and testing are available at many health departments and community agencies, including some outreach testing sites.

Cervical and Vaginal Exams 

Cervical cancer is treatable if detected early. There are often no noticeable symptoms, so it is important that women get screened regularly and have a Paptest. The test can find any abnormal changes that could turn into cancer. 

-A Pap test is used to examine cells collected from the cervix. The cervix is the lower, narrow end of the uterus or womb and opens into the vagina or birth canal. A sample of cells is taken from in and around the cervix and placed on a slide for later viewing in a lab. Collecting cells from your cervix is not painful.

- Women should begin to have yearly Pap tests at 18 years of age or when sexual activity begins. The best time of the month to have a Pap test is between 10 and 20 days after your last period started. If you no longer have periods, the Pap test can be done anytime. 

- Medicare covers Pap tests and pelvic exams once every 24 months, or once every 12 months for women at high risk. Tests are free. 

-Your risk for cervical cancer increases if any of the following are true: You have had an abnormal Pap test, have had cervical or vaginal cancer in the past, have a history of sexually transmitted disease, began having sex before age 16, have had many sexual partners, your mother took DES (Diethylstilbestrol), a hormonal drug, when she was pregnant with you. 

- The Illinois Breast and Cervical Cancer Program offers free mammograms, breast exams, pelvic exams and Pap tests to women living in Illinois without insurance who are 35 to 64 years old (some younger women may be eligible.)

(Fuente/Source:U.S. Department of Health and Human Services, Illinois Department of Public Health)