SIGN THE CALL TO ACTION: Addressing the HIV Crisis Among Latinx Gay and Bisexual Men in the United States

Published: February 21, 2019

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BACKGROUND

In the United States (U.S.) and dependent areas in 2017, the majority (70%) of diagnosed HIV infections were among gay and bisexual men.  In the same year, 26% of all new HIV diagnoses were in the Latinx community; of those, 78% were among gay and bisexual men. Between 2012-2016, new HIV diagnoses among Latinx gay and bisexual men increased 12%; the greatest increase occurred in men between the ages of 25 to 34 (a 22% increase).  Although Latinx gay and bisexual men would benefit from biomedical interventions such as preexposure prophylaxis (PrEP), only a small percentage of these men have access. [1]

Geographically, rising diagnoses of HIV among Latinx gay and bisexual men are mainly localized in seven jurisdictions.  From 2010-2014, 84% of the increase in HIV diagnoses among Latinx gay and bisexual men was in six states –  Arizona, California, Florida, Illinois, New York, and Texas – and Puerto Rico. [2] Moreover, statistically significant increases were observed in the following jurisdictions within each of the states: (1) Phoenix; (2) California jurisdictions other than Los Angeles, San Francisco, San Diego, Oakland and Sacramento; (3) Miami, Tampa, and Florida jurisdictions other than Miami, Fort Lauderdale, West Palm Beach, Orlando, Tampa, and Jacksonville; (4) Chicago; (5) San Antonio and Texas jurisdictions other than Houston, Dallas, Fort Worth, Austin, San Antonio, and El Paso.

In 2015, among all U.S. Latinx people living with HIV, only 59% received HIV medical care, 49% were retained in HIV care, and 50% had a suppressed viral load.[3] Access to HIV care and treatment services is seriously compromised for Latinx gay and bisexual men by stigma, homophobia, and discrimination.  Today the situation is worsened by:

  1. Persistent U.S. Immigration and Customs Enforcement (ICE) raids that demonize and criminalize immigrant, migrant, and undocumented communities and violate their human rights. [4]
  2. Receding support for the Affordable Care Act (ACA), reduced funding for Ryan White HIV/AIDS Care Program and Medicare expansion. These universal health programs provide access to life-saving medications and the ability to prevent new infections to uninsured, low-income and undocumented people. [5]
  3. A National HIV/AIDS Strategy (NHAS) that lacks a proactive vision for addressing the specific needs and concerns of Latinx gay and bisexual men.  Missing from the numerous iterations of the NHAS are indicators or targets specific to addressing this crisis. [6]
  4. Local planning bodies that insufficiently engage Latinx gay and bisexual men and/or fail to prioritize community-led comprehensive sexual health and prevention programs, that include unfettered access to PrEP. [7]
  5. The lack of, or severely underfunded, community-led Latinx programs and organizations that deliver stigma-free, culturally/linguistically competent, evidence-informed and rights-based, comprehensive sexual health programs, inclusive of PrEP and PEP, as well as mental health, substance use, legal other support services. [8]

If current trends continue, 1 in 5 Latinx gay and bisexual men will be diagnosed with HIV during their lifetimes. [9]

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A CALL TO ACTION

We must address both the HIV service needs of Latinx gay and bisexual men in all parts of the country AND the need to fully fund and scale-up tailored prevention efforts where new HIV infections are rising. In response to increases in HIV incidence and the structural barriers to service access among Latinx gay and bisexual men, we call on allies, policy makers, funders, and public health officials at the local, state and national levels to:

  1. Publicly denounce any anti-immigrant initiatives/laws. Develop action plans and implementation guidelines for ensuring unimpeded access to services for Latinx gay and bisexual men regardless of immigration status. This includes opposing changes to Public Charge rules. [10]
  2. Include targets for Latinx gay and bisexual men and other men who have sex with men across ALL indicators in the National HIV/AIDS Strategy (NHAS) update, in close consultation with community leaders.
  3. Prioritize the HIV prevention and treatment needs of Latinx gay and bisexual men in the End the Epidemic Initiative, especially in focus jurisdictions experiencing increases in new HIV infections.
  4. Direct increases in domestic HIV funding to Latinx gay and bisexual men’s programs and organizations that provide comprehensive, community-led prevention programs that include PrEP and PEP.
  5. Increase funding for the Ryan White HIV/AIDS Program and support Medicaid and Marketplace reforms that advance universal health coverage and reject health care reforms that result in increased uninsured rates and reduced access to medically necessary prevention, care and treatment services. [11]
  6. Create guidelines for state and local health department HIV planning bodies that address recruitment, engagement, retention, and leadership development practices that are culturally/linguistically competent to ensure the full participation of Latinx gay and bisexual men.
  7. Fund comprehensive (one-stop-shop) stigma-free, culturally/linguistically competent, evidence-informed and rights-based programs that include HIV/STI testing, prevention, care, and treatment, mental health, substance use, legal and other support services.
  8. Meaningfully support the leadership pipeline by funding training and learning exchanges, creating safe professional development spaces, and creating leadership positions and other jobs for young Latinx gay and bisexual men in the HIV sector.

