Latino Sexual Minority Men Overlooked in US HIV Prevention Initiative.
Latino Sexual Minority Men Overlooked in US HIV Prevention Initiative
A new analysis provides recommendations on how local leaders can better engage with Latino men who have sex with men on HIV prevention and treatment to achieve the nation’s goal of ending the HIV epidemic by 2030.
Despite improvements in HIV prevention over the last two decades, Latino gay, bisexual, and other men who have sex with men (MSM) continue to disproportionately experience higher rates of HIV, as well as barriers to healthcare treatment and prevention tools. The Ending the HIV Epidemic Initiative (EHE), a national plan to end the HIV epidemic in the United States by 2030, aims to close these gaps by providing locally tailored prevention and treatment strategies. The plans launched initially in 57 priority counties and states that reported the highest incidence of HIV.
As the initiative prepares to expand these efforts more broadly across the nation from 2026-2030, a new analysis by researchers at the School of Public Health and the University of Miami Miller School of Medicine (UM) examines how Latino gay, bisexual, and other MSM are represented in these plans, and whether improvements can be made to track and address their specific HIV prevention health needs, cultural barriers, and other factors as the nation aims to reduce new HIV cases by 90 percent over the next five years.
Published in JAMA Health Network, the analysis found significant gaps in HIV data among Latino sexual minority men.
The analysis showed that EHE plans in only 19 of the 57 prioritized counties or states explicitly identified the needs of Latino gay, bisexual, and other MSM, while 22 plans acknowledged the barriers that this population faces to HIV prevention or treatment. Only two jurisdictions (Washington, DC and New York) discussed how to track progress among this population within their EHE plans.
While national HIV infections declined by nearly 20 percent from 2010 to 2022, HIV cases increased by 24 percent among Latino sexual minority men, and 95 percent among younger members of this population aged 25-34. Identifying local variations in how EHE plans incorporate HIV data among Latino gay, bisexual, and other MSM will enable local leaders to improve their strategies in HIV planning and ensure that these plans are relevant to the specific populations they serve.
“Latino sexual minority men are disproportionately affected by adverse HIV prevention and care outcomes because of social, structural, and behavioral factors that increase their vulnerability. But they are not a monolithic group,” says study co-corresponding author Carlos Rodriguez-Diaz, chair and professor of community health sciences, who authored the analysis with co-corresponding author Jahn Jaramillo, a PhD candidate at UM. “For example, research shows that Mexican-born men in Chicago often delay HIV care due to significant pre- and post-migration concerns, including poverty and social stigma, and lack of access to healthcare. But Central American Latino immigrant sexual minority men have low HIV testing rates due to low HIV awareness, experiences of violence, and chronic stress.”
For the analysis, the researchers reviewed publicly available EHE plans and reports from the Centers for Disease Control and Prevention, the National Alliance of State and Territorial AIDS Directors, and local health departments.
Most EHE plans omitted specific metrics to measure progress in HIV prevention for Latino sexual minority men, instead incorporating this information into measures of broader demographics. The researchers say that the lack of specific data about this population not only inhibits the development of targeted HIV interventions, it also contributes to the erasure of a community that is highly affected by HIV—and it is happening alongside the federal government’s concerted removal of health data that it deems promotes “gender ideology” from government websites.
In addition to few disaggregated metrics, many EHE plans also lacked an understanding of the social and economic barriers to HIV prevention and treatment services that Latino sexual minority men face, and only 19 plans tracked engagement with this population in local communities.
In the next phase of the EHE initiative, the researchers urge EHE planners to engage Latino sexual minority men in all stages of local planning, as well develop and track the initiative’s performance and outreach with this population, and utilize local data to inform tailored and culturally competent EHE policies and resources to effectively treat the population.
“Community leadership is fundamental, considering the actions of the current federal government to limit or erase access to essential data to address the HIV epidemic,” Rodriguez-Diaz says.
Local and state governments should support efforts to archive and continue collecting vital information for disease surveillance, evaluate the effectiveness of interventions, and design future strategies, he says. “Community engagement ensures the relevance, success, and sustainability of public health efforts aimed at improving HIV outcomes. It is the only way to end the HIV epidemic.”