1. HIV/AIDS AMONGST LATINO MALES
Elena Kennedy
Political Science 422
Marquez & Scarano
15 December 2015

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Introduction
Human immunodeficiency virus (HIV), which becomes acquired immunodeficiency
syndrome (AIDS) if untreated, continues to be a highly stigmatized disease across the globe.
Despite likely having origins in Africa long ago, literature is heavily focused on the disease post-
1980 when it emerged amongst several white, gay, males living in Los Angeles, CA.1 By June of
1982, researchers in Southern California believed it was a sexual disorder and they named it
Gay-related immune deficiency (GRID).1 After further investigation, the disease was also found
in Haiti, Uganda and other countries, and researchers gave it the current day name of acquired
immune deficiency syndrome or AIDS later that same year.1 Despite the short time frame that
the disease was given a direct relationship to the gay community, the stigmatization as a gay-
related disease still permeates discussion and many people’s perception of the disease.
Every first of December marks another World AIDS Day, a day that since 1988 has
celebrated progress, and represents the support for the millions impacted indirectly or directly by
the disease.2 In the year 2015, despite being what some say is the most hopeful of the last 35
years celebrated, the day also signifies another year gone past with continued diagnoses of a
disease we have yet to cure.2 Most importantly, the day also honors all those who have lost their
battle with AIDS, a disease that has claimed 40 million lives thus far, but one that many feel can
realistically be controlled by 2030.1,3 With the first identification of the disease in 1984, this year
marked the thirty-first year of struggle.4 Today, the United Nations (U.N.) reports that of the 37
1
"History of HIV and AIDS Overview | AVERT." History of HIV and AIDS Overview| AVERT.
AVERT,1 May 2015. Web. 1 Nov. 2015.
2
Beyrer,Chris, and Anthony Fauci. "World AIDS Day: Time to Write Last Chapter on HIV." CNN.
November 30, 2015. Accessed November 30, 2015. http://www.cnn.com/2015/11/30/opinions/beyrer-
fauci-world-aids-day-hiv/.
3
Mhofu, Sebastian. "AIDS Conference Ends in Harare."VOA. 4 Dec. 2015. Web. 5 Dec. 2015.
4
"World AIDS Day."World AIDS Day. 2015. Web. 26 Nov. 2015.

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million people living with HIV, 26 million, or nearly 70 percent live in Sub-Saharan Africa.5
The U.N. also reports that nearly 16 million of those living with HIV are currently taking some
combination of drugs, commonly referred to as antiretroviral treatment (ARV), to combat the
diseases symptoms and progression into AIDS.5 The WHO believes ARV treatment must be
expanded significantly and is calling for universal ARV treatment, saying it could prevent nearly
21 million AIDS-related deaths and 28 million new infections before the year 2030.5 Despite the
progress and continual recommendations for future elimination, AIDS is still the leading cause of
death among women of reproductive age, the leading cause of death in all of Africa, and affects a
projected 19 million people who are living with the disease unknowingly.6
Antiretroviral Pre and Post-Exposure Prophylaxis Treatments
Scientific progress and the continued funding for research will be key in ending the
HIV/AIDS epidemic. Over the years testing for HIV/AIDS has been greatly improved, as we
now use rapid diagnostic tests (RDTs) to determine a person’s status in just seconds.7 Science
has also brought us ARVs, which can help treat and prevent HIV if used with appropriate
adherence and drug combinations.7 ARVs come in two treatment forms, Pre-exposure
prophylaxis (PrEP), for people at-risk for contracting HIV, and post-exposure prophylaxis (PEP),
for those who have likely already been exposed to HIV.8,9 The WHO has now recommended that
5
"WHO Urges Antiretroviral Treatment for All with HIV." VOA. December 1,2015. Accessed
December 1, 2015. http://www.voanews.com/content/who-urges-antiretroviral-treatment-for-all-with-
hiv/3082328.html.
6
Buse,Kate,Jonathan Jay, and Morolake Odetoyinbo. "AIDS and Universal Health Coverage- Stronger
Together." The Lancet:Global Health. November 30, 2015. Accessed November 30,2015.
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00273-9/abstract.
7
"HIV Treatment & Care Policy Brief." World Health Organization. 2015. Accessed December 1,2015.
http://apps.who.int/iris/bitstream/10665/198064/1/9789241509893_eng.pdf.
8
"PEP- HIV Basics."Centers for Disease Control and Prevention. March 24, 2015. Accessed December
1, 2015. http://www.cdc.gov/hiv/basics/pep.html.
9
"PrEP- HIV Basics."Centers for Disease Control and Prevention. June 25, 2015. Accessed December 1,
2015. http://www.cdc.gov/hiv/basics/prep.html.

