COMMUNITYFEATURE ARTICLES

NATIONAL LATINO AIDS AWARENESS DAY 2021: “IT’S TIME TO ACT. IT’S TIME TO END HIV”

By: Al Ballesteros, MBA

Stigma, poverty, no or limited medical insurance, language and cultural barriers, lack of information, substance use, mistrust and limited access to the health care system are believed to be contributing to the continued spread of HIV infection among Latinx populations, according to local and national health care leaders. Experts say these challenges must be addressed and additional resources invested to bring HIV infections down in Latinx populations in Los Angeles County and across the United States.

After more than 40 years the HIV pandemic continues to infect people. The United States now has more than 1.1 million persons living with HIV and in calendar year 2019 alone, 36,801 new HIV diagnoses were found. It is not clear how many people in the Unites States get infected annually, but most public health experts believe the number is approximately 40,000. That is a huge number. Los Angeles County has approximately 60,000 persons living with HIV/AIDS and it is believed between 1,500-1,800 become infected with the virus each year.

The HIV epidemic affects Latinx people at high rates. In 2019, 10,502 Latinx persons were diagnosed with HIV in the United States, about 29 per day. While Latinx people represent 18.4% of the US Population, they account for 28.5% of all new HIV diagnoses and 22.8% of all people living with HIV in the United States (source: LCA; NLAAD). In 2019, the New York-based Latino Commission on AIDS cites a study where it found just 53% of Latinos living with HIV have achieved an Undetectable Viral Load. This is important because when a person has achieved an undetectable viral load, they not only have better health, but they are exceedingly less likely to transmit the virus to others. The same study also found that one in six Latinos living with HIV were unaware they have the infection. This reality has huge prevention implications related to identifying persons who are HIV positive and helping them achieve viral load suppression.

Additionally, 53% of Latinos have never been tested for HIV in their lifetime and 62% of Latinos diagnosed with HIV who disclosed their place of birth were Foreign-Born. (Source: LCOA; NLAAD). Lastly, the majority of new Latinx HIV cases are male, accounting for 9 out of 10 persons.

Latinx men who have sex with men (MSM) accounted for 24% (138,023) of all U.S. MSM living with diagnosed HIV infection at the end of 2018 (source, CDC.gov). In 2019, Latinx people represented 16% of the United States population aged 13 and older, but 29% of those diagnosed with HIV.

HIV Can be Prevented: While there is still no vaccine for HIV there are highly effective ways people can protect themselves from getting infected with the virus. Biomedical prevention, PREP is shown to be nearly 100% effective if taken correctly to prevent infection. However, with respect to PREP and Latinx populations, findings from a 2019 study showed that only 1 in 4 Latinx people receiving a CDC-funded HIV test were aware of PREP, and only 1 in 5 who were eligible for a PREP referral actually were referred to PREP providers. This is an important study that should have all take notice because Latinx populations at risk of HIV infection are more likely to rely on CDC funded HIV testing programs than the general population. Low levels of PREP awareness and referrals among Latinx people suggest the need to identify the barriers to PREP services, routinize PREP education and referrals, expand coverage for PREP medications (source: Morbidity and Mortality Weekly Report, cdc.gov).

Undetectable = Untransmittable or U=U: There are highly effective treatments for those living with HIV infection and if the person takes their medications as prescribed, they can live normal life spans with relatively few physical effects of the disease. It is also true that when a person living with HIV takes their medications as prescribed and achieves what is called “Undetectable Viral Loads” and sustains this undetectable state for a sustained period this person can’t transmit the virus to others through sex. Some refer to this as “Treatment as Prevention” meaning persons living with HIV disease themselves can prevent further transmissions in their community by adhering to their medical programs. However, are these conversations and concepts being fully had and embraced by Latinx communities? In white and/or gay-identified populations where the U=U strategy was more talked about early on, conversations about one’s HIV status are said to have been more frequent and open. Experts say this may be more of a challenge in Latinx populations where discussions about sex, gay identity and HIV status are said to be more limited due to stigma and cultural reasons.

