AIDS Hotline Signs on Deaf Consumers 

By Jennifer Brooks


Closing the Gap, Disabilities • October/November 1999


Deafness/hard of hearing is the second most common chronic health 

condition in the United States. More than 28 million Ameri 

cans have some form of hearing loss, and 80 percent of those have 

irreversible and permanent hearing damage, according to the National 

Association of the Deaf. Yet the deaf community is an underserved “subculture” that often relies on other deaf people for health information. 

The Centers for Disease Control and Prevention (CDC) established a 

National AIDS Hotline TTY Service to provide confidential and reliable 

information on HIV/AIDS and other STDs to the deaf community. This 

service is the only one of its kind in the country. 

The following is an interview with Chad Ludwig, BSW, senior 

supervisor of the TTY Service. 

Q:	 Does the deaf community have special needs when it comes to 

obtaining health information? 

Chad: The deaf community is broken into sub-groups that have a 

variety of special needs when it comes to obtaining health information. It could be through written communication, TeleTYpe (TTY) 

communication, community’s grapevine, using interpreters, speech 

reading, verbal communication, and signed communication. But not 

every member within the deaf community is fluent in each of the 

modes of communication as mentioned. 

It is the responsibility of each party to ensure that the health 

information is accessible. Normally, members within the deaf community are aware and familiar with the best methods of gaining health 

information. Health care providers should be attentive to their patients and make an attempt to fulfill their needs in obtaining health 

information. 

Q:	 What barriers to prevention and treatment information do deaf 

people face? 

Chad: The health care community either isn’t willing, doesn’t have the 

option, or lacks the resources or information to have the ability to 

fulfill the service needs of members within the deaf community by 

providing the health information. One report states that the average 

reading level among members of the deaf community is between the 

4th and 5th grade levels. Many magazines, newspapers, captions on 

TV, brochures, and other information sources are written in English 

well above this reading level. This is another barrier to health information across the deaf community. 

It is important to note that more than half of the United States 

has recognized American Sign Language (ASL) as a foreign language. 

The ASL is commonly used by deaf people as their first language. 

The ASL is a visual language, and the way to express the information 

is a lot different than spoken English. To attempt to mix the spoken 

English language and ASL creates yet another barrier. 

For example, a doctor had an interpreter present 

with a deaf patient who is living with HIV. The patient 

questions if he needs to finish his bottle of medicine. The doctor 

explained that he must finish it. The patient came back to the doctor 

for his quarterly visit and the doctor asked how he doing with the 

medicine. He said that he had finished it a while ago. The doctor 

questions why he didn’t have it refilled. He explained that he thought 

he only had to finish one bottle of pills and not the refills. This type of 

misunderstanding that had occurred between the patient and doctor—an information communication barrier—raises concern about 

the patient’s health. 

Q:	 What is the deaf community’s most common vehicle for obtaining information? 

Chad: A common vehicle for getting information to the deaf community is through the community grapevine. The grapevine may be 

viewed negatively, although it is very useful for many members within 

the deaf community.There are some members that don’t have access 

to written information. There are some members who are educated in 

certain specialties. There are some members who are actively involved 

in other areas. These members attend social gatherings, club meetings, 

and main events and would exchange information among the members so that the information could be constantly updated among 

themselves. 

There are also many electronic bulletin boards, newspapers, magazines, and videotapes that are used to disseminate the information 

among deaf community members. 

Q:	 Are deaf people more or less at risk for HIV/STDs than other 

populations? 

Chad: Some research has shown that “high rates of substance abuse 

exists among the deaf community, one in seven (1 in 7) deaf persons 

has a history of substance abuse, compared to one in ten (1 in 10) in 

the hearing population.” Substance abuse can be a risk factor for HIV 

by lowering inhibitions and impairing judgement, which can lead to 

unsafe sexual behaviors. Sharing injection equipment is also a risk for 

HIV transmission. (See “What are risk factors for HIV?” in the University of California, San Francisco Center for AIDS Prevention Studies 

fact sheet, What are deaf persons’ HIV prevention needs?) 