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the use of both be started as soon as possible, with research showing the best outcomes in
patients who were started them at the earliest stages of intervention.7 The recommendations also
specifically target pregnant women and their newborn babies, in hopes of eliminating mother-to-
child HIV transmission, suggesting all HIV positive mothers be placed on ARVs throughout
their pregnancies, and babies be given PEP immediately following birth.7
PrEP treatment consists of a single oral medication taken daily, meanwhile PEP has been
shown most effective in a two or three drug cocktail that must be started within 3-days of
potential HIV contact and consists of a strict 28-day regime.8,9 In order for PrEP and PEP
treatments to be effective, the full medication regime must be strictly followed, which can be
very hard for some patients, and also leaving researchers and clinicians frustrated over how to
increase regime adherence. Daily PrEP has been shown to lower the risk of contracting HIV by
over 90 percent, and even as high as 70 percent in patients who are IV drug users.10
Once a person is diagnosed with HIV, the ARV cocktail is adjusted once again, from the
PEP 28-day plan, to one that would include three to five different medications to be taken each
day for the rest of a person’s life.11 Not only is medication adherence crucial to success, ARV
treatments are accompanied by frequent blood testing to check the person’s HIV viral load and
adjust medication as needed, as well as visits to medical facilities for other diseases associated
with one’s suppressed immune system. While ARVs do not cure HIV, they have been found to
prolong the lives of those living with HIV, as well as helping to prevent HIV transmission to
others, showing its importance as a preventative and responsive intervention.11
10
Han,Da Hee. "CDC Not Enough High-risk Adults Receiving HIV PrEP."MPR. November 30, 2015.
Accessed November 30, 2015. http://www.empr.com/features/cdc-not-enough-high-risk-adults-receiving-
hiv-prep/article/456602/.
11
"FDA-Approved HIV Medicines | HIV/AIDS Fact Sheets | Education Materials | AIDS info." AIDS
info. May 4, 2015. Accessed December 1,2015. https://aidsinfo.nih.gov/education-materials/fact-
sheets/21/58/fda-approved-HIV-medicines.

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In talking about any medical treatments in the United States cost must remain central to
the discussion. As most of the focus surrounding HIV has shifted into preventative measures,
PrEP is the most widely recommended way to curb future diagnosis. In a study done on PrEP
usage amongst men who have sex with men (MSM), a very vulnerable population, researchers
did a cost-benefit analysis of PrEP treatment to see how viable it is as a prevention mechanism.12
The study found that in the year of 2006 the average drug cocktail cost $753 per month, with
some regimens costing as much as nearly $1,600 per month.12 Based on efficacy, which has a lot
to do with adherence to the regimens, and the cost effectiveness shown through quality of life
yearly gains, the study concluded that PrEP was too expensive of a method to be attractive as an
intervention in the US.11 Therefore, studies show that PrEP intervention is one of the most
effective methods of prevention, however, the U.S. health care system and pharmaceutical
companies have not allowed it to be an affordable solution.
Prevalence in the United States
Just this month, studies found data revealing progress in the reduction of HIV diagnoses
in the United States, however the decreases were not spread throughout all populations, finding
that for Latino gay and bisexual men new diagnosis have actually risen 24 percent between the
years of 2005 to 2014.13 With National data showing an overall decrease of 19 percent, the
disproportionately faced by Latino gay and bisexual men is alarming.13
12
Paltiel, A. David, Kenneth A. Freedberg, Callie A. Scott, Bruce R. Schackman, Elena Losina, Bingxia
Wang, George R. Seage, Caroline E. Sloan, Paul E. Sax, and Rochelle P. Walensky. 2009. “HIV Pre-
exposure Prophylaxis in the United States:Impact on Lifetime Infection Risk, Clinical Outcomes, and
Cost-effectiveness”. Clinical Infectious Diseases 48 (6). Oxford University Press:806–15.
http://www.jstor.org.ezproxy.library.wisc.edu/stable/40309040.
13
CDC. "HIV Diagnoses Decline Almost 20 Percent,but Progress Is Uneven." Blogaids.gov HIV Policy
Programs Research New Media. Centers for Disease Controland Prevention, 6 Dec. 2015. Web. 7 Dec.
2015.

