For more than four decades, the fight to end the HIV epidemic has raged on, ushering significant developments and innovations in treatment and care. However, progress has been uneven and fragile, illuminating major disparities in care and access to care that leave certain demographics disproportionately burdened by the impact of HIV and AIDS; highlighting a growing health crisis within the Latinx community.
New data shows that, while overall HIV diagnoses have decreased or plateaued in recent years, HIV diagnoses among Latinx gay and bisexual men have continued to increase, directly impacting more than 195,000 Hispanic/Latinx men in the U.S. and its territories, including Puerto Rico.[i] This data shows the standard of care is not benefitting everyone equally.[ii]
For many Latinx men living with or affected by HIV or AIDS, this disparity is rooted in a number of social and cultural factors outside of their control, including long-standing and systemic issues such as poverty and unequal access to education, housing and reliable, safe public transportation that impact health outcomes across the board.[iii] Additionally, clinics and organizations often are unable to provide health education materials or translational services to the more than 37 million Spanish-speakers estimated to live in the U.S.[iv] The lack of culturally responsive and language-appropriate healthcare providers and materials create both a practical and psychological barrier to care.
“When I first started working in the HIV space, I was the only LGBTQ person on staff – the only one who knew and understood what being gay and Latino in our community felt like and looked like. My being there shaped and changed the way we delivered our services,” says Elias Diaz, LMFT, Mental Health Clinician, Maverick County Hospital District. “The men we support tell stories about their experiences living with HIV that share common themes; stigma around their diagnosis and being LGBTQ, lack of emotional supports, in some instances, dependency on drugs. They struggled to find resources that reflected their experiences. What was being done with and for the LGBTQ Latinx community just wasn’t enough.”
Fear and stigma associated with a positive diagnosis are compounded by the dynamic forces of family, religion, culture, economics – all of which are further exacerbated by anti-immigrant sentiment toward the Latinx community. These factors contribute to discrepancies in services offered to Latinx men leaving them to shoulder a greater burden that extends beyond their diagnosis and medical care.[v]
To address these needs, community leaders and advocates agree on the importance of maintaining a pulse on the evolving landscape for and needs of Latinx gay, bi and trans men of all ages from different neighborhoods, economic situations and immigration statuses. A new report, “Here As I Am/Tal Como Soy” from ViiV Healthcare’s Positive Action for Latinx Men program, uses insights derived from a community-guided Listening Initiative to investigate how social, economic and political forces affect the health and well-being of Latinx men and influence access and adherence to care for those living with HIV. Conducted over the course of 10 months, the report features first-hand stories from members of the community that help to identify and fuel solutions that make a difference in the lives of Latinx men living with and affected by HIV.
“As HIV and AIDS diagnoses are continuing to rise within our communities, we [are] sounding alarms to demand change. I [have] seen too many people who are fearful of following up with their healthcare providers in HIV care because of inadequate healthcare infrastructure and lack of culturally responsive services. This, coupled with internalized fear and shame within our community, is creating an obvious barrier to care and is a threat to our survival,” says Miguel Ángel (former Advocacy Associate Manager at NMAC). “As leaders and advocates who have been working in this space for many years, [we are] taking the lead by bringing our voices and needs forward to engage providers and policymakers in solutions to improve our access to care through ensuring all prevention initiatives consider language justice and many other unique needs of the Latinx community.”
To learn more about Here As I Am/Tal Como Soy and ViiV Healthcare’s commitment to community-driven solutions through the Positive Action for Latinx Men initiative, and to read the report, available in both English and Spanish, visit: bit.ly/2Tbc2IU.
[i] Centers for Disease Control and Prevention. Diagnoses of HIV Infection in the United States and Dependent Areas. HIV Surveillance Report (updated). 2018, Vol. 31, page 59. Published May 2020. Accessed May 8, 2020.
[ii] MPact. National Call to Action: Addressing the HIV crisis among Latinx gay, bisexual men and other men who have sex with men. MPact Global Action website. Published 2019. Accessed March 2, 2020; O’Neill Institute. Bolstering Latinx Gay and Bisexual Men to Promote Health and Reduce HIV Transmission. Georgetown Law’s O’Neill Institute website. Published March 2019. Accessed March 2, 2020.
[iii] For example: Ramirez, A., Aguilar, R., Merck, A., Sukumaran P., Gamse C. The state of Latino housing, transportation and green space: A research review. Salud America website. Published May 14, 2019. Accessed March 2, 2020.
[iv] Pew Research Center. Use of Spanish Declines among Latinos in Major U.S. metros. Pew Research Center website. Published October 31, 2017. Accessed on March 2, 2020.
[v] Centers for Disease Control and Prevention. Diagnoses of HIV Infection in the United States and Dependent Areas. HIV Surveillance Report (updated). 2018, Vol. 31, page 102. Published May 2020. Accessed May 8, 2020.