The federal government has committed to an initiative it’s calling Ending the HIV Epidemic: A Plan for America, which is designed to slash new infections of HIV by 75 to 90 percent in the next five to ten years through the expansion of prevention and treatment programs. But the challenges of addressing HIV within the Latinx community is fraught with issues such as lack of access and awareness as well as the stubborn prevalence of stigma, all of which factor into the rapidly increasing incidence of HIV diagnoses among young Latino men.
“I call it the invisible epidemic,” said Professor Vincent Guilamo-Ramos to The Guardian earlier this year. Guilamo-Ramos founded the Center for Latino and Adolescent and Family Health at New York University. He cited the disproportionate impact that HIV and inadequate public health policies have on people of color, people living in poverty, and both documented and undocumented immigrants. “Whatever strategy the Trump administration comes up with, it’s going to have to grapple with who in fact is disproportionately impacted by HIV/Aids: it’s brown and black, it’s disadvantaged.”
Between 2010 and 2016, infections among U.S. Latinos spiked by about 14 percent, according to figures cited by Newsweek, affecting Latinos who have male to male sexual contact, an estimated 1 in 4 transgender Latinas, and new immigrants who contract the virus here.
Most Latinos are contracting HIV through male-to-male sexual contact. Of the nearly 10,000 new HIV diagnoses among Latinos in 2017, nearly 86 percent of those were attributed to male-to-male contact, according to national figures from the CDC. Many of those cases affect young men between the ages of 25 and 34. Looking more specifically at different Hispanic populations groups, we get a better understanding of the patterns in which HIV is spread. For example, Puerto Rican-born Latinos are more likely to become infected with the virus through intravenous drug use or male-to-female sexual contact than through male-to-male contact, a reality that suggests the need to take a multifaceted, informed approach to HIV prevention. As of today, only about half of those who need it are receiving some level of HIV care, while 1 in 6 aren’t even aware that they have contracted the virus.
A pre-exposure prophylactic like PrEP has the potential to make a significant dent on new cases of HIV by preventing contraction in people who know that they will be partaking in high-risk behaviors. Currently, though, less than 1 in 5 Americans who Health Secretary Alex Azar says ought to be taking HIV PrEP are taking the drug, and this is largely due to lack of access. Because the price of the drug is a significant barrier to its use, the federal government has partnered up with the pharmaceutical company behind PrEP for their Ready, Set PrEP initiative, where over 2 million bottles of a generic version of the drug will be donated on an annual basis to help the country nearly eliminate HIV transmission among its population over the next decade. The drugs will be donated through 2030.
However, the Ready, Set PrEP program is not without its costs for users. NBC News reported that though the medication will be free, the blood work in order to be prescribed the drug will not be covered by the federal campaign. “As a result, people who access PrEP through the Medication Association Program were found to have a statistically significant lower rate of PrEP initiation and a longer time between PrEP prescription and initiation [than insured users],” James Krellenstein, an activist who has been pushing for a program like Ready, Set, PrEP, told the publication.
California Governor Gavin Newsom recognized this significant barrier to treatment and signed into law a bill that would allow PrEP, as well as the post-exposure prophylactic PEP, to be available over the counter in the new year. In order to truly end the HIV epidemic among all U.S. populations, other states will have to take equally bold moves to ensure that everyone regardless of insurance or immigration status can access free or affordable treatment and prevention options without the significant barriers that they face today.