Antiretroviral therapy (ART) adherence is crucial for viral suppression and achieving Undetectable Viral Loads, a key part of the U=U strategy. But there are barriers to ART adherence among Latinx MSMs cited in studies. Data analyzing the barriers from the Medical Monitoring Project were collected during 2015–2019 to examine ART adherence and reasons for missing ART doses among 1,673 HIV-positive Latinx MSM. The reasons were: Younger age, poverty, recent drug use, depression, and unmet needs for ancillary services. The most common reason for missing an ART dose was forgetting. (source: CDC.gov). Interventions that support ART adherence and access to ancillary services among Latinx MSM might help improve clinical outcomes and reduce transmission. (Source: CDC.GOV).

If HIV transmissions can be substantially prevented in communities via HIV testing, PREP and Treatment as Prevention or achieving Undetectable Viral Loads why are these strategies not benefiting Latinx communities at higher levels? The National Association of County and City Health Officials (NACCHO) recommends raising awareness, promoting HIV testing, disseminating prevention strategies, and connecting Latinx people to care leads to improved health outcomes at the individual and community levels. (Source: National Association of County and City Health Officials (NACCHO)

Footnote: Those surveyed included individuals on the front lines, physicians, health educators, those in health policy and administration. Many of the respondents say there is a need for substantial investments by government, communities, non-profits, businesses, the healthcare system and philanthropical entities to end HIV amongst Latinx populations.

Other studies show that the estimate of recent incidence rate for HIV infection amongst Latinx persons in the United States was four times that of non-Hispanic White persons based on 2018 data (source: CDC.gov).

I keep hearing about U=U. What does that really mean?

Q: If I am on HIV medications and my viral load is undetectable (meaning that the virus isn’t showing up on blood tests), can I still pass the virus to another person through sex?
U=U is an informational campaign about how effective HIV medications are in preventing sexual transmission of HIV. U=U means “Undetectable = Untransmittable”.
This indicates that if a person with HIV is on HIV meds (antiretroviral therapy, or ART) with a consistently undetectable HIV viral load, the virus cannot be transmitted to a sex partner. As a prevention strategy, this is often referred to as Treatment as Prevention, or TasP. U=U and TasP are based on substantial scientific data. In fact, the U.S. Centers for Disease Control and Prevention has said that, “People who take ART daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.” So, if you have HIV: Take your HIV meds every day. This is important for your personal health and to prevent HIV transmission. (Source: HIV.va.gov)

Adelante Magazine asked community leaders, HIV advocates, persons living with HIV and medical and public health professionals, the following three questions:

1 – What more needs to be done to bring awareness of HIV testing, prevention and treatment to Latinx communities?

2 – Is there anything new or different in 2021 and beyond which needs to be considered with respect to HIV/AIDS awareness efforts?

3 – If you could choose one area to place enhanced community energy with respect to Latinx HIV/AIDS awareness efforts, what would this be?

BRIDGET GORDON
Co-Chair, Los Angeles County Commission on HIV

What more needs to be done to bring awareness…?
Try new ways of reaching diverse members of the community, HIV impacts all of us in some way if we continue rolling out the same programs that no longer work, lives will continue to be negatively impacted. Invite the whole community into the “HIV awareness” conversation. The impact will make a significant difference.

Is there anything new or different in 2021 to be considered…?
Yes, use the same urgency and resources on a cure and vaccine for HIV that has been applied to the Covid 19 virus – we seem to have forgotten that HIV is also a global pandemic.

If you could choose one area for enhanced community energy…?
If I could choose one area to place enhanced energy in raising awareness and education efforts it would be reuniting the writers of ‘Sin Verguenza’ (Without Shame) for production of at least three more years of the award winning telenovela produced in both Spanish and English. This groundbreaking, creative work brought heart and compassion to the issues Latinx communities face in dealing with topics surrounding HIV, sexuality, stigma and protecting people in the community.

LUIS LOPEZ, MBA, MPP
Nonprofit Healthcare Director

What more needs to be done to bring awareness…?
This is the 40th anniversary of HIV/AIDS. Despite hard-won progress and reduced mortality, we still face denial, ignorance, and stigma. We need to continue efforts to destigmatize HIV and talk about prevention and sex education at every opportunity starting in middle and high school years on up. We need ongoing campaigns, particularly in Spanish, to normalize testing and make it as routine as taking your annual flu shot.

