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LETTER: Latinos and HIV, breaking the silence and shame
By David Ernesto Munar, President and CEO, Howard Brown Health Center
2015-10-14

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The numbers speak for themselves: despite recent advances in HIV treatment and prevention, the Latino community as a whole is suffering a spike in HIV infections.

According to the CDC, in 2013 Latinos in the U.S. represented nearly three times the rate of new HIV infections compared to non-Hispanic whites. Among Latinos living with HIV, only about 35 percent were engaged in HIV medical care. Racial and ethnic health disparities for HIV in Chicago mirror the disparities observed across the nation.

Stigma and cultural factors can work together to prevent greater acceptance of HIV testing, care, and prevention strategies. For Latino gay men, a culture of shame and silence surrounding sex and gender roles compounds the barriers. To come out as gay and/or HIV-positive risks family and cultural dishonor and rejection, which are heavy burdens to bear for people raised to value family above all else.

As CEO of Howard Brown Health Center, I see these dynamics at play every day in the patients we care for in our LGBTQ-focused community health center. As a Colombian-American gay man living with HIV, I have had to reconcile and affirm the many elements of my identity. This includes learning to live with HIV and taking steps to improve and promote my and my community's health.

Breaking the silence and shame of HIV, for me, is the most compelling call to action for National Latino AIDS Awareness Day ( NLAAD ), commemorated each year on October 15.

From a healthcare perspective, there are two important paths to end the HIV/AIDS epidemic. First, our nation must provide high-quality, culturally competent and life-long medical care and treatment for people—all people—living with HIV. In tandem, we must promote routine HIV testing as part of a comprehensive wellness plan and assist HIV-negative individuals to stay HIV free.

Both of these efforts involve a robust system of education, linkage-to-care and access to state-of-the-art prevention and care services. Howard Brown sees tens of thousands of patients each year, many of them Latino. We know from experience that the barriers they face in accessing care have common threads.

Confidentiality concerns are huge. Carlos Orengo, manager of our HIV/STI Walk-In Clinic, assists thousands of patients each year with HIV and STI testing and treatment. He has delivered hundreds of test results — many with bad news.

"The major concern that always comes up is confidentiality. Patients want to feel secure in what they discuss with us. Some patients who are undocumented, or who have never discussed sexual health before express to me they want to make sure their information will not be shared with anyone," Carlos said.

The comfort and familiarity obtained from a Spanish-speaking provider also helps reach more people in our community. Michelle Cuevas, a Nurse Manager at Howard Brown, said that Spanish-speaking staff are essential in providing Latinos a welcoming place. "We have Spanish speaking staff in our Call Center, and we have steadily increased our Spanish-speaking in all areas of service, including medical staff, to ensure people feel welcome as soon as they decide to try and access healthcare services."

Lina Diaz, one of our Financial Counselors, echoes how important that is adding, "I have seen incredible changes in bridging language barriers between patients and providers."

Shaping more open and accepting attitudes toward sexuality and diversity among Latinos will take time, of course. But National Latino AIDS Awareness Day is an opportunity for us to initiate this dialogue and shine a light on the best practices and strategies needed to turn the tide against the HIV/AIDS epidemic.


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