HIV & Latinos in the US

Disparities in HIV Infection Rates Among Latinos in the U.S.

HIV and Latinos

Despite overall declines, Latinos face higher rates of new HIV infections, with the Southeast showing the highest diagnosis rates.

While estimated new HIV infection rates declined 23% in the United States from 2012 to 2022, a KFF Health News-Associated Press analysis found the rate has not fallen for Latinos as much as it has for other racial and ethnic groups. The analysis found Latinos are experiencing a disproportionate number of new infections and diagnoses across the U.S., with diagnosis rates highest in the Southeast.

Rising HIV Rates Among Latinos

African Americans continue to have the highest HIV rates in the U.S. overall, but Latinos made up the largest share of new HIV diagnoses and infections among gay and bisexual men in 2022, per the most recent data available. Latinos are about 19% of the U.S. population but accounted for about 33% of new HIV infections, according to the Centers for Disease Control and Prevention.

Federal Campaign to End HIV Epidemic

The federal government launched a campaign in 2019 to end the HIV epidemic and has funneled millions of dollars annually to certain areas with the highest infection rates. However, there’s no clear mandate for that money to be spent on a particular group, leaving it up to the cities, counties, and states to come up with targeted strategies. Public health experts and advocates say what’s needed is a better way to address systemic, cultural, and economic inequities that Latinos face, and that includes more funding.

Additional Federal Funding for States and Counties

A federal initiative called Ending the HIV Epidemic, which launched in 2019, has distributed more than $2.2 billion to 57 jurisdictions with the highest rates of new HIV diagnoses. Here’s a quick glance at some areas included in the initiative:

States:

  • Alabama
  • Arkansas
  • Kentucky
  • Mississippi
  • Missouri
  • Oklahoma
  • South Carolina

Territories:

  • Puerto Rico

Counties:

  • Arizona (1): Maricopa
  • California (8): Alameda, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco
  • Florida (7): Broward, Duval, Hillsborough, Miami-Dade, Orange, Palm Beach, Pinellas
  • Georgia (4): Cobb, DeKalb, Fulton, Gwinnett
  • Illinois (1): Cook
  • Indiana (1): Marion
  • Louisiana (2 parishes): East Baton Rouge, Orleans
  • Maryland (3): Baltimore City, Montgomery, Prince George’s
  • Massachusetts (1): Suffolk
  • Michigan (1): Wayne
  • Nevada (1): Clark
  • New Jersey (2): Essex, Hudson
  • New York (4): Bronx, Kings, New York, Queens
  • North Carolina (1): Mecklenburg
  • Ohio (3): Cuyahoga, Franklin, Hamilton
  • Pennsylvania (1): Philadelphia
  • Tennessee (1): Shelby
  • Texas (5): Bexar, Dallas, Harris, Tarrant, Travis
  • Washington (1): King
  • Washington, D.C.

Investigating State and Local HIV Rates

To explore HIV diagnoses, prevalence, and other indicators in your community, use the CDC’s AtlasPlus data query system. The most recent data available is from 2022.

For example, to find out how many cases of HIV were diagnosed in the Memphis metro area in 2022:

  1. Check the “HIV diagnoses” box in the indicator section.
  2. Select “Metropolitan Statistical Area (MSA)” in the geography section.
  3. Choose “Memphis-TN-MS-AR” from the drop-down menu.
  4. Select “2022” under the year section.
  5. Click “Create my Table” to see that there were 397 diagnosed cases in the Memphis area in 2022.

HIV Prevention and Treatment Funding

The U.S. spends tens of billions a year on HIV treatment, prevention, cash and housing assistance, global efforts, and research. KFF policy experts have created guides to federal funding for overall HIV funding and the Ryan White program, which serves over half of those in the country diagnosed with HIV.