Is there anything new or different in 2021 to be considered…?
HIV and AIDS are still with us. The virus is still a threat and makes other infections more dangerous. As we emerge from the COVID-19 pandemic, we must bear in mind the disparate impact and heavy toll this epidemic and others inflict upon underserved, people of color, and low-income communities. Our awareness efforts need to account for and also confront the many challenges faced by people from underserved communities, from food and housing insecurity to substance abuse and unsafe neighborhoods, and empower people to not only face these challenges through collective action, but also become advocates for change. I am encouraged by how often I now hear my colleagues in healthcare and leaders in and outside government talk about how they are applying lessons learned from four decades of fighting HIV-AIDS, including in overcoming COVID. Our struggle is now guiding others in fighting for public health and winning social justice.

If you could choose one area for enhanced community energy…?
Heightened visibility. We are in a battle against forgetting. We need to honor the many people and families who have suffered and lost their lives but also taught us so much about how we can collectively fight for a substantive, effective, timely government response, investments in research, and access to care. The best way to honor their legacy is to elevate our collective voice and exercise our constitutional right to petition our government for universal healthcare as a human right. We have the power to secure this for each and every American, regardless of immigration status, income, geography, language, education level, age, gender, sexual orientation, or gender identity. One lesson of the 40-year fight to stop HIV-AIDS is that we can achieve such goals through passion, well-trained diverse leaders, and unrelenting teamwork.

HECTOR RODRIGUEZ
(GIPSY)

What more needs to be done to bring awareness…?
“I think we should continue to do events at festivals, clubs, clinics etc., and not let our guard down on the subject.”

Is there anything new or different in 2021 to be considered…?
“I would include emphasis that this is not an LGBT or Latinx problem. It concerns every ethnicity, age and sexual preference does not matter.”

If you could choose one area for enhanced community energy…?
“I would work on all communities together as one. HIV/AIDS is something we all have to be aware of.”

JOSE LUIS PEREZ, MD
Chief Medical Officer, South Central Family Health Centers

¿Qué más necesita hacerse?
Continúan existiendo trés barreras al accesso de servicios de VIH específicament en la comunidad Latina: El estigma aún asociado con esta enfermedad; El desconocer donde se puede recibir estos servicios, especialmente con delicadez y privacidad; y el impedimento del lenguaje. La educación del público en general y de la comunidad hispana, en particular en español, es crucial
El Centro comunitario de South Central Family Health Center está dedicado a combatir estas trés barreras. Proveémos servicios contra el VIH por especialistas en el tratamiento del VIH, Lo hacemos en nuestra lengua, y tenemos un pabellón específico para la privacidad de nuestros pacientes.

¿Hay algo nuevo o diferente en 2021 para ser considerado?
La nueva generaciones desconocen todo el trabajo y sacrificios que ocurrieron en los años ochenta y noventa para incrementar el conocimiento y el tratamiento del VIH. Especialmente, el uso de medidas preventivas ha decaído, lo que pone en peligro la salud de nuestros jóvenes. La continua educación a todos los niveles: en los medios de diffusion, en las clínicas y en las escuelas es crítico.
Adicionalmente, los avances en el tratamiento y prevención del VIH have que esta enfermedad se haya vuelto muy tratable y no una sentencia de muerte como en el pasado.

¿Si pudiera elegir un área de energía comunitaria mejorada?
Educación, educación y más educación. El centro comunitario de South Central ha asegurado recursos financieros, específicamente diseñados para educar a nuestra comunidad. Somos parte de la red de proveedores de servicios de VIH en la internet en el condado de Los Angeles, Instruímos a nuestros doctores, Asistentes y Enfermeras a facilitar la plática con nuestro pacientes sobre los riezgos en la adquisición de esta enfermedad y anunciamos estos servicios en nuestra presencia digital.

ROLAND PALENCIA
Community Activist

What more needs to be done to bring awareness…?
It’s key to know who are the influencers for the audience(s) we are trying to reach. Influencers are not necessarily celebrities, but could be family members, friends, mentors, teachers. Those whom they trust and whose opinion they value.

