Equity in HIV/AIDS cases still lags

As we approach the end of 2021, we are reminded of significant milestones in the health care community, many of which were focused on treating and preventing COVID-19.

However, we can’t forget that HIV continues to pose one of the most serious health and developmental challenges globally, and San Antonio is certainly not immune. COVID has shown us the same disparities in health care access and outcomes among communities of color, including those in Texas, as HIV has. This June marked the 40th anniversary of the first recorded case of HIV/AIDS, and while we have achieved much since then, we still have a long way to go toward health equity and ending the epidemic.

At Kind Clinic in San Antonio, where I work as a patient advocate, we believe progress is only possible when everyone is part of the conversation about HIV. That means ensuring access to Latinx patients. We know HIV disproportionately impacts the Latinx community, and we have seen firsthand the significant health care barriers many in our community face, such as stigma, affordability or lack of Spanish-speaking providers.

According to the Centers for Disease Control and Prevention, in 2018 Latinos represented 18 percent of the U.S. population but 23 percent of people living with HIV. To reduce the number of new HIV infections in the United States, Health and Human Services developed a plan in 2019 that aims to provide additional resources where HIV transmission occurs more frequently — including Texas. If we do not take action, nearly 400,000 more Americans will be diagnosed with HIV over the next decade. As of 2019, the Texas Department of State Health Services reported 226 new HIV diagnoses among Hispanic/latinx people in the San Antonio area and surrounding counties, with a rate of new diagnoses nearly 2.75 times higher than that of white counterparts.

Community-based organizations are a critical way to partner with patients to prevent, diagnose and treat HIV. We fight against the stigma that many Latin Americans face, and if they do have access to medical care, many patients feel they are being judged and their concerns ignored. We must address the stigma associated with sex, gender and sexual orientation in our community or these disparities will continue to widen.

With a limited number of clinics specializing in culturally affirming or Lgbtqia+-centered medical care, there is a substantial lack of information on prevention, safety and the cost of treatment plans for those who may not have access to medical insurance and those who are often most vulnerable.

The treatment of HIV has come a long way since the start of the epidemic. PREP (pre-exposure prophylaxis) is a once-daily pill regimen that is nearly 99 percent effective at preventing HIV transmission. With the correct medication and treatment plans, Hiv-positive patients are able to reach the status of undetectable viral load, meaning that a patient’s HIV has been reduced to such a small quantity that it can no longer be detected in the blood and no longer passed to others through sex, something we refer to as U=U — undetectable equals untransmittable.

As we reflect on 40 years, we are reminded that we all must come together to fight stigma and to ensure every person has access to culturally affirming care.