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Not Twice in My Lifetime: The Unignorable Crisis of HIV Among Latinx Communities in the U.S.

Read the Spanish language version here.

I write this blog from a place of immense privilege. I am a cisgender, gay, born U.S. citizen and son of an immigrant, and I have been living with HIV for about 10 years now. I have access to healthcare, medication, stable housing, and have been living a recovery journey of sobriety for two years now. For this National Latinx AIDS Awareness day, attention must be drawn to a burgeoning crisis of HIV among Latinx living in the United States. I say this not only as a program manager at AIDS United, but also as a member of the Latinx community.

In 2017, the Center for Disease Control reported 38,700 new HIV diagnoses in the United States. For many, this was progress, as ten years earlier in 2007, new incidence in the US was just over 53,000. Those figures alone, though, do not tell a complete picture of those affected most.

Now keep in mind, 2017 was only the first year of the Trump administration. In July 2017, there were 58.9 million Latinx people living in the United States, representing 18.1% of the nation’s total population. Of the 38,700 people diagnosed with HIV in 2017, 25% were Latinx people. That statistic highlights the overrepresentation of new HIV incidence among Latinx. Trends demonstrate that 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 (by 22%). We are about to wrap up the third year of the Trump administration as we head into an election year. This timeline becomes important for several reasons.

Earlier this year, President Trump, in his State of the Union address, announced moving forward with a plan to end the HIV epidemic in the U.S. The goals of “Ending the HIV Epidemic: A Plan for America” are to reduce new HIV incidence by 75% in 5 years, and by 90% in 2030. This seems on the surface to be progress, but a look at very recent proposals by this administration seem to run counter to this plan.

Since Trump took office, the Administration has engaged in repeated attempts to repeal the Affordable Care Act. There have been ongoing efforts to cut the budgets of agencies that are integral to the HIV response in the United States including the Centers for Disease and Control and Prevention, the Department of Health and Human Services, and the Housing Opportunities for People with AIDS Program. Most recently, the Trump administration proposed a change to the public charge rule. Under this proposed rule, the definition of what constitutes a public charge in the immigration process—i.e., a person who would likely be partly dependent on the federal government for subsistence—would be significantly expanded, creating what would amount to a financial and medical litmus test for all immigrants coming to the United States. This would in effect ban all people who are not independently wealthy and who are living with HIV and other chronic health conditions from becoming U.S. citizens. Anecdotally, healthcare workers and community advocates have already noticed that many people awaiting citizenship are not accessing public health benefits they qualify for because it could jeopardize (or they fear it could jeopardize) their applications for visas, work permits, and citizenship.

And we simply cannot ignore the ugly reality of the blatant attacks on the broader Latinx community. To be clear, ICE actions on undocumented Latinx people and the treatment of Latinx asylum seekers at border “detention facilities” are not just an attack on those who are undocumented. They are designed to generate fear among a group of people based solely on their ethnicity. This fear is intended to extend to entire communities of Latinx people. The most vulnerable in the U.S. Latinx community have been affected by harmful policies which have the potential to further hinder the success of the United States HIV response.

As marginalized communities do when they see a need in a community, people within the community came together in crisis to try to identify need and solutions. In 2018, a group of Latinx gay/bi/queer and other men who have sex with men convened through the O’Neill Institute over the course of two in-person meetings and multiple phone calls. We drafted, finalized, and signed off on a nationwide call to action: Addressing the HIV Crisis Among Latinx Gay and Bisexual Men in the United States.

In promoting the call to action and the recommendations of these representatives from the most vulnerable and affected community, we were a part of several convenings of thought leaders, policy makers, and federal agency representatives. In the efforts to get actionable answers from the federal government agency representatives, community members asked some very difficult questions. At the National HIV Prevention Conference in March of this year, I remember a younger colleague asking, “You know the data, we’ve told you personally from the community stories that support the need. What will YOU do to help my community?” His plea for help and support was answered very politely and bureaucratically, in essence advising Latinx communities in need to apply for technical assistance on how to apply for competitive community grants.

It makes no sense to expect that this community, which has been negatively impacted by legislation and policy change from the current administration, to trust any agency that is under its purview. Asking a community to wait to receive technical assistance before applying for competitive funding is also impractical, particularly when language, education, and other structural barriers exist that prevent this.

What can we, as the HIV advocacy community and those connected to philanthropy, do in this crisis? One of the recommendations from the Latinx Gay and Bisexual Men’s HIV Prevention and Treatment Action Coalition’s call to action is:

“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.”

As AIDS United continues to review its mission and vision, we are now more committed than ever to examine our grantmaking portfolios to ensure that our priorities align with community need. We also need to continue to meaningfully work with the Latinx community to determine how we can support the innovation that is already occurring at the community level. We must approach this support in ways that lower barriers for accessing grants, funding, and that truly seek to engage community in a way that will help end the epidemic in an equitable way. It is also important that we continue to ensure that the leadership developed to address the current HIV epidemic is reflective of the communities most affected by/vulnerable to HIV. It is important to note, that the statistics of HIV in the Latinx community come from the first year of the Trump administration. The likelihood of their increase is high.

I was born in the 70’s and I grew up in the 80s and 90’s. I remember the lack of political will to address AIDS when it seemed it was only affecting gay men. But those men were mostly white and cisgender and were able to organize and mobilize to a degree because of their privilege.  Those most vulnerable for HIV in the Latinx community do not have that same privilege and voice and the resurgence of xenophobia in the current climate of the United States can be demoralizing to a community that is already in need.

As someone who identifies as a gay man, and Latinx, seeing this play out in another marginalized community that I identify as in my lifetime; I cannot personally and professionally not say something and not try to mobilize a response. We cannot sit in good conscience and wait for our federal partners to move funding to address this crisis in the Latinx community. We must work with anyone who can provide support in a faster-than-timely way to help our Latinx family and friends in need. The right thing to do isn’t always the easy thing to do, but when people are pleading for their lives, it is clear that a response is critical.

For “Let’s Stop HIV Together” resources in Spanish, click here. To learn more about National Latino HIV/AIDS Awareness Day, visit

Posted By: Julio Fonseca - Tuesday, October 15, 2019

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