New Approach NEEDED NOW TO END HIV/AIDS CRISIS AMONG LATINOS

The fight to make an invisible crisis more visible continues today with an important new paper published in the New England Journal of Medicine.

In “The U.S. Latino HIV Crisis — Ending an Era of Invisibility” experts are urging all sectors of the health and public health community to urgently evolve their approaches to meet the largely invisible ongoing  HIV/AIDS crisis among Latinos. This call-to-action comes at a time when the decades-long effort to end the epidemic in the U.S. is showing overall progress—but, not for Latinos.

“As we celebrate overall success in curbing the HIV/AIDS epidemic, Latino HIV health inequities and the continuing HIV/AIDS crisis stand out as a historic national failure that must be addressed urgently. The good news is that if we act now with a combination of existing and new approaches, we can achieve the kind of HIV prevention and care improvements for Latinos that we are seeing with other populations,” said lead author Dr. Vincent Guilamo-Ramos, executive director of the Institute for Policy Solutions at Johns Hopkins School of Nursing and director of the Center for Latino Adolescent and Family Health. “To secure progress in ending the HIV epidemic for Latinos, we must address the structural drivers of HIV among Latino communities and engage a diverse set of stakeholders to rethink and improve our national response to this crisis.”

The authors point to several factors that are likely driving Latino HIV inequities: HIV prevention, testing, and treatment services that are not designed nor delivered to meet the needs of Latinos; lack of effective programs addressing the harmful social determinants of health that impede many Latinos from achieving optimal HIV prevention and treatment outcomes; and a lack of urgency to adequately invest in interventions that can end the Latino HIV crisis.

In their article, Guilamo-Ramos and his colleagues outline a comprehensive multisectoral approach involving researchers, public health practitioners, clinicians, policymakers and other community and private-sector actors, that can end the Latino HIV crisis. The approach offers a blueprint for action divided into six- priority areas: Raising Visibility, Meaningfully Engaging the Latino Community, Improving the Public Health Response, Tailoring HIV Service Delivery, Addressing Structural Drivers, and Promoting Research and Evidence Generation.

HIV surveillance reports issued by the Centers for Disease Control and Prevention (CDC) in May 2024 illustrate commendable reductions in estimated new HIV infections for the country at large and for many racial and ethnic groups, but the data also point to an alarming trend for Latinos, who continue to experience a growing HIV crisis in the U.S. According to the CDC data, between 2010 and 2022, the overall number of new infections per year in the U.S. decreased by 19%, including a 29% reduction among Blacks and a 25% reduction among Whites. But during the same period,  annual new HIV infections among Latinos increased by 12%. In 2022, about one in three of all new HIV infections occurred among Latinos, a figure that has grown significantly since 2010, when Latinos comprised about one fourth of all new infections.

The Latino HIV crisis is most severe for Latino men who have sex with men (MSM) and transgender Latina women. In 2022, for the first time ever, Latino MSM accounted for more new HIV infections than MSM of any other racial or ethnic group and represent the largest number of new infections of any other group in the nation. Most alarming in the MSM data is a 15% single-year increase in new infections among Latino MSM ages 25 to 34, part of a 95% increase in this group since 2010. Additionally, the number of new HIV diagnoses among transgender Latina women grew by 94% between 2014 and 2022.

“For more than a decade, I have been working with colleagues and stakeholders to raise awareness of the HIV prevention and treatment needs of the Latino community and to secure adequate policy and program resources to stop this crisis before it escalates further,” stressed  Guilamo-Ramos. “This new data amplifies the need for greater visibility, political will, and increased and focused resource allocation to stem the spread of HIV among Latinos, the largest minoritized racial and ethnic group in the U.S. and growing.”

Recently, visibility of the issue has been gaining ground: Guilamo-Ramos spoke at the ¡Adelante! Summit hosted at the White House by the Office of National AIDS Policy — joining other speakers including U.S. Secretary of Health and Human Services Xavier Becerra, Congressional HIV/AIDS Caucus Co-Chair U.S. Rep. Barbara Lee, Director of the White House Domestic Policy Council, Neera Tanden, Chief, HIV Surveillance Branch, CDC Dr. Angela Hernandez, and an array of leaders at the forefront of community-driven programs and initiatives. President Biden issued a proclamation for Hispanic heritage month 2024 where he stated that his administration is “prioritizing the expansion of HIV services to reach all Americans — especially Latino gay men, who now represent the highest incidence of new HIV cases in the country.”

“Everyone has a role to play in making the crisis visible, and acting to end it,” Guilamo-Ramos urged.