Experts Highlight Alarming Jump in HIV Infections Among Latinos

More resources are urgently needed to overcome the growing HIV crisis among Latinos in the U.S., researchers argued.

While annual HIV surveillance reports released by the CDC in May showed that the number of estimated new HIV infections per year nationwide fell by 19% from 2010 through 2022, there was a 12% increase in infections among Latino people, reported Vincent Guilamo-Ramos, PhD, MPH, of the Johns Hopkins School of Nursing in Baltimore, and co-authors.

In comparison, the estimated number of new HIV infections per year decreased by 29% among Black people and by 25% among white people over this time period, they wrote in a perspective in the New England Journal of Medicine.

In 2022, about one in three new HIV infections occurred among Latino people, compared with one in four in 2010, “reflecting a stark increase,” according to the authors.

“The HIV epidemic in U.S. Latino communities has remained largely invisible,” Guilamo-Ramos and colleagues stressed. “Although surveillance data documenting this unfolding crisis are released annually, attention and coverage have routinely centered on aggregate HIV data showing progress overall.”

Notably, 2022 marked the first year that new HIV infections in Latino men who have sex with men (MSM) outpaced those in all other racial and ethnic groups. “The most alarming finding is a 15% single-year increase among Latino MSM 25 to 34 years of age, part of a 95% increase in this group since 2010,” the authors noted.

These “disconcerting trends among Latino people — the country’s second-largest racial or ethnic group after white, non-Latino people — reflect persistent failures in HIV-prevention and treatment systems that have been overshadowed by this overall progress,” Guilamo-Ramos and colleagues wrote.

Carl Schmid, executive director of the HIV+Hepatitis Policy Institute in Washington, D.C., said he “wholeheartedly agreed” that the Latino HIV crisis has not received the attention it deserves.

“We have the data, and we just have to follow the data. And it’s a shame that we’re not devoting the necessary resources to the populations that are most impacted,” Schmid told MedPage Today.

Guilamo-Ramos and colleagues pointed out that despite pressure from the Hispanic Health Network, a delegation of more than 100 Latino health and social welfare organizations in the U.S., which has worked alongside the CDC to address the growing concerns about HIV in the Latino population, and a national summit hosted by the network in May, adequate investment is still lacking.

While drivers of HIV trends in Latinos aren’t well understood, possible contributing factors include inequities in existing prevention, testing, and treatment services; a lack of prioritization of health in the Latino population; and the fact that the healthcare and public health workforce are not prepared to meet Latino people’s cultural and linguistic needs.

Social determinants of health are another likely contributor, particularly among underserved Latinos, including migrants who experience serious social, economic, and political adversity, the authors noted.

Schmid also pointed out that uninsured rates are higher among the Latino population.

Regardless of these barriers, the authors argued that “in the context of the federal Ending the HIV Epidemic initiative, the failed response to HIV in Latino populations threatens national goals.”

As for solutions, Guilamo-Ramos and colleagues highlighted the community-engaged approach employed in the 2022 national mpox vaccination campaign. The mpox epidemic was initially marred by the same kinds of racial and ethnic inequities seen in HIV testing, pre-exposure prophylaxis uptake, and viral suppression, but a grassroots campaign succeeded in reaching MSM of color, including Latino MSM, they noted.

They also called for equitable resource allocation and building a “Latino-specialized workforce” that should include more Latino clinicians and other clinicians with the appropriate linguistic skills and cultural competence.

Schmid called these solutions “common-sense,” adding that “people feel comfortable with providers who look and talk like them, and especially when you’re dealing with sensitive issues like HIV… it’s really important that you have a provider who you can relate to.”

He also noted that President Biden appointed Francisco Ruiz, DrPH, a Latino gay man, as director of the White House Office of National AIDS Policy. “I think that’s important too,” he said.

As for resources, Schmid said the CDC has about $975 million for HIV prevention, which it distributes across states, large cities, and large clinics. State and city health departments are responsible for ensuring that money goes to the populations that are most impacted, and that includes Latino communities.

However, he added that House Republicans have proposed $700 million in cuts to domestic HIV programs, which would be “detrimental” to any progress.

Overall, Guilamo-Ramos and colleagues emphasized that “underprioritization” of the Latino HIV crisis has increased mistrust of the healthcare system and led to less engagement in HIV services among Latino MSM, though they noted that federal programs that aim to target the incidence of HIV among Latino MSM do exist, including Project Confianza, which seeks to identify drivers of medical mistrust and identify opportunities for increasing the acceptability of HIV services.

“Greater visibility, political will, and resource allocation will be indispensable for a more successful response,” Guilamo-Ramos and colleagues wrote.

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