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Latinos
In 2013, twenty-three percent of all new HIV diagnoses were in Latinos, with 85 percent
being men. Of these men, 81 percent were classified as gay, bisexual, or men who have sex with
men (MSM).14 In 2013, HIV was the eighth leading cause of death for Latinos ages 25 to 34 and
the ninth for those aged 35 to 54, showing the impact greatest on young males.14 Between the
year 2012 and 2013, eighty-three percent of HIV positive Latinos reported they were receiving
medical care within three months of their diagnoses, however only 54 percent were retained, and
of those only 43 percent were on ARVs.14 Latina women and children are also disproportionately
impacted by HIV/AIDS when compared to whites, however at much lower rates than males.
What is important to note in relation is that 86 percent of Latina women contract HIV through
heterosexual relations with males, meaning that the higher rate of male cases is still very
impactful on the lives of both women and their children.14
Data analysis is a great way to get a general glimpse at where disparities lie, however,
when looking at “Hispanics/Latinos” we must remember we are analyzing a vast population
composed of many sub-groups. Even in the notes section of the CDC’s spreadsheet they state
“Hispanics/Latinos can be of any race,” reminding us of vague ethnic categorizations our country
uses may not be the best way to analyze populations.14 HIV/AIDS differentially affects Latinos
based on their ethnicity and place of birth, and recognizing such serves as a reminder that the
vague categorization is an important part of implementing appropriate preventions. Language
14
"HIV Among Hispanics/Latinos." Centers for Disease Control and Prevention. October 15, 2015.
Accessed November 23, 2015. http://www.cdc.gov/hiv/group/racialethnic/hispaniclatinos/.

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barriers, suspicion or fear of deportation, race and place of birth can all be factors contributing to
inaccuracies in Hispanic/Latino data, as many may be left out of the representation.15
Prevalence in Latin America
It is also important to discuss the prevalence of HIV in Latin America, as many
individuals may have contracted the virus prior to immigration to the U.S., another way data may
include inaccuracies. In the year of 2014, 36.9 million people were living with HIV globally,
with 1.7 million, less than 5 percent, residing in Latin America.16 New infections of HIV
decreased 17 percent in Latin America between the years 2000 and 2014.16 Of those aged 15 and
over in Latin America, only 47 percent are receiving ARVs. UNAIDS data showed that in 2014
there were 26,000 deaths from AIDS in the Western and Central Europe and North America
region, 41,000 in Latin America and 790,000 in Sub-Saharan Africa.16 Resources, technology
and money can certainly account for death rates being so dispersed, showing us how HIV/AIDS
is impacting the lives of humans globally at very different levels.
Latino Males in the United States
Factors
In 2010, a study done including 37 states and Puerto Rico found the estimated lifetime
risk (ELR) of being diagnosed with HIV three times higher for Hispanics/Latinos, lagging only
behind blacks/African Americans with the highest rates.17 Amongst Latinos, the ELR is much
greater in males than in females, which is attributed to the high rate of diagnoses amongst
15 Brown, Anna. "The Unique Challenges of Surveying U.S. Latinos." Pew Research Center RSS. November 12,
2015. Accessed December 1, 2015. http://www.pewresearch.org/2015/11/12/the-unique-challenges-of-surveying-u-
s-latinos/.
16 "UNAIDS." Fact Sheet 2015. 2015. Accessed November 20, 2015.
http://www.unaids.org/en/resources/campaigns/HowAIDSchangedeverything/factsheet.
17 “Estimated Lifetime Risk for Diagnosis of HIV Infection Among Hispanics/Latinos — 37 States and Puerto Rico,
2007”. 2010. “Estimated Lifetime Risk for Diagnosis of HIV Infection Among Hispanics/Latinos — 37 States and
Puerto Rico, 2007”. Morbidity and Mortality Weekly Report 59 (40). Centers for Disease Control & Prevention
(CDC): 1297–1301. http://www.jstor.org.ezproxy.library.wisc.edu/stable/23320873.

