Irma Torres loves her job. The 39-year-old Puerto Rican woman devotes the lion’s share of her energy to HIV counseling at Lyon Martin Women’s Health Services, a San Francisco clinic. Torres (profiled in the April 1996 POZ) works mainly with HIV positive Spanish-speaking women, giving them a leg up and over the language barriers of the health care system. Having tested positive in 1986, Torres takes a Crixivan/d4T/3TC combination and relieves stress by lifting weights; the last time she looked, her viral load was 14,000, her CD4s were 458 and she could press 100 pounds. Aside from the occasional diarrhea and fatigue, her meds don’t give her cause to worry—it’s the state of health care and prevention for Latinas and lesbians that gets Torres going. She talks with POZ about community, career and how she gave up cigs.

How does your work with other Latinas with HIV affect your attitude about your own health care?
Well, it’s obvious that I don’t work at Lyon Martin for the salary—I do it because it’s part of my healing process. Every woman I see is a mirror of me. The women I work with don’t always speak English, and a lot of them are undocumented immigrants. It’s very hard to get services for them. The discrimination against Latinos and Latinas is so obvious and open here in California. San Francisco might be a mecca of health services for gay men, but other than a few nonprofit organizations like WORLD [Women Organized to Respond to Life-threatening Diseases], women’s health just doesn’t get much attention at all.

For example, I have a client with AIDS who’s basically dying right now. When she first came here, she had been treated at a major hospital for a year and they’d never even given her a Pap smear. So we gave her one, and she had late-stage cervical cancer and didn’t even know it. That’s how bad health care is for Latina women. We need to learn how to use the system the same way the system has been using us.

One way you recently stopped being used by the “system” was by quitting smoking. What led you to give up cigs?
We have a quitting program at Lyon Martin called the Last Drag. Everyone wanted me to do it, but I was like, “I’m not gonna quit smoking—I like it. I’ve been smoking since I was a teenager.” But for the past five years I’ve had an HIV-related pulmonary disease called diffused infiltrative lymphocytosis syndrome, and I was hospitalized for breathing problems last Christmas. After that I said: “I have to quit. This shit is gonna kill me.” And I feel a lot better now. When I can’t breathe, I have to take steroids, and I hate steroids—they’re really bad. I get psychosis. I go crazy, lose memory, get out of control.

After being a dedicated smoker, how do you control your craving for nicotine?
It was clear to me that I needed help with physical withdrawal, so I’m using a patch. But in this program, the first thing we all do is write a list of 25 reasons why we want to stop. And every time I want to smoke, I just go back to my list again.
I know I’m gonna die sooner or later of AIDS, but I don’t want to die just because I didn’t quit smoking in time.

As a lesbian with HIV, how do you deal with lesbians who don’t want to hear about the risk of HIV infection?
I’m just very direct and honest. There’s a lot of denial in the lesbian community. Many women don’t want to talk about having sex with bi men or problems with alcoholism that may lead to risky behavior. And the community in San Francisco is so racially segregated—I feel like that’s the biggest problem we have. To be visible in this pandemic, you have to have some kind of unity within your community first.

I also work with a lot of women who identify as lesbians and who are prostitutes or active drug-users. These are the women no clinical studies reach. But with women like that, I don’t only talk about HIV—a lot don’t even know about basic health. I feel that women need to make a contract with themselves to be aware of their health situation. That’s what I’ve done, and I’m very proud of it.