The Hidden Hispanic/Latino HIV Crisis

The Trump Administration aims to put an end to the HIV epidemic by 2030. Data concerning overall HIV-incidence in the United States paints a positive picture of the fight against the epidemic, with a decline of 6% since 2010.

Yet despite progress, there are hidden crises that might be obscured by these steps forward. In the same period, HIV incidence has increased among Hispanic/Latino populations in the United States by at least 14%.

A new commentary published in the American Journal of Public Health outlines the drivers of this HIV health disparity, pointing out the specific Hispanic/Latino populations which would be key targets for improving HIV prevention and treatment. The authors of the commentary highlight the particularly barriers among Hispanic/Latino men who have sex with men (MSM), recent Hispanic/Latino immigrants, and transgender Latina women.

MSM are the largest affected population in the ongoing Hispanic/Latino HIV crisis, with diagnoses in this population, accounting for approximately 80% of estimated HIV incidence among Hispanics/Latinos. Since 2010, annual new HIV transmissions have increased by 30% among Hispanic/Latino MSM. The crisis is even more concentrated among Hispanic/Latino MSM between the ages of 25-34 years, a population who experienced a 68% rise in new HIV cases since 2010.

The situation for transgender Latina women also needs improvement. It is estimated that roughly 1 in 4 transgender Latina women are living with HIV. According to estimates the prevalence in the studies reviewed by commentary authors ranged from 8% to 60%.

Hispanic/Latino individuals born outside the United States accounted for at least 1 in 3 new HIV diagnoses for all Hispanics/Latinos in 2017. Commentary authors noted that it has been suggested that the majority of foreign-born Hispanic/Latino individuals living with HIV acquired the infection in the United States rather than their prior places of residence. This population faces challenges related to immigration status, language barriers, cultural differences, and differences in social norms with respect to seeking health care.

Commentary authors wrote that racial and ethnic disparities persist, pointing out that compared with the general population Hispanic/Latino individuals were less aware of HIV-positive status, used preexposure prophylaxis less frequently, and received HIV care at a substantially lower rate.

Only 60% of Hispanics/Latinos living with HIV received care in 2015, and approximately 1 in 5 of those treated were not retained in care. Overall, the commentary authors estimated that no more than 51% of total HIV-positive Hispanics/Latinos in the US were virally suppressed.

Barriers to care also included mistrust of health care systems and a lack of culturally appropriate care options. On the macro level, the most significant barrier identified was the need for insurance to access health care. The authors pointed out that Hispanics/Latinos are the most underinsured and uninsured racial/ethnic group in the United States.

“Given the significant proportion of the overall US population that is—and will be—Hispanic/Latino, failure to address gaps in the national response to the Hispanic/ Latino HIV crisis has significant population-level implications for the fight against HIV/AIDS and the Trump administration’s goal to contain HIV transmission by 2030,” the authors concluded.