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Hispanic/Latino men who have sex with men (MSM).17 Another way we can note vulnerabilities
amongst Latinos is looking at AIDS specific data, as the progression from HIV to AIDS is a
clear sign that adequate care and attention are likely not being given to the population. In the
year 2005, Latinos had a 26.4 per 100,000 case rate of AIDS, whites were at 7.5 per 100,000 and
blacks held the overwhelming majority of cases with a 75 per 100,000 case rate.17 Of all Latinos
with AIDS, 80 percent live in New York, California, Puerto Rico, Florida, Texas, and New
Jersey, where Latinos represent disproportionate rates of those living in poverty.18 Six
metropolitan cities accounted for 61 percent of all newly diagnosed AIDS cases in 2004: New
York, Los Angeles, Miami, San Juan, Houston, and Chicago, in order of most to least.18
Knowing where Latinos are facing the worst outcomes of the HIV/AIDS epidemic is crucial to
creating realistic policies to target such disproportionalities.
Immigration Status
In 2014, it was estimated that 11.3 million unauthorized immigrants were living in the
U.S.19 Of the 19 million immigrants in 2013, 46 percent self identified as of Hispanic origin,
making up 35 percent of all Hispanics living in the United States.20 The overwhelming majority
of Latino immigrants are from Mexico and now reside in primarily the West and Southwest
states of our country.19 For undocumented immigrants living in our country, not only is
18
Marilyn Aguirre-Molina and Luisa Borrell and William Vega and David Williams et. al. Health Issues
in Latino Males: A Social and Structural Approach. NewBrunswick:Rutgers University Press,2010.
https://muse.jhu.edu/ (accessed December 1,2015).
19
Passel,Jeffrey,and D'Vera Cohn. "Unauthorized Immigrant Population Stable for Half a Decade."Pew
Research Center RSS. July 22, 2015. Accessed December 1,2015. http://www.pewresearch.org/fact-
tank/2015/07/22/unauthorized-immigrant-population-stable-for-half-a-decade/.
20
Zong, Jie, and Jeanne Batalova. "Frequently Requested Statistics on Immigrants and Immigration in the
United States."Migrationpolicy.org. February 25, 2015. Accessed December 1,2015.
http://www.migrationpolicy.org/article/frequently-requested-statistics-immigrants-and-immigration-
united-states#Demographic, Educational, and Linguistic.

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navigating health care a challenge, but many fear deportation or other measures may be
associated with seeking care.
Positive Status
Similarly, immigrants may also fear the diagnoses of a positive HIV status could lead to
similar consequences of deportation. For instance, over the last thirty years Haitians have
experienced severe barriers associated with presumed HIV status.21 In fact, Haitians were cited
as the only asylum-seeking group to ever have been legally tested and detained for positive HIV
statuses by the U.S.21 Knowing that such a policy has been used in our country may spark fears
amongst other immigrant groups regarding HIV positive statuses.
The perception that HIV/AIDS is a disease of gays is also an important reason why many
would fear their positive status be known, as some would fear automatically being assumed gay.
The associated stigmas of homosexuality have limited the ability for many to be comfortable
revealing a positive status, whether it be to sexual partners and or family, which impedes on
prevention measures.
Language Barriers
The U.S. follows Mexico as the country with the second largest population of Spanish
speakers in the world.22 More than 41 million in the U.S. are categorized as native Spanish
speakers.21 In 2012, a study found a strong correlation between bilingualism and self-rated
physical and mental health amongst Latinos, meaning those with the ability to speak both
21
Kurzban, Ira J.. 1993. “United States Policy Toward Haitian Refugees:Is It Only Institutionalized
Racism?”. In Defense of the Alien 16. The Center for Migration Studies of New York, Inc.: 130–34.
http://www.jstor.org/stable/23140869.
22
Tharoor, Ishaan. "Chart: There Are More Spanish Speakers in the U.S. than in Spain." Washington
Post. June 30, 2015. Accessed December 3,2015.
https://www.washingtonpost.com/news/worldviews/wp/2015/06/30/chart-there-are-more-spanish-
speakers-in-the-u-s-than-spain/.