SIGN ON TO THE NATIONAL CALL TO ACTION

A SHOUT OUT TO OUR ALLIES

… who are federal policy makers and funders: KEEP LATINX GAY AND BISEXUAL CENTRALLY VISIBLE. Fully engage Latinx gay and bisexual in the articulation of goals and indicators – for both the End the Epidemic Initiative and updates to the NHAS.

… in the Latinx community: PRIORITIZE LATINX GAY AND BISEXUAL MEN in HIV-related prevention, care, treatment and support services.

… in the mainstream HIV/AIDS and LGBTI communities: VISIBLY ELEVATE LATINX GAY AND BISEXUAL MEN. Our needs are distinct and merit respect and focus.

STAND IN SOLIDARITY WITH LATINX TRANSGENDER WOMEN AND MEN

We love and support our trans brothers and sisters.  Any comprehensive response to heal Latinx communities and effectively address HIV requires that we give space for them to articulate their own needs and grievances.  It is not our place to speak for them.  Nonetheless, we recognize that the challenges Latinx gay and bisexual men face in American society often intersect with those experienced daily by trans people.  We support Latinx trans people in their efforts to articulate their needs and we stand in solidarity with them and are ready to assist in their efforts to demand respect, safe spaces, support, and action so that all Latinx and other trans people can live long, happy, meaningful and safe lives.

SIGN ON TO THE NATIONAL CALL TO ACTION

Latinx Gay and Bisexual Men’s HIV Prevention and Treatment Action Coalition

Moises Agosto, NMAC

Kevin Al Perez, Somos Familia Valle

Alex Aldana

George Ayala, MPact Global Action for Gay Men’s Health and Rights

Adrian Castellanos

Edwin Corbin-Guitieerrez, NASTAD

Homero E. Del Pino, Charles R. Drew University of Medicine and Science

Oscar De La O, Bienestar Human Services, Inc.

Jorge Delos Santos, TruEvolution

Elias Diaz, Maverick County Hospital District

Angel Fabian, MPact Global Action for Gay Men’s Health and Rights

Sergio Farfan, Louisiana Latino Health Coalition for HIV/AIDS Awareness

Julio Fonseca, AIDS United

Jose Ramon Garcia Madrid, Union Equals Fuerza: The Latinx Institute

Alex Garner, Hornet

Carlos Gomez, Bienestar Human Services, Inc.

Jose Javier

Oscar Lopez, Valley AIDS Council

Adan Martinez

Louie Ortiz-Fonseca, Advocates for Youth

Alexander Perez, NASTAD

Marco Antonio Quiroga, Our Fund Foundation

Leandro Rodriguez, Latino Commission on AIDS

Carlos Rodriguez-Diaz, George Washington University

Francisco Ruiz, Centers for Disease Control and Prevention

Pedro Alonso Serrano, Cook County Health

Beto Soberanis, McDermont Haymarket Center

Jorge Vidal, Vera

SIGN ON TO THE NATIONAL CALL TO ACTION

 

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The National Call to Action Adressing the HIV Crisis Among Latinx Gay and Bisexual Men has been endorsed by

Pamela Foster, AframSouth, Inc.
Eduardo Ramirez, Aguilas El ambiente

Eduardo Morales, PHD, AGUILAS of San Francisco
Toure Claver, ALTERNATIVE CÔTE D’IVOIRE
Luis Torres, ANDISEX
Jeffry Acaba, APCASO

Leila Charlemagne, Borinquen Medical Centers
Ilia Otero, Center for Evaluation and Sociomedical Research
Mukiibi Henry, Children of the Sun Foundation Uganda LTD
Pedro Serrano, Cook County Health/Hektoen Institute of Medicine

Damiàn Cabrera-Candelaria, Directorio de Servicios LGBTQ de Puerto Rico
Yolandra Hancock, George Washington University
Harrison Mwima, GIRL INSPIRATION GROUP-ZAMBIA
Samuel Obeng, GN Media (Ocean 1TV)
Martha Villanuevam, Grupo Safo
Tamara Henry, GWU
Ben Collins, International HIV Partnerships (IHP)
Ivan Fredrick Kasonko, Key Populations Uganda
Idrisa Saad, KUCHU SHINERS
Manuel Diaz-Ramirez, La Clinica del Pueblo, Inc.