Is there anything new or different in 2021 to be considered…?
The messages need to speak the true and authentic language to those we want to impact with the messages. Innuendos and euphemisms will not work. It’s got to be clear and direct.

If you could choose one area for enhanced community energy…?
To promote PrEP as one of the many strategies to stop HIV infections. Also, efforts at the Federal level to have a breakthrough vaccine or as close to a cure as we can. Behavioral change strategies are much harder to implement and to sustain.

DAVID P. LEE
Community advocate

What more needs to be done to bring awareness…?
There really needs to be more barrier free HIV treatment and prevention services for the Latinx community. Services need to be in the language of the patient, available regardless of insurance or immigration status, and one-stop shop (the doctor, laboratory, and pharmacy need to be in one place).

Is there anything new or different in 2021 to be considered…?
Although PrEP is not new, more education about its availability needs to be provided in the Latinx communities, especially those in East and South LA. Information about injectables also needs to be increased in Latinx communities.

If you could choose one area for enhanced community energy…?
The sobering fact that one quarter of Latinx gay men are project to be diagnosed with HIV in their lifetime should energize us to put more effort into raising awareness in this community. Resources should follow any community awareness efforts to address structural barriers to accessing treatment and prevention services.

oznorCO

FELIPE GONZALEZ
Commissioner, Los Angeles County Commission on HIV

What more needs to be done to bring awareness…?
Bring HIV out of the closet by funding Latinx innovative outreach and messaging campaigns. We need to have more open discussions from all types of people in our community directly, and get a diverse group involved on this effort. Focusing on providing additional resources to people who are at an increased risk because of social or economic disadvantage or other underlying health disparities is important.
A cohesive and innovative community based outreach should be formulated which addresses the unique cultural barriers facing the Latinx communities.
Carefully crafted messaging that reassures Latinx individuals that their privacy will always be protected when disclosing private information goes a long way in easing inherent fears related to sexual identity.

Is there anything new or different in 2021 to be considered…?
HIV/Aids awareness efforts need a reboot after being relegated (and understandably so) to the sideline by COVID-19. People in the HIV/AIDS movement have a long legacy of compassionate advocates. To strengthen this reboot, we must include the same kind of compassionate people, specifically people living with HIV who represent communities most affected by the pandemic, including the Latinx community, as part of the awareness and de-stigmatization of HIV.
This extraordinary group of people can bring a renewed focus that vigilance in HIV prevention should be top of mind now that there are less restrictions on movement.

If you could choose one area for enhanced community energy…?
We can break the cycle of transmission in 2 key ways,
1. Promote the use of PrEP in our community and call on the political establishment to improve access for all disadvantaged communities not just Latinx.

2. Undetectable equals untransmittable. Improve access to treatments and medications for all individuals living with HIV. Current treatments can reduce viral loads to an undetectable level. We need to make sure that Latinx and all others who already have the virus maintain an undetectable viral load by providing information and connecting people to easy, compassionate and affordable care. We need to meet them where they are, and make it easier to get the care and support they need.

Ending the HIV epidemic remains elusive because of disparate access to preventive and life-saving medicines. Addressing the disparity experienced by Latinx individuals is a big step in the right direction to redefine the battlefield of infection and end the many years of suffering caused by HIV.

Felipe Gonzalez works fighting the HIV epidemic with the City of Pasadena’s Department of Public Health.

EVERARDO ALVIZIO, LCSW
Commissioner, LA County HIV Commission

What more needs to be done to bring awareness…?
Enlist trusted messengers that know the language and have the trust of la comunidad (the community). Stigma continues to impede honest and open conversations about sexual health, HIV and treatment. When I first came out, the first thing my mom blurted out to me was, “¡Te vas a morir del SIDA!” (You’re going to die of AIDS!). We’ve come a long way, my mom and I, but I know many in the Latinx community still carry this stigma and fear.

Is there anything new or different in 2021 to be considered…?
In 2021, we carry the knowledge that the COVID pandemic has made us all aware of, the vast health inequities experienced by communities of color. Only by working together, housing/homeless service providers, healthcare, HIV/AIDS advocates, and anyone involved in social justice work, will we truly be able make an impact on raising awareness and actually improving the lives of those at risk and/or living with HIV/AIDS.

