Latinx Queer And Trans Men Face Many Barriers To HIV Care, New Report Finds

Sign for a sexual health clinic. Many Latinx gay, bisexual, and transgender men who are affected by … [+] HIV avoid seeking care due to stigma, discrimination, and policies that exclude them, a new report found.
getty
HIV and AIDS and the fear and stigma that go with them are becoming a growing health crisis among Latinx gay, bisexual, and transgender men in the United States and Puerto Rico, according to a new report released Tuesday.
Here As I Am, a joint effort of ViiV Healthcare and the Latino Commission on AIDS, offers insight into the intersecting ways HIV affects Latinx queer and trans menbut with more than just statistics. The report used a Listening Initiative in 11 cities across the U.S. and Puerto Rico to give policymakers, health care providers and advocates a clearer picture of the lived realities of these men. They detailed the stigma and discrimination they face, both in their personal lives and when seeking healthcare.
In 2018, an estimated 186,900 Hispanic/Latino gay and bisexual men in the United States were living with HIV and AIDS, according to data from the Centers for Disease Control and Prevention. Overall HIV diagnoses have recently decreased or plateaued, but diagnoses among Hispanic/Latino men are increasing. The standard of care is not benefiting everyone equally, the report states.
To figure out why that might be, the report used a two-pronged approach: First, ViiV Healthcare worked with the Latino Commission on AIDS to conduct a six-month collaborative and community-based research study called Mi Vida, which means My Life. Then, they carried out a 10-month Listening Initiative,
The reports Listening Initiative is unique when it comes to research, because its less about numbers, and more about the voices of men who are affected by HIV/AIDS. The initiative included group discussions, interviews and storytelling with more than 760 Latinx gay, bisexual and trans men living with or affected by HIV, as well as some interviews with advocates and health care providers. The report used this information to examine how social, political and economic forces affect the health and wellbeing of men, including their ability to access preventive care and HIV treatment.
Why Listening And Storytelling Matter
Storytelling was central to the report, according to Marc Meachem, Head of U.S. External Affairs at ViiV Healthcare. You have to involve the people who are facing the disparities, who are bearing those issues themselves, Meachem said in a phone interview. If you don’t have an understanding of them, and if you’re not involving them in a solution, youre not going to close the gaps.
Guillermo Chacón, president of the Latino Commission on AIDS, said storytelling also allowed researchers to better understand the nuances of different communities. For example, men in Puerto Rico more often reported that HIV testing sites and clinics were closing or reducing services than men in the U.S. Men also reported different experiences depending on where they were born.
One of the concerns that we have is the huge difference between Latino gay and bi men that were born in the U.S. and those that were born outside the U.S. and they arrive here at an early age, Chacón said. The best way to develop a deeper understanding is by storytelling and creating the safest space for people to speak up.
The Myriad Cultural and Political Forces That Keep Men From Seeking Care
Mens common experiences and health outcomes are organized into five key insights in the report, with the first and one of the most significant being that their lives and health are greatly impacted by their family and community. Participants said family acceptance was crucial to their self-worth.
…Family (and the interweaving of religion) were primary sources of abuse, rejection, stigma and isolation that diminished many men, the report states. For some, family can be the origin of stigma and shame that can permeate all aspects of their life, making it difficult to value themselves enough to engage in care for themselves.
Chacón said the gut reaction of many LGBTQ+ activists might be to condemn those unaccepting families and write them off, but that advocates should evaluate whether they have tried to engage those people and educate them through community groups. Hopefully this report will make [the problem] more visible, but also trigger a call to action to begin to change our own personal bias, but also how we pay attention to our families and our communities, he said.
A close-up of PrEP text on blue pills. PrEP is a daily medication that reduces your chances of … [+] getting HIV.
getty
The other insights found that interruptions in care for Latinx queer and trans men happened for many reasons beyond their control. When they could get care, providers often werent culturally competent or materials werent available in Spanish. Men said a lack of diversity in clinic staff or materials was a clear sign that one group is prioritized over another group, which impacts if and where they seek care, the report states.
Finding providers who were affirming and knowledgeable about HIV and PrEP was also a barrier participants reported. “I have had to leave my doctor because they didnt understand the type of sex I was having,” one participant said.
Chacón said that providing quality care goes beyond having a staff diversity training and has to include systemic changes in hiring and cultural education. It’s not just about understanding that a segment of a population is heavily impacted [by HIV], he says. If my staff in a community center or wellness center do not understand the painif you don’t understand the impact of homophobia in our communities or transphobia or xenophobiait creates immediately a terrible experience.
Both participants and providers said xenophobia and legislation like the Trump administrations public charge rule prevented men from seeking care. Several people described being harassed or attacked for being Latinx, and some said they experienced discrimination due to immigration status.
Community Groups Offer Some Solutions
Meachem says ViiV Healthcare wanted to not only highlight barriers that queer and trans Latinx men face when accessing care, but it also wanted to show that they need ongoing, holistic care. Some people believe that once the levels of HIV in someones blood are undetectable due to treatment, they stay that way. But thats just not the reality, he says.
We lift up the fact that treatment interruption has happened, Meachem says. The next step is breaking down barriers to care.
The final insight of the report details how men reported building resilience through community connections. As a result, it notes that Latinx-led groups and networks need more support, potentially through grants that are meant for grassroots, Latinx organizations.
Chacón described two initiatives that fit the bill: Encuentro: Reconstructing Our Health, which is a regional conference that brings people together to address health disparities in Latinx, LGBTQ, and HIV positive people living in the South; and the Dennis deLeon Sustainable Leadership Institute, a space for emerging community leaders to enhance and develop leadership skills in order to impact HIV/AIDS local, state and federal health policy affecting Latinos in the Deep South, according to the Latino Commission on AIDS website.
By digging into the why behind statistics, the report aims to offer better solutions. Its also a major step toward breaking the invisibility of our communities, Chacón said. Theres nothing more powerful than when you gather a group of individuals, and then you hear their challenges and their needs to develop a deeper understanding… and begin to do an internal transformation to better serve those in need.read more