La Vida Latina
BY Benjamin Ryan
November 18 2010 5:00 AM ET
The need for improved strategies to target Latino men at risk for and living with HIV is great — perhaps even greater than for any other demographic because of the historical lack of attention paid to their plight. Theirs is an epidemic that has run silently over the decades. Latinos have no Magic Johnson to serve as a role model or as a public face for living with the disease. Latino churches, by and large Catholic, tend to be as AIDS-phobic and homophobic as — or more so than — African-American churches. In comparison, though, there is little public outcry over this major source of stigma, which otherwise has the potential to become a pulpit for greater awareness.
The rate of new AIDS diagnoses among Latino men, according to the White House strategy report, is three times that of white men, and as a risk category, Hispanic men who have sex with men have the fourth-highest numbers of new HIV infections per year at 5,710, behind white and black MSM, respectively, and black heterosexual women.
More than any other an ethnic group in the United States, Latinos are alienated from health care and proper health screenings, according to the Kaiser Family Foundation. Nearly a quarter of HIV-positive Latinos are uninsured; 41% test late and develop AIDS within a year of their HIV diagnosis; and, as Carlos Hernandez’s story illustrates, they are more likely to delay medical care after a diagnosis.
The triple-layered effects of poverty, racism and homophobia drive the epidemic among Latino gay men in particular, according to Rafael M. Díaz, Ph.D., who studies HIV in Latin culture at San Francisco State University. Men so heavily oppressed are more likely to seek solace by taking sexual risks and are likely to do so while under the influence of alcohol or illicit drugs. With HIV infection thrown into the mix, men are at even higher risk for substance abuse disorders, anxiety, and depression — which can all compromise antiretroviral treatment. Díaz’s research of HIV-negative gay Latinos’ attitudes has found that they tend to blame HIV-infected men both for their infections and for infecting others and also shun them as potential romantic partners.
“The number 1 problem is the stigma associated with HIV and AIDS,” says Guillermo Chacon, president of the Latino Commission on AIDS. This stigma, which is fueled in part by a rigid Catholic belief system and the machismo ideal of the masculine, domineering head of the household discourages Latinos from getting tested and into care.
Also to blame, says David Ernesto Munar, who is vice president of the AIDS Foundation of Chicago, is the isolation Latinos experience because of cultural or language barriers. HIV-positive Latino men may have to fracture their sense of self and wind up with a lack of full emotional support from their family — the bedrock of existence across the many diverse shades of Latin American culture.
“They may be out in the gay community, or they may be bicultural or more Americanized,” Munar says, “but in their Latino family or their Latino enclave, they can’t talk about gay issues, or they don’t feel safe talking about health issues or HIV issues.”
Like Morales, heterosexual Latino men are largely infected through unsterilized needles. And they can suffer homophobia by association for their HIV status and shoulder yet another layer of blame because of their substance abuse.
“They’re often faced with the idea that this is a community of discard,” says Ruben Acosta, who is a health educator at the Los Angeles Gay and Lesbian Center. Speaking ironically, he continues, “I mean, they’re drug addicts. If somebody wants to take a needle and stick it in their arm and it’s not clean, that’s on them.”