If you could choose one area for enhanced community energy…?
Combating the stereotype that HIV/AIDS is a ‘gay’ issue, or that its impact is only limited to gay men. HIV/AIDS does not discriminate – cis-women and heterosexual men, particularly from communities of color, are also impacted by this disease. Sex/sexual health is such a taboo subject in Latinx communities. A renewed effort is needed to encourage us all to care about and learn to love one another.

Everardo Alvizo, LCSW
HIV/STD Strategic Implementation Specialist
Long Beach Department of Health and Human Services, City of Long Beach Representative on the LA County Commission on HIV

HERNAN MOLINA
Political Analyst

What more needs to be done to bring awareness…?
We need to do more to make testing more readily available. We need to do the same about PreP.

If you could choose one area for enhanced community energy…?
There should be intensive media campaigns in all mediums/platforms about PreP. (The same needs to happen with STIs, which we are in the midst of a crisis). This is not new, but funding has always lacked.

MARTIN ALATORRE
HIV & Biomedical Operations
Manager, Ending the HIV Epidemic
JWCH Institute, Inc., & Wesley Health Centers

What more needs to be done to bring awareness…?
In my humble opinion, I believe in order to end the HIV epidemic we need to ensure that the most recent and accurate information is available to and being disseminated by our community-based organizations, clinics, programs and staff. The community needs to be armed with information about all aspects of HIV and prevention and locations where high-risk people can go and receive services. This is especially important for those in underserved areas which are lacking in access. We also must show empathy and compassion for those who are in situations beyond their control. Meeting people where they are at and not forcing them to seek care, but eliminating the barriers, stigma and dealing with unresolved trauma or issues is important. Often these problems get in the way or prevent people from seeking care or cause a lack of motivation to care for one’s self.

Is there anything new or different in 2021 to be considered…?
I believe we need to open more social groups, behavioral and mental health group sessions that address sexual health, substance and physical abuse and how these impact the person that is seeking to be educated on HIV awareness. LGBTQ youth especially are disproportionately impacted by multiple forms of childhood trauma, including physical abuse, sexual abuse, dating violence, sexual assault, and peer violence. Trauma-informed care and trauma-specific interventions can make significant contributions to the needs of traumatized youth and can reduce long-term consequences for sexual abuse survivors. Male sexual abuse survivors have twice the HIV-infection rates of non-abused males. In a study of HIV infected persons 12 to 20 year old, 41% reported a sexual abuse history. We need to provide behavioral health treatment to address these traumas while at the same time providing access to biomedical prevention or encouraging one to stay compliant to their meds so as to stay undetectable. Medication should be combined with behavioral health to assess any trauma that are triggers for them or barriers for them seeking care or taking charge of their sexual health.

If you could choose one area for enhanced community energy…?
Education is key to getting people to explore options for their sexual health without being shamed or belittled to be confident in what they like. Educating men, women and youth and giving them the basics on STI, HIV and PrEP. In addition, creating safe spaces for all ages to come together in support of each other for each other to end the HIV epidemic. When you add these components for high risk groups, in their language, it helps them feel seen and not dismissed.

DANIEL P’LOPEZ
Writer & HIV Health Educator

What more needs to be done to bring awareness…?
I think bringing more testing sites to these areas to test and educate the Latinx communities would bring more awareness to people. I think teaching Latinx people about PREP and PEP would also educate and bring down the infection rates. There needs to be educators who know the answers and can educate and work with people to raise awareness for HIV.

Is there anything new or different in 2021 to be considered…?
PREP and PEP are really helping with bring down rates of HIV and AIDS. Unfortunately, not everyone knows about PREP and PEP. I think there needs to be more education and awareness for PREP and PEP in schools, parks, public places, especially in LGBTQ communities and in the entertainment media.

If you could choose one area for enhanced community energy…?
Educate people about HIV/AIDS and about PREP and PEP, especially those of Latinx decent. Include those who are from those communities and educators who are also HIV positive. Include those who are on PREP as spokespersons to not only educate but advocate for these causes.