Given that information, auditory and communication barriers 

could create risks for members of the deaf community to become 

infected with HIV/AIDS and sexually transmitted diseases (STDs). If 

a member cannot access spoken English and/or comprehend the English language, this could increase the risk of becoming infected with 

HIV/AIDS and STDs. 

continued>>>> 

Office of Minority Health Resource Center	 1 U.S. Department of Health and Human Services 
AIDS Hotline Signs on Deaf Consumers 

By Jennifer Brooks


Closing the Gap, Disabilities • October/November 1999


Q:	 Are deaf people discriminated against in health care? As with 

many minority groups, is cultural competency an issue among 

deaf people trying to obtain health services? 

Chad: Discrimination occurs when a health care professional refuses 

to fulfill a deaf person’s communication needs such as providing an 

interpreting service. Some deaf people attempt to obtain the health 

service and are refused just because they don’t know the resource, 

information, or who to contact. 

Some deaf people attempt to contact the health service by using 

the relay service, but are hung up on just because the health care 

facility was not able to handle the relay call or felt that it would take 

too much of their valuable time. And, a cultural issue may arise when 

language and/or communication becomes a barrier between a deaf 

person and a health care provider—this would make a deaf person feel 

that the service is not adequately fulfilling his or her needs. 

Q:	 How does the CDC National AIDS Hotline TTY Service address those issues and meet the health information needs of the 

deaf community? 

Chad: The CDC NAH is available as an information, resource, referral, and technical assistance service. It contributes to health care by 

providing a better service to the members within the deaf community. 

Q:	 Do you do any outreach to deaf minorities? 

Chad: Yes, the CDC NAH does outreach to the deaf minority community by promoting materials via the electronic mail, Internet, newspapers, magazines, newsletters, mass mailings, mass e-mails, video conferences, group calls, classroom calls, and by participating in the deafrelated events such as conferences and community gatherings. By 

doing so, we increase the visibility that allows the deaf community to 

use the CDC NAH as an information, resource, referral, and technical 

assistant. 

Q:	 How does someone access the Hotline? 

Chad: Callers can access our service by using TeleTYpe (TTY) equipment. TTY is equipment that allows the individual to place a call to 

another party who has TTY equipment and/or using the Relay Service to get connected to another individual who doesn’t have TTY. 

The TTY is a machine that allows an individual to effectively communicate the information to a person on another end. To access the 

CDC NAH’s TTY Service, one needs to use either TTY or relay 

service to get through to the TTY operator. 

More information: The CDC NAH is operated under contract 

by the American Social Health Association (ASHA). 

For further information write to P.O. Box 13827, Research Triangle Park, NC 27709, or browse the Web site: http:// 

www.ashastd.org; or the teen Web site: http://www.iwannaknow.org. 

Access the hotline at 1-800-AIDS-TTY; 919-361-8454 TTY; 919­

361-8484 TTY2; 919-361-4855 FAX 

Note: between December 15th and the end of this year, the 

ASHA will be launching a new, video-enhanced Web site which allows ASL users to click on the Internet and be able to view signed 

information and prevention messages on HIV/AIDS. 

In addition to his role at the CDC National AIDS Hotline, Chad 

Ludwig is chair of the National Coalition on Deaf Community and 

HIV/AIDS (NCDH). He can be contacted by e-mail at: 

chadludwig@earthlink.net. The NCDH’s address is - Dann Trainer, IV; 

NCDH Secretary; PO Box 8401; Minneapolis, MN 55408.

CDC National AIDS Hotline TTY Service 

Many people have questions about HIV/AIDS and don’t know where to get answers. The CDC National AIDS 

Hotline TTY Service can help. 

•	 Trained staff are available to answer questions and talk about HIV and AIDS and other sexually transmitted 

diseases. 

•	 They can mail informational brochures that explain details about HIV and AIDS testing, prevention, and more. 

•	 They can put people in touch with many different services all over the country. 

1-800-243-7889 • All calls are free and private. 

Office of Minority Health Resource Center	 2 U.S. Department of Health and Human Services