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Spanish and English reported having the highest self-rated health and wellbeing.23 The study also
found that although having English dominance alone revealed better outcomes than Spanish
dominance alone, bilingualism was associated with the highest self-rankings, which researchers
attached to the idea of a “cultural flexibility” that allowed immigrants to better navigate systems
of health..22
Isolation and Loneliness
Migration to the United States can cause social, familial, and sexual relationships to be
strained or disrupted entirely, which for many can lead to depression and or feelings of loneliness
or isolation. This change in mental state has been linked to HIV high-risk behaviors,” such as use
of drugs and or prostitution as coping mechanisms.17
Not only is this phenomenon seen amongst immigrants, but is also connected to a broader
disenfranchisement of those living in poverty conditions. When living under the stresses of
poverty conditions, it can lead to boredom and loneliness, and is heavily associated with HIV
high-risk behaviors.18
MenWho Have Sex with Men
As noted, the most vulnerable population for new HIV diagnosis are bisexual, gay and
MSM Latino males. MSM is the primary mode of HIV/AIDS transmission exposure for all
Latino male sub-groups except Puerto Ricans, who are exposed instead primarily through IV
drug use (IVDU).18 In 2005, 64 percent of Mexican born Latinos newly reported with AIDS
were MSM cases, while nationwide MSM compromised 68 percent of all male AIDS cases.18 In
1990, in a survey on HIV/AIDS impacts felt by Latinos it was noted that in the Spanish language
23
Schachter,Ariela, RachelT. Kimbro, and Bridget K. Gorman. 2012. “Language Proficiency and Health
Status: Are Bilingual Immigrants Healthier?”. Journal of Health and Social Behavior 53 (1). American
Sociological Association: 124–45. http://www.jstor.org.ezproxy.library.wisc.edu/stable/23113206.
18
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there is no specific word for “gay” and that instead labels such as maricón, mariacas or raro
(“sissy,” “faggot” or “rare”) were seen as popular terms to describe homosexuales.24 One can see
that using terms with such negative connotations may have also contributed to negative
sentiments and stigmatizations surrounding Latino bisexual, gays and MSM, as their sexual
preferences are clearly condoned even through basic language use.23 Homosexuality has also
been directly condoned by government regimes, for instance the wide migration of gay and
bisexual Cubans to the U.S. to seek freedom from the social hostility.23 Heterosexism is also
dominant in the U.S. and “operates through invisibility, social hostility, and the denial of civil
and or human rights,” meaning many bisexual and gay citizens are continually discriminated
against and stigmatized for their sexual preferences, adding additional barriers when seeking
HIV/AIDS prevention and or treatment.18
IV Drug Use
IV drug use (IVDU) is heavily associated with HIV diagnoses, as the sharing of needles
and subsequent bodily fluids is a HIV high risk behavior. IVDU is the primary mode of exposure
for Puerto Ricans, making them the only Latino subgroup without MSM as the primary mode of
exposure.18 As mentioned, IVDU is commonly linked to poverty and other high-risk behaviors.
Social and Cultural Stigmas
As most of the initial and ongoing HIV prevention has been targeted towards white
bisexual and gay men, the disease has become highly stigmatized. In fact, until 1983 HIV/AIDS
articles and research were listed under “homosexuality” headings and has been stigmatized to be
24
Singer, Merrill, Cándida Flores, Lani Davison, Georgine Burke, Zaida Castillo, Kelley Scanlon, and
Migdalia Rivera. 1990. “SIDA: The Economic, Social, and Cultural Context of AIDS Among
Latinos”. Medical Anthropology Quarterly 4 (1). Wiley: 72–114.
http://www.jstor.org.ezproxy.library.wisc.edu/stable/648524.
18
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associated with the “fast-track gay lifestyle,” which made people horribly frightened and created
the social construction that still surrounds the epidemic today.23 HIV/AIDS preventions also
largely frame it as a personal issue, a disease caused by a person’s ill behaviors or lack of
knowledge, rather than framing it as an issue of social, cultural, or environmental issues that may
be impacting one’s life.18 Stated perfectly, “the emphasis on personal responsibility for
preventing HIV transmission continues to implicate the individual as the sole agent in creating
risk and therefore the sole agent for eliminating it” making a re-victimizing the victim type claim
for how preventative efforts are failing to succeed, especially with minority populations who are
already undergoing significant pressure from society through racial discrimination.18
Racial Discrimination
Over the course of history, Latinos have been placed in a sticky middle ground when it
comes to racial classification in the U.S. For instance, those with African ancestry have often
been categorized “black,” meanwhile fair skinned Latinos were often deemed “Spanish” or even
“white.25” The introduction of Jim Crow laws in the 1880’s brought strict segregation and
racialized politics to our country that have had lasting impacts on minorities, especially blacks in
our country.18 Some have argued Latinos have been more susceptible to black categorizations,
which has lead to negative outcomes to social determinants like wealth, income, health.24 Black
Latinos give us the perfect angle to see such treatment, as they often fair much worse than their
lighter skin Latino counterparts, which many call an “economic rent” or “tax paid” through
additional burdens faced in having darker complexions.18 In fact, Hispanic black men were found
to experience the worst health outcomes of all Hispanics.18 Discrimination or perceived
25 Thomas, Lorrin. Puerto Rican Citizen History and Political Identity in Twentieth-century New York City. Chicago,
IL: University of Chicago Press,2010.
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discrimination based on skin color are also strong indicators of worse states of mental health
amongst Mexicans, Puerto Ricans and Dominicans.18
Socioeconomic Status
No surprisingly, socioeconomic status has long served as a predictor for health outcomes,
with those living in poverty at much higher vulnerabilities for poor health.18 It is said that
“differences in access to care, experiences of racism, social conditions (e.g. crime) and lifestyle
patterns (e.g. smoking, exercise, and eating habits), and psychological well-being are all aspects
of one’s health tested when living in lower socioeconomic classes.”18 The inability to find
employment, education, and quality housing are all socioeconomic outcomes tied closely to race,
showing us why Latinos may fair worse than whites in all categories.18
Segregated Communities
Socioeconomic status and race have also greatly dictated where low-income residents are
able to live. Race and poverty have led to disenfranchised communities with tremendous racial
segregation.18 These communities lack resources needed for residents to find social opportunities
and employment which has resulted in social discrimination, meaning these communities are
effectively separate from all else. Poverty has also resulted in limiting the pool of sexual partner
choices to be confined to one’s neighborhood, as travel outside one’s neighborhood would be too
costly for most to support.18
Health Care
Despite interventions such as PrEP being highly successful in mitigating the progression
of HIV to AIDS, the treatment regimes are very expensive. When accounting for all the
additional appointments that may also be needed, HIV treatment can be seen as out of reach for
many low income individuals. Latinos disproportionately live in poverty, showing access to