LEOPOLDO CABRAL, MPA
HIV Admin Director & Program Manager
El Proyecto del Barrio

What more needs to be done to bring awareness…?
Providers, educators, and leadership must be the starting point in conversation about HIV Treatment and Prevention to the Latinx Community. They need to be able to provide all these aspects in the given language and especially be able to educate the client in the best way the client can receive the information. Not only will this bring more awareness about HIV Treatment and prevention but will allow the community to have an open conversation about how far HIV has come over the past decades.

Is there anything new or different in 2021 to be considered…?
Ideas for awareness efforts that needs to be considered is accessibility for those who are either uninsured or undocumented. Provide vital information on how to receive preventative care for those who are interested, and especially those not being allowed access to care do to the inability to have access to healthcare.

If you could choose one area for enhanced community energy…?
An area to put enhanced community energy would most likely be towards adolescence and young adult groups. Given that HIV rates are higher among these age groups, many may not be aware of preventative services. This is very clear to the latinx community and other people of color.

JOAQUIN GUTIERREZ JR.
He/Him/His
Connect to Protect Los Angeles Coordinator

What more needs to be done to bring awareness…?
I believe that agencies really need to invest in communities beyond the conversation of HIV. Agencies need to address the social determinants of health that impact folx in our community, such as housing, food insecurity, employment, immigration status, and accessible health care to name a few. As providers of services we need to reflect on the systematic barriers that the spaces we work for create for members of our community and create change to break down those barriers. Its hard to talk to a young person living in the streets about the importance of taking an HIV test, when they had their last meal over 12 hours ago and have no idea where they will sleep at night.

Is there anything new or different in 2021 to be considered …?
One big lesson to take a way from this pandemic we are experiencing is the need for services to be virtual. HIV services and awareness efforts need to be accessible in virtual spaces for the members of the community that find comfort in this new way of health care. With that being said, agencies need to address the lack of accessibility to technology that our community faces. Build computer labs, create tech grants for virtual arts, and invest in making your services virtual.

If you could choose one area to put enhanced community energy…?
I believe we need to improve our messaging and accessibility to PrEP/PEP services. The messaging has to be delivered in a way that is relatable to Latine/Latinx folx. Accessibility for all folx regardless of gender, sexuality, social-economic status or immigration status needs to be at the forefront of awareness. It is important to note that our communities have fractured relationships with pharmaceutical companies due to the years of traumatic trials and experiments on communities of color. So addressing the investment of pharmaceutical companies in community driven grants, ethical practices and investment are also much needed in order to enhance community energy around PrEP.

GENEVIEVE FILMARDIROSSIAN
Chief Operating Officer & Associate Executive Director, South Central Family Health Centers

What more needs to be done to bring awareness…?
We need to provide access for all communities to a regular source of health care. Universal Health Coverage is critical and needs to provide education, preventative medicine and access to regular medical care at early ages to adolescents and young adults so they can be informed and make decisions with sound information.

Is there anything new or different in 2021 to be considered …?
Communities are hurting and impacted due to the recent and on-going Covid-19 pandemic. Issues such as food security, low-cost housing, assistance with basic necessities of life are critical and these can be barriers to care.

If you could choose one area to put enhanced community energy…?
More community information and health education materials especially in Spanish and placed in locations where at risk people can access these easily.

DIA NACIONAL LATINO DE CONCIENTIZACION SOBRE EL SIDA 2021:
“ES HORA DE ACTUAR. ES HORA DE ACABAR CON EL VIH”
By/Por Al Ballesteros, MBA

Se cree que el estigma, la pobreza, la falta de seguro médico o un seguro médico limitado, las barreras lingüísticas y culturales, la falta de información, el uso de sustancias, la desconfianza y el acceso limitado al sistema de atención médica están contribuyendo a la propagación continua de la infección por el VIH entre las poblaciones Latinx, de acuerdo con los líderes locales y nacionales del cuidado de la salud. Los expertos dicen que se deben abordar estos desafíos e invertir recursos adicionales para reducir las infecciones por el VIH en las poblaciones Latinx en el condado de Los Ángeles y en todo Estados Unidos.