Wuilmer Diaz, Latino Comission on AIDS

Nelson Silverio, Latino Comission on AIDS

Estefania Amparo, Latino Commission on AIDS/ Oasis LGBTS Wellness Center
Patricia Bermudez, Latino Outreach and Understanding Division (LOUD)
Elie Ballan, M-Coalition
Sonya  Arreola, MPact
Johnny Tohme, MPact

Nadia Rafif, MPact
Jose J. Martinez-Velez, NY Department of Health

Joe Hawkins, Oakland LGBT Community Center

Carlos Candido, Prosa Asociaciòn

Christopher Cuevas, QLatinx
Javier Hourcade Bellocq, Quiero PrEP
Joseph Saidi, Rainbow Sunrise Mapambazuko
Russell Roybal, San Francisco AIDS Foundation
Musa Sibindi, Sexual Rights Centre
Kevin Perez, Somos Familia Valle
Omar Martinez, Temple University
Mark Brennan-Ing, The Cat’s Meow Consulting Services
Armonte Butler, The Gran Varones
Cuauhtemoc Peranda, The House of Lauren
Bamby Salcedo, The TransLatin@ Coalition
Adriana Garriga-Lopez, Todo Kalamazoo con Puerto Rico
Shadreck Lenny Nasho, Trans and Intersex Rising Zimbabwe

Nana   Millers, Trans Youth Initiative – Uganda(TYI-Uganda)
Cecilia  Chung,  Transgender Law Center

Rich Guasco, TPAN
Andrew Spieldenner, United States People living with HIV Caucus
Professor Gibran, Guido University of California, San Diego
Isar Godreau, University of Puerto Rico
Rafael  Rivera-Quinones, University of Puerto Rico, Medical Sciences Campus

Luis Arroyo-Andujar, University of Puerto Rico, Medical Sciences Campus

Robert Cooke, Washington DC Regional Planning Commission on Health and HIV Consumer

Andrea Ngo
Allan Muhaari
Jean-Christophe Bégué
Ejay De Wit
Jessica Xavier
Jeremy Kwan
Abigail Blanchfield

SIGN ON TO THE NATIONAL CALL TO ACTION

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[1] HIV prevention pill not reaching most Americans who could benefit – especially people of color. https://www.hiv.gov/blog/hiv-prevention-pill-not-reaching-most-americans-who-could-benefit-especially-people-color March 6, 2018.
[2] McCree DH, Walker T, DiNenno E, et al. A programmatic approach to address increasing HIV diagnoses among Hispanic/Latino MSM, 2010-2014. Preventive Medicine. 2018;114:64-71.

[3] Centers for Disease Control and Prevention. HIV Surveillance Report, 2017; vol. 29. http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html.  Published November 2018.
[3] Centers for Disease Control and Prevention. HIV Surveillance Report, 2017; vol. 29. http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html.  Published November 2018.
[4] Northern California HIV Policy Research Center. Immigrant Health: Implications for HIV Care in California. 2018. http://www.chprc.org/wp-content/uploads/2018/04/Immigration-HIV-Brief_April2018_CHPRC.pdf.
[5] Kaiser Family Foundation. The Affordable Care Act, The Supreme Court, and HIV: What are the implications? 2012. https://www.kff.org/health-reform/report/the-affordable-care-act-the-supreme-court-and-hiv-what-are-the-implications/.
[6] National HIV/AIDS Strategy for the United States, Updated to 2020, Indicator Supplement. December 2016. The White House, Washington. https://www.hiv.gov/federal-response/national-hiv-aids-strategy/nhas-update.
[7] National Latino AIDS Action Network. National Latino/Hispanic HIV/AIDS Action Agenda. 2010.  http://www.nmac.org/wp-content/uploads/2012/08/National-Latino-HIV-Action-Agenda-NLAAN.pdf.
[8] Call to Action: Bridging the Gap for Quality Health Services for Gay, Bisexual and MSM, 2010/2014.  National State and Territory AIDS Directors.
[9] Hess KL, Hu X, Lansky A, et al. Lifetime risk of a diagnosis of HIV infection in the United States. Ann Epidemiol. 2017 Apr;(4):238-243.
[10] Immigrant Legal Resource Center. 2018. https://www.ilrc.org/overview-public-charge.
[11] AIDS United, TAEP & HIV Caucus. Talking Points, AIDS Watch 2019. https://www.aidsunited.org/resources/aidswatch-fact-sheets?docid=77.

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