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affordable health care a primary concern. However, A study done in 2010 found that Latinos are
more willing than whites to pay higher rates for health care. 26 The study evaluated Asians and
Latinos based on their willingness to pay more or spend more time to access health care in order
to assess the value the population places on health care.26 Latinos of moderate health were
willing to spend more time for health, but Latinos in poor health were less willing to trade time
to seek health than non-Latino whites.26
Other barriers in accessing health care include how health facilities are likely outside
impoverished neighborhoods, meaning transportation may be needed. Based on the previous
study, we can see how a Latino in poor health may be less willing to seek transportation,
especially public transportation, as it could take from their time.26 The initial barrier of
transportation, the expenses associated with care and immigration status are all factors Latinos
may face in accessing adequate care in time to cease HIV’s progression to AIDS.
Implications for Further Research
As discussed, individualized research needs to be done to help account for statistical
inaccuracies from using vague categorizations of “Hispanics” and or “Latinos” to help us see
whether disparities can be minimized through targeting specific sub-groups. This research would
greatly benefit policies created for further prevention of HIV, as it would help us cater
programming to specific populations where help is most needed.
18 Pages 220-221
26 Mulvaney-Day, Norah E., Marcela Horvitz-Lennon, Chih-nan Chen, Mara Laderman, and Margarita Alegría.
2010. “Valuing Health in a Racially and Ethnically Diverse Community Sample: An Analysis Using the Valuation
Metrics of Money and Time”. Quality of Life Research 19 (10). Springer: 1529–40.
http://www.jstor.org.ezproxy.library.wisc.edu/stable/40927204.

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Policy Suggestions Specific to Latinos
In a perfect world the United Nations Sustainable Development Goal (SDGs) of 2030 to
end the AIDS epidemic will be realized, however as we saw with the previous Millennium
Development Goals (MDGs) of 2015, vague frameworks may not be as helpful as specific policy
suggestions.27,28 In realizing such, I hope to provide several suggestions based on my research for
policy improvements to help reduce the disproportionate incidence of HIV/AIDS within the
Latino population of the U.S.
Comprehensive Immigration Reform
Despite being a lofty goal, comprehensive immigration reform should remain a high
priority, with health outcomes of citizens being just one proposed benefit. Immigration policies
could help a tremendous amount of U.S. residents gain legal citizenship and also help change
attitudes surrounding immigration. Improved systems of citizenship and the reduction of anti-
immigration sentiments would allow Latinos to access health care without fear of rejection and
or discomfort surrounding their presumed immigration status.
Universal Health Care
With increased legal citizenship would come the opportunity to access social services
such as Medicaid and Medicare that have strict restrictions, by both federal and state level
government regarding eligibility be for U.S. citizens.29 Emergency Medicaid, or services
provided by Emergency Departments are expensive and inefficient ways that undocumented
27
"Sustainable Development Goals - United Nations." UN News Center. September 25, 2015. Accessed
November 10, 2015. http://www.un.org/sustainabledevelopment/sustainable-development-goals/.
28
"United Nations Millennium Development Goals." UN News Center. September 1,2000. Accessed
November 12, 2015. http://www.un.org/millenniumgoals/.
29
"Medicaid Eligibility." Medicaid.gov. Accessed December 1,2015. http://medicaid.gov/medicaid-chip-
program-information/by-topics/eligibility/eligibility.html.