Después de más de 40 años, la pandemia del VIH continúa infectando a las personas. Estados Unidos tiene ahora más de 1.1 millones de personas que viven con el VIH y tan solo en el año 2019, se encontraron 36,801 nuevos diagnósticos de VIH. No está claro cuántas personas en los Estados Unidos se infectan anualmente, pero la mayoría de los expertos en salud pública creen que el número es de aproximadamente 40,000. Ese es un número enorme. El condado de Los Ángeles tiene aproximadamente 60,000 personas que viven con el VIH/SIDA y se cree que entre 1,500 y 1,800 se infectan con el virus cada año.

La epidemia del VIH afecta a las personas Latinx a tasas elevadas. En 2019, 10,502 personas Latinx fueron diagnosticadas con VIH en los Estados Unidos, alrededor de 29 por día. Si bien las personas Latinx representan el 18,4% de la población de EE. UU., ellos constituyen el 28.5% de todos los nuevos diagnósticos de VIH y el 22.8% de todas las personas que viven con el VIH en los Estados Unidos (fuente: LCA; NLAAD). En 2019, la Comisión Latina sobre el SIDA con sede en Nueva York cita un estudio en el que encontró que solo el 53% de los latinos que viven con el VIH han alcanzado una carga viral indetectable. Esto es importante porque cuando una persona ha alcanzado una carga viral indetectable, no solo tiene mejor salud, sino que es mucho menos probable que transmita el virus a otras personas. El mismo estudio también encontró que uno de cada seis Latinx que viven con el VIH no sabía que tenía la infección. Esta realidad tiene enormes implicaciones de prevención relacionadas con la identificación de personas VIH positivas y ayudarlas a lograr la supresión de la carga viral.

Además, el 53% de los latinos nunca se ha hecho la prueba del VIH en su vida y el 62% de los latinos diagnosticados con el VIH que revelaron su lugar de nacimiento es el extranjero. (Fuente: LCOA; NLAAD). Por último, la mayoría de los nuevos casos de VIH en Latinx son hombres, lo que representa 9 de cada 10 personas.

Los hombres Latinx que tienen sexo con hombres (HSH) representaron el 24% (138,023) de todos los HSH de EE. UU. que vivían con una infección por VIH diagnosticada a fines de 2018 (fuente, CDC.gov). En 2019, los latinos representaban el 16% de la población de Estados Unidos de 13 años o mayores, pero el 29% de los diagnosticados con VIH.

El VIH se puede prevenir: Si bien todavía no existe una vacuna contra el VIH, existen formas muy eficaces de protegerse contra la infección por el virus. Prevención biomédica, se ha demostrado que PrEP es casi 100% efectivo si se toma correctamente para prevenir infecciones. Sin embargo, con respecto a las poblaciones de PrEP y Latinx, los hallazgos de un estudio de 2019 mostraron que solo 1 de cada 4 personas Latinx que recibieron una prueba de VIH financiada por el CDC conocían del PrEP, y solo 1 de cada 5 que eran elegibles para ser referidos a PrEP en realidad fueron referidos a los proveedores de PrEP. Este es un estudio importante del que todos deberían tomar nota porque las poblaciones Latinx en riesgo de infección por el VIH tienen más probabilidades de depender de los programas de pruebas del VIH financiados por el CDC que la población en general. Los bajos niveles de conocimiento de PrEP y referencias entre las personas Latinx sugieren la necesidad de identificar las barreras para los servicios de PrEP, hacer rutina la educación y las referencias de PrEP, ampliar la cobertura de los medicamentos de PrEP (fuente: Informe Semanal de Morbilidad y Mortalidad, cdc.gov).

