Stigma is keeping LGBTQ+ Hispanic and Latino men from seeking HIV care: report (2024)

Even as women break glass ceilings around them, some men remain trapped by a patriarchal ideal of manhood. “Machismo,” in Spanish, is a strong or aggressive masculine pride often associated with a man’s role in a traditional, heterosexual family. A new study by ViiV Healthcare and TCC Group finds that for gay and bisexual Latino/Hispanic men with HIV, that machismo can be a threat to their identity and lives.

“Here As I Am” is a listening initiative with more than 760 Latino/Hispanic gay, bisexual and trans men affected by HIV that included community mapping and interviews with health care providers in eleven cities across the United States, including Puerto Rico. Almost half — 46 percent — of the respondents were living with HIV. Justmore than half — 55 percent — were open about their sexuality.

“The biggest challenge for men in this study was navigating the mix of familial, societal and political responses to their multiple identities – as sons and brothers, as gay, bi or trans men, as men living with HIV and as Latinx men. In this uncertain landscape, familylike networks and providers that are highly trusted are especially important,” the study found.

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An estimated 186,900 Hispanic/Latino gay and bisexual men are living with HIV, according to the study, with nearly 80 percent of new diagnoses among Hispanics/Latinos in 2018 found in gay and bisexual men,2 out of3 of whom were between ages 13 to 34. In comparison, adult and adolescent gay and bisexual men made up 70 percent of the new HIV diagnoses among the general United States population in 2017, according to the Centers for Disease Control and Prevention.

Several respondents reported being kicked out of their homes by their families after coming out or being outed as gay or bisexual, leaving them both traumatized and homeless. For those who had their family’s support, the community around them carried its own stigma against the LGBTQ+ community.

“Our second year doing our Pride event, my mom decided she wanted to volunteer. People knew that I was gay, but they didn’t know how my mom felt about it. There was a cultural shift that I saw just in my personal network, people being okay to embrace their sons because my mom was okay to embrace me,” one respondent said.

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For men especially, a good relationship with their provider — especially one that can speak their language or shares their sexuality — is key to engaging in care.

“I have had to leave my doctor because they didn’t understand the type of sex I was having,” another respondent said.

Nearly1 in5 newly diagnosed Hispanic/Latinio gay and bisexual men were diagnosed late, the study found, meaning with HIV and AIDS concurrently. Hispanics have the highest uninsured rates of any racial or ethnic groupin the United States, according to the Census Bureau, and those that do often depend on public health insurance coverage — which has its own set of hurdles to clear.

“I don’t have enough information, I don’t know where to go, there is no organization or department that focuses on Latino immigrants that don’t have insurance or money. Private consultation is extremely expensive. I don’t have enough money to pay for all the services,” one respondent said.

Other respondents said politics plays a major role in seeking out health care, especially for those living in fear of deportation. For Afro-Latinx LGBTQ+ people, their Black identity is under attack at the same time as their ethnicity, sexuality and gender.

“Despite progress made to decrease HIV diagnoses in the US overall, disparities still exist – particularly for people of color,” said Marc Meachem, Head of US External Affairs, ViiV Healthcare, in a statement. “Further, while we have medicines to effectively treat and manage HIV, one-in-three Latino men living with HIV are not virally suppressed. The unique experiences of the Latinx community necessitate community-driven approaches to close gaps in care in order to meet the national goal of ending the HIV epidemic by 2030.”

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