When the Centers for Disease Control and Prevention released predictions of lifetime risks for different groups becoming HIV-positive, headlines focused on Black gay and bisexual men, who have a 50 percent chance of becoming positive in their lifetime. Those truly shocking odds make all others pale in comparison. But we must not dismiss the risks facing Latino men who have sex with men because of it, as they have a one in four chance of becoming HIV-positive in their lifetimes. One quarter of all gay and bi Latinos are predicted to become HIV-positive versus 9 percent (one in 11) White gay and bi men.
Lifetime risk for all Latin men is one in 48 (versus one in 132 for White men) and for Latinas it's one in 227 ( versus one in 880 for White women). That means Latin men are nearly 3 times more likely to get HIV than White men, and Latinas nearly 4 times as likely than White women, despite the fact that Latinx people represent only 17 percent of the U.S. population.
In a 2015 Morbidity and Mortality Weekly Report, the CDC revealed that Latinxs continue to bear a disproportionate burden of HIV despite declines in recent years. Between 2008 and 2013, the rate of HIV diagnoses in the Latino community fell from 28.3 to 24.3 per 100,000 individuals (from .0283 percent to .0243 percent).
But new HIV diagnoses among Latino men who have sex with men spiked during that same period, when, the CDC reported, the number of diagnoses attributed to male-to-male sexual contact increased 16 percent. The CDC was unable to ascertain if those higher numbers represent an actual increase in HIV cases, an increase in HIV testing in the gay and bisexual Latino community, or due to a combination of factors.
In 2012, CDC announced a dramatic decrease in the HIV infection rates (based on a 2009 survey) among injection drug users nationwide since it peaked at 18 percent in the 1990s. And the 2015 report showed the largest declines in new infections for both Latinx women and men were among those with HIV attributed to injection drug use.
Over 40 percent of the Latino population in American who are diagnosed as HIV-positive were born outside the U.S. HIV transmission routes among Latinos varied by place of birth. For example, Latino males born in Puerto Rico reportedly had a higher proportion of HIV infections attributable to injection drug use (24.9 percent) than those born elsewhere.
“In terms of injection drug use,” Elicia Gonzales, the executive director of the queer Latino organization GALAEI, told The Body, "Multiple systems of oppression impact black and brown bodies differently so that, to cope, one might turn to drugs. Undoubtedly, we have to consider the role that a failing school system, lack of adequately paying jobs [and] the prison pipeline all [play in] drug use and HIV transmission."
New male-to-male sexual transmissions accounted for the majority of new HIV infections among Latino males, irrespective of their place of birth, but ranged from a low of 53.6 percent among men born in Puerto Rico to a high of 86.4 percent of men born in South America.
The CDC concluded that "much work still needs to be done to reach Hispanics or Latinos at high risk for acquiring or transmitting HIV infection." The agency says it is pursuing "a high-impact prevention approach to maximize the effectiveness of current HIV prevention methods."
“Young black men, young Latino men are not on the radar of many of us,” Guillermo Chacon, president of the Latino Commission on AIDS, toldNew York’s Gay City News. “We need to do a better job to revisit, redesign, and reset the button on our strategy to engage these communities.”
"We fail to recognize and fund efforts to address social determinants that impact HIV and continue to insist on talking about individual risk factors for Latinos," Gonzales added, expressing mixed feels about the report and the impact it will likely have on policy. "When funding is only limited to getting someone tested and linked to care, we neglect that person's need for food, shelter, and clothing."
In their report, the CDC stresses the importance of considering language, service and economic barriers when developing HIV prevention interventions for diverse Latino communities. Language barriers and immigration status could have real impacts on efforts to reach this population, since the CDC estimated that “43 percent of Hispanics or Latinos who received an HIV diagnosis were not born in the United States or Puerto Rico.”
HIV prevention messages in English could be ineffectual and accessing medical care difficult. Although undocumented immigrants with HIV can qualify for Ryan White funds, they are barred from other governmental programs like Medicaid.
“This is the missing link,” Chacon said. “We need to deliver a message in English to U.S.-born Hispanics and in Spanish for foreign-born Hispanics… Our marketing among Hispanics that [only speak Spanish] is extremely weak and inconsistent.”