Indetectable = Intransmisible o I = I: Existen tratamientos altamente efectivos para quienes viven con la infección por VIH y si la persona toma sus medicamentos según lo prescrito, puede vivir una vida normal con relativamente pocos efectos físicos de la enfermedad. También es cierto que cuando una persona que vive con el VIH toma sus medicamentos según lo prescrito y logra lo que se llama “cargas virales indetectables” y mantiene este estado indetectable durante un período prolongado, esta persona no puede transmitir el virus a otras personas a través del sexo. Algunos se refieren a esto como “Tratamiento como prevención”, lo que significa que las personas que viven con la enfermedad del VIH por sí mismas pueden prevenir más transmisiones en su comunidad al adherirse a sus programas médicos. Sin embargo, ¿estan conversaciones y conceptos siendo plenamente sostenidos y adoptados por las comunidades latinx? En las poblaciones identificadas blancas y/o gay donde la estrategia U=U fue más hablada al principio, se dice que las conversaciones sobre el estado de VIH de uno han sido más frecuentes y abiertas. Los expertos dicen que esto puede ser un desafío mayor en las poblaciones Latinx, donde se dice que las discusiones sobre sexo, identidad gay y estado del VIH son más limitadas debido al estigma y razones culturales.

La adherencia a la terapia antirretroviral (TAR) es crucial para la supresión viral y lograr cargas virales indetectables, una parte clave de la estrategia U = U. Pero existen barreras para la adherencia al TAR entre los MSM Latinx citados en los estudios. Los datos que analizan las barreras del Proyecto de Monitoreo Médico se recopilaron durante 2015-2019 para examinar la adherencia al TAR y razones por las que se omiten las dosis de TAR entre 1,673 HSH latinos VIH positivos. Las razones fueron: edad temprana, pobreza, consumo reciente de drogas, depresión y necesidades de servicios auxiliares no satisfechas. La razón más común para omitir una dosis de TAR fue el olvido. (fuente: CDC.gov). Las intervenciones que apoyan la adherencia al TAR y el acceso a servicios auxiliares entre los HSH Latinx podrían ayudar a mejorar los resultados clínicos y reducir la transmisión. (Fuente: CDC.GOV).

Si las transmisiones del VIH se pueden prevenir sustancialmente en las comunidades a través de la prueba del VIH, PrEP y Tratamiento como prevención o logrando cargas virales indetectables, ¿por qué estas estrategias no benefician a las comunidades Latinx en niveles más altos? La Asociación Nacional de Funcionarios de Salud del Condado y la Ciudad (NACCHO) recomienda crear conciencia, promover las pruebas del VIH, difundir estrategias de prevención y conectar a las personas Latinx con la atención que conduce a mejores resultados de salud a nivel individual y comunitario. (Fuente: Asociación Nacional de Funcionarios de Salud del Condado y la Ciudad (NACCHO)

Nota a pie de página: Los encuestados incluyeron a personas que trabajan con pacientes directamente en persona, médicos, educadores de salud, personas en política y administración de salud. Muchos de los encuestados dicen que se necesitan inversiones sustanciales por parte del gobierno, las comunidades, las organizaciones sin fines de lucro, las empresas, el sistema de salud y las entidades filantrópicas para acabar con el VIH entre las poblaciones Latinx

Otros estudios muestran que la estimación de la tasa de incidencia reciente de infección por VIH entre personas Latinx en los Estados Unidos fue cuatro veces mayor que la de las personas blancas no-hispanas según los datos de 2018 (fuente: CDC.gov).

P: Si estoy tomando medicamentos contra el VIH y mi carga viral es indetectable (lo que significa que el virus no aparece en los análisis de sangre), ¿puedo transmitir el virus a otra persona a través del sexo?
U = U es una campaña informativa sobre la eficacia de los medicamentos contra el VIH para prevenir la transmisión sexual del VIH. U=U significa “Indetectable = Intransmisible”. Esto indica que si una persona con VIH está tomando medicamentos contra el VIH (terapia antirretroviral o TAR) con una carga viral del VIH constantemente indetectable, el virus no se puede transmitir a una pareja sexual. Como estrategia de prevención, esto a menudo se conoce como Tratamiento como prevención o TasP. U=U y TasP se basan en datos científicos sustanciales. De hecho, los Centros para el Control y la Prevención de Enfermedades de EE. UU. (CDC) han dicho que “las personas que toman TAR a diario según lo prescrito y logran y mantienen una carga viral indetectable no tienen ningún riesgo de transmisión sexual del virus a una pareja VIH negativa”. Entonces, si tiene VIH: tome sus medicamentos contra el VIH todos los días. Esto es importante tanto para su salud personal como para prevenir la transmisión del VIH. (Fuente: HIV.va.gov)