USCA 2014: Spotlight on HIV in Latino Communities

The U.S. Conference on AIDS (USCA)Exit Disclaimer got underway in San Diego yesterday and members of the HIV.gov team are among the participants. In the coming days, we’ll be sharing some highlights from the conference for those of our readers who are not able to attend.

In its 18th year, USCA is the largest AIDS-related gathering in the U.S. this year. Organized by the National Minority AIDS Council (NMAC)Exit Disclaimer, the conference has brought together over 2,000 individuals from all fronts of the HIV/AIDS epidemic—from case managers and physicians, to public health workers and advocates, people living with HIV/AIDS (PLWHAs) and policy-makers—to build national support networks, exchange the latest information, and learn cutting-edge tools to address the challenges of HIV/AIDS.

The conference opened with a plenary session that put the put the spotlight on HIV among Latinos in the United States.

HIV among Latinos in the United States

In 2010, according to the CDC, Hispanics/Latinos accounted for over one-fifth (21% or 9,800) of all new HIV infections in the United States and 6 dependent areas despite representing about 16% of the total U.S. population. Unpacking those statistics reveals further disparities. The majority of new infections among Hispanics/Latinos (87% or 8,500) were among men, and the majority of those infections(79% or 6,700) were attributed to male-to-male sexual contact. The estimated rate of new HIV infection among Hispanics/Latinos in the United States in 2010 was more than 3 times as high as that of whites (27.5 vs. 8.7 per 100,000 population).

The conference’s opening plenary, The Impact of HIV/AIDS in the Latino Community: A Silent Epidemic, put a spotlight on these concerning facts. Among the themes that emerged during the panel presentation were:

• HIV-related and other stigmas persist in Latino culture, even more than 30 years into the epidemic. As panelist Maria Mejia, an activist and peer educator who has been living with HIV for 25 years, observed, “Latinos are taught to keep things like HIV and sexuality in the family, a sort of “don’t ask, don’t tell” approach.” Unfortunately, she observed, this approach fosters stigma, shame, and taboos that prevent many Latinos from seeking HIV testing or accessing care if they have been diagnosed. Panelist Dr. María Luisa Zúñiga of San Diego State University’s School of Social Work noted that this not only leads to poorer health outcomes for Latinos living with HIV, it also increases the risk of HIV transmission because of undiagnosed or untreated infections..
• Community partners can be vital to the success of HIV services targeted to Latino populations. Panelist Lorena Borjas, a Latina trans woman advocate from New York observed that it is important to find community gatekeepers who will transmit messages that are are correct, appropriate, and non-judgmental. This is especially true, she emphasized, when programs seek to reach racial/ethnic minority trans women at risk of or living with HIV. Echoing this recommendation, other panelists encouraged more health care providers and HIV service organizations to seek or strengthen collaborations with such Latino organizations as part of any efforts to enhance outreach to and engagement of Latinos in culturally and linguistically appropriate services.
• Many Latinos face a complex mix of challenges that pose obstacles to HIV prevention, care, and treatment. Offering the perspective of a physician who delivers health care to Latino PLWH, Dr. Leandro Mena of the University of Mississippi Medical Center in Jackson, highlighted some of the particular challenges faced by his Latino patient population, including the fact that many are undocumented, only speak Spanish, and have low incomes, often including no insurance. He noted that his patients often come to care very late in the progression of their HIV disease, and once in care, they often reveal little knowledge about HIV transmission. Challenges to keeping his patients in consistent HIV care include the fact that taking time off for medical appointments can be both difficult and costly for those who often earn an hourly wage. Additionally, even if they want to try to stay in care, they often experience obstacles when trying to contact clinics to schedule or reschedule appointments, since few clinics have bilingual clerical or nursing staff to field such calls. Addressing this complex mix of challenges is particularly important in the southern U.S., Dr. Mena observed, since that region, according to the 2011 CDC HIV incidence data, has the highest percentage of Latinos with new HIV diagnoses of any U.S. region.

Among the actions panelists suggested to address some of these issues were targeted, culturally and linguistically appropriate social marketing efforts about HIV testing and treatment. As Dr. Mena remarked, “There is no doubt that social marketing is powerful in terms of generating awareness about HIV which can drive people to seek testing or access care.” His comments underscore the importance of education campaigns such as CDC’s new HIV prevention campaign, “We Can Stop HIV One Conversation at a Time” (Podemos Detener el VIH Una Conversación a la Vez). This national communication campaign encourages Latinos to talk openly about HIV/AIDS with their families, friends, partners, and communities as one means of helping to reduce new HIV infections and decrease HIV-related stigma. Another bilingual CDC campaign is Reasons/Razones, which encourages HIV testing among Latino gay and bisexual men.

The panelists’ thoughtful reflections and recommendations were reminders of the importance of developing a fuller appreciation of the various obstacles to HIV prevention, care, and treatment experienced by each population that is disproportionately impacted by HIV, so that these can be addressed as we work to identify and implement solutions that bring us closer to achieving the goals of the National HIV/AIDS Strategy.