Working to lower HIV infections rates among the LGBT Latinos

By Alonso Reyna

Organizations are trying to get more LGBT Latinos like Juan Garza to take an HIV prevention medication called pre-exposure propylaxis or PrEP. But Garza is not fully convinced that PrEP is the answer for lowering new diagnosed HIV cases even though it can reduce infections.

Garza, who lives in Austin and is part of the LGBT community, said using condoms should always be encouraged since the medication is not 100 percent effective.

“I’m on the fence with PrEP because it prevents, but it’s also giving people the opportunity to start having sex without protection,” Garza said.

In spite of new medicine and treatment options, LGBT minorities are increasingly at risk of getting HIV or AIDS. According to the latest statistics, in 2014 approximately 37,600 new HIV cases are diagnosed in the U.S., with 70 percent affecting gay and bisexual men. The Southern states, which are predominantly conservative and have less population, account for 50 percent of all new HIV cases. New HIV cases in white LGBT men went down from 9,400 to 7,700, a reduction of 18 percent. However, Latino cases increased from 6,100 to 7,300, an increment of 20 percent.

Charles Loosen, who works with LGBT communities to promote cooperation and collaboration between citizens, organizations, and City of Austin leadership, says that having access to routine examinations while growing up leads to openness in discussing health issues with physicians. Latinos are less likely to have health care benefits growing up which makes it increasingly difficult for them to talk to their physicians about HIV or treatment.

“There is an increase between HIV incidents and poverty,” Loosen said, “and we know that communities of color are disproportionately affected by poverty.”

Experts say Latinos often wait until they are sick to go see the doctor. Because they didn’t get routine exams while they were growing up, they don’t see regular checkups as a necessity.

Loosen added that due to the lack of insurance coverage while growing up, many Latinos don’t access their benefits even if they are covered. “It is not normalized behavior,” he said.

He said that stigma also plays a role in the high HIV rates of the Latino LGBT community. He says that HIV is portrayed as the “trans disease,” a byproduct of cross-dressing and transgender men, or the “gay disease,” without people actually talking about the disease and the reality of it.

Research has shown that Latinos are typically oriented toward family well-being, rather than individual well-being. It’s difficult for LGBT Latinos to discuss their sexuality freely with family members, which makes it complicated for them to discuss things openly with a physician who hardly knows them.

Eduardo Salinas, a San Antonio resident who grew up in a small conservative town in South Texas, has experienced such difficulties.

“As a Latino, it’s hard to come out because you don’t want to shame the family,” Salinas said. “That makes it even harder to get tested for HIV.”

Steven Tamayo who is a counselor at The Q Austin, a clinic providing a safe place for LGBT members, sex education and sexually transmitted disease testing. Tamayo says that HIV education is the first step for lowering stigma and preventing new HIV cases. He said that numerous LGBT members don’t know how HIV replicates or of the available preventative treatments.

“You need to make the advertisement materials directly in Spanish and make it culturally relevant for Latinos,” he said.

Loosen, a member of Austin’s newly formed LGBTQ Quality of Life Commission, says that activists and LGBT members are working on including all minorities in mass preventative advertisements. This includes the display of people of color in advertisement billboards and pictures in city buses. The idea is to make minorities feel like the campaign is talking to them.

“There has been a lot of emphasis on ensuring that PrEP advertisement and awareness campaigns are culturally and linguistically tailored to the populations that are hit hard by the epidemic,” Loosen said.

But Tamayo said that making PrEP campaigns directed for every minority in different languages is difficult, expensive and the language doesn’t always translate well.

“It’s like murmurings,” Tamayo said. “People have heard of it, but don’t really know the specifics of PrEP.”

PrEP, also known as Truvada, provides from 92 to 99 percent reduction in the risk of acquiring HIV. Taking PrEP raises antiretrovirals (ARVs) high enough before any exposure to HIV. If the person taking PrEP is exposed to HIV, these ARVs prevent the virus from establishing in the person.

On a press release earlier this year from the Centers for Disease Control Division of HIV/AIDS Prevention, Eugene McCray, M.D. and the director of the division, said that ending the HIV epidemic is possible.

“Maximizing the power of these new prevention tools in conjunction with testing and education efforts, offers the hope of ending the HIV epidemic in this nation,” McCray said. “Science has shown us the power of HIV treatment medicines in benefitting people with and without HIV.”

Loosen agrees with McCray and says that everyone should do everything possible to prevent the spread of HIV, starting with education and personal responsibility.

“We have an obligation to the half-million people who have lost their lives to HIV,” Loosen said, “and to the approaching 2 million people living with HIV today.”