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immigrants are currently able to receive care.30 Universal health coverage (UHC) would not
address immigration policy directly, but would greatly impact Latino citizens through making
health care affordable. The Vermont Worker’s Center began a proposal for UHC in their state
using human rights implications as their primary argument.31 In their plea for coverage they note
how increasing costs of health care across the nation will leave detrimental impacts on citizens.
Vermont’s “Healthcare is a Human Right” campaign should be expanded on a national scale.29 If
implemented, UHC would greatly benefit those living in or near poverty through making health
care more affordable. UHC would have profound effects on the Latino community, as increasing
financial accessibility to health care would lead to improved health outcomes for the population.
Reduce Associated Stigmas
The continued emphasis for HIV interventions to be done on an individual level is not
only reinforcing stigmas, but is also not a realistic way to prevent further spread of the disease.18
Changing HIV/AIDS prevention to focus on social determinants of the disease can help change
the discussion from an individual level to a comprehensive effort for elimination. With regards to
Latinos, it is important that educational materials be available in both English and Spanish, and
also include cultural sensitivity surrounding issues like MSM and IVDU. Despite Latino HIV
diagnosis being largely attributed to the two, focusing too heavily on those factors would once
again reinforce stigmas. Including information on all groups can help show how HIV/AIDS can
impact all lives, not just those of MSM or IVDU individuals. Changing from a victim blaming
30 Galewitz, Phil. "How Undocumented Immigrants Sometimes Receive Medicaid Treatment." PBS. February 13,
2013. Accessed December 1, 2015. http://www.pbs.org/newshour/rundown/how-undocumented-immigrants-
sometimes-receive-medicaid-treatment/.
31 McGill, Mariah. 2012. “Human Rights from the Grassroots Up: Vermont's Campaign for Universal Health
Care”. Health and Human Rights 14 (1). [Harvard School of Public Health/François-Xavier Bagnoud Center for
Health and Human Rights, President and Fellows of Harvard College]: 106–17.
http://www.jstor.org.ezproxy.library.wisc.edu/stable/healhumarigh.14.1.106.
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model to one that encompasses community building and empowerment will encourage
discussions surrounding the disease, instead stigmatizing it any further.
Desegregate Neighborhoods
Policy that could help with the desegregation of neighborhoods would help uplift
disenfranchised communities, where HIV seems to thrive under the conditions of poverty.
Community building can help rebuild impoverished neighborhoods, through creating increased
employment opportunities, improving access to public transportation systems for commutes in
and out of the neighborhood, and reducing crime so that people can feel safe in their homes.
Efforts could also be made to bring health resources to disenfranchised communities, for
instance through the use of mobile health clinics. Bringing care to populations in need is an
effective way to eliminate barriers such as transportation. Staff can also be specifically trained to
address the needs of the community, with awareness to cultural and social factors associated with
HIV/AIDS care allowing them resources to help reduce stigmas and encourage the community to
take advantage of the health resources.
Conclusion
Researching HIV and its associated stigmas was able to show how treatment and
prevention efforts can be improved to target the disproportionate impacts of the disease faced by
U.S. Latinos. My research was significantly challenged by the broad categorization of “Latinos,”
showing how individualized data on sub-groups could greatly improve general knowledge and
inform further research. Overall, if the stigmatizations surrounding HIV were changed from a
victim blaming perspective to one that encompasses all potential vulnerabilities, the Latino
population would see an increased willingness to discuss and confront the disproportionate
outcomes they face. It will take a community effort to find prevention and treatment methods

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that work best for individualized sub-groups of Latinos, which further research needs to help
inform.

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