State and Local Funding

Assessing state and local funding beyond federal contributions can be challenging and might require public records requests. Start by contacting health departments to inquire about federal, state, and local funding for HIV prevention, testing, and treatment, including grants beyond the Ending the HIV Epidemic and Ryan White funding.

Key Questions for Local Health Departments and Nonprofits

  • Has the Latino population grown in your region, and has this affected HIV rates?
  • Does the county or state have a plan to reduce HIV rates, specifically mentioning Latinos?
  • What measures are local authorities and nonprofits taking to prevent HIV rates from rising?
  • Are HIV outreach strategies inclusive of all racial and ethnic populations, provided in multiple languages, and culturally relevant?

Additional Local Resources

  • Speak with local and state epidemiologists about trends in HIV infections and diagnoses.
  • Contact local and state HIV testing and treatment organizations for insights into gaps in HIV care.
  • Review state and county health plans to see if HIV prevention and treatment are priorities.
  • Talk to individuals living with HIV to understand the strengths and weaknesses of HIV care in your area.
  • Reach out to health clinics or organizations receiving Ryan White funding to learn about challenges in treating HIV patients.
  • Consult policy organizations for assistance in understanding local budgets and anti-LGBTQ legislation that may impact HIV prevention and treatment efforts.

This article highlights the ongoing disparities in HIV infection rates among Latinos in the U.S. and emphasizes the need for targeted strategies and funding to address these inequities.

Biktarvy as PEP: Boston Study

HIV Post-Exposure Prophylaxis (PEP) and the Efficacy of Biktarvy

HIV post-exposure prophylaxis (PEP) is a crucial HIV prevention strategy. Studies on simian immunodeficiency virus (SIV), which is closely related to HIV, have shown that a combination of antiviral drugs can reduce infection risk if administered within 72 hours of exposure. Current guidelines recommend initiating PEP as soon as possible after potential HIV exposure, with a maximum window of 72 hours.

Research on Biktarvy for PEP

Researchers at Fenway Health in Boston, a clinic and research center serving the LGBT community, conducted a study on the use of Biktarvy as PEP. Biktarvy is a single-pill regimen containing:

Biktarvy is widely used in high-income countries for HIV treatment due to its efficacy and tolerability.

Study Methodology and Findings

The study involved 52 adults who had recent potential exposure to HIV and sought PEP. Participants underwent brief interviews and HIV rapid testing. Those who tested negative for HIV were provided with a 28-day supply of Biktarvy. Follow-up testing up to two months later confirmed that all participants remained HIV negative, and the medication was well-tolerated with mild and uncommon side effects.

Recruitment and Participant Profile

Participants, who may have been exposed to HIV through unprotected sex, were referred through:

  • Primary care providers
  • An HIV treatment and prevention clinic hotline
  • Self-referrals after community education campaigns

The study’s participants were predominantly men (49 out of 52), mostly gay or bisexual, with an average age of 37 years (ranging from 21 to 71). The ethnic distribution was 77% White, 12% multiracial, and 12% Hispanic. Notably, 56% reported more than one recent potential HIV exposure.

Side Effects and Completion Rates

Common side effects included:

  • Nausea or vomiting (15%)
  • Fatigue (10%)
  • Diarrhea or loose stools (8%)

Most symptoms were mild and temporary. However, one participant discontinued due to excessive fatigue. Overall, 90% of participants completed the 28-day PEP regimen, while 10% lost contact with the clinic.

Comparative Analysis and Recommendations

Researchers compared their findings with historical PEP regimens, concluding that Biktarvy was better tolerated. They also noted that other PEP regimens, such as those involving dolutegravir, TDF, and FTC, require multiple pills daily.

Conclusion: Biktarvy PEP

The results are promising, suggesting that Biktarvy is an effective and well-tolerated PEP option. Larger studies with diverse populations are needed to confirm these findings. For individuals with ongoing HIV exposure risks, discussing HIV pre-exposure prophylaxis (PrEP) with a healthcare provider is recommended.