Introduction
HIV is a severe issue that affects the world’s population regardless of numerous initiatives implemented in order to minimalize its prevalence. Within the diverse population of the USA, “gender and sexual minority Latinxs [Latino population] are at particularly high risk for infection” (Page at al., 2017, p. 390). Being immigrants and having non-traditional orientation, these individuals face barriers that prevent them from minimalizing risks of having HIV. Fortunately, they are likely to benefit from the US Pre-exposure prophylaxis (PrEP) and adoption of policies that can eventually change their behavioral mechanisms.
Determinants
This research is mainly based on homosexual male Latinxs because this population is believed to be the most vulnerable in comparison to other minorities that can be seen in the USA. Three major determinants of HIV can be outlined while concentrating on this sample:
Behavioral mechanisms
When the first cases of AIDS were reported, professionals identified that gay and bisexual men were those Americans who suffered the most. Further research revealed that the homosexual male population represented the majority of people affected by AIDS and HIV in different states. As a result, professionals managed to conclude that sexual practices could be used as determinants of HIV among Americans. According to the research studies conducted in the second half of the 20th century, scientists found out that anal intercourse and multiple partners were critical predictors of HIV (Bingenheimer & Geronimus, 2009). In this way, the necessity of behavior change for the improvement of the observed situation cannot be ignored.
Biological mechanisms
With the course of time, professionals also revealed that the presence of other sexually transmitted infections except for HIV/AIDS increased the vulnerability of the population (Bingenheimer & Geronimus, 2009). Soon, male circumcision and genetic influences on HIV transmission were associated with the increased prevalence of this disease.
Demographic and biomedical factors
The representatives of minorities are more likely to be affected by HIV because of their economic conditions and poor access to healthcare resources (Bingenheimer & Geronimus, 2009). They have fewer opportunities to obtain those things they require and are more likely to wait as long as possible before seeking treatment.
Interventions
PrEP presupposes the use of “a combination tablet containing tenofovir and emtricitabine” as the major treatment of HIV infection (Page at al., 2017, 390). This intervention has already proved to be advantageous; however, its positive effect was observed among the population of educated homosexuals who have high socioeconomic status while the representatives of minorities lag behind.
WHO (2012) emphasizes that those couples (including homosexual ones) that are going to have sexual relationships should put efforts to minimalize the possibility of HIV transmission. Thus, if one of them is HIV-positive, the use of early treatment is required. It is not enough for the infected partner to take antiretrovirals, the uninfected one should use PrEP at the same time to increase the possibility of avoiding transmission. PrEP is also a preventive measure that should be used by men who have sex with men even if they are not aware of their partners’ HIV status (WHO, 2012). Of course, people should not overuse drugs and PrEP is not an exception. However, it is better to ensure that one will not be affected by HIV than to avoid taking preventive medicines. Even though it is an additional intervention, its benefits should be neither ignored, nor overlooked.
As it was already mentioned, gender and sexual minority Latinxs need to implement behavior-change interventions in order to mitigate the risk of HIV. In particular, this improvement can be obtained with the help of immigration policies (Page et al., 2017). Latinxs enter the USA in different ways, which affects their access to healthcare services and other vital resources. For instance, having no legal status these people do not have an opportunity to receive legal advice or buy insurance. They can hardly obtain a well-paid job, which means that they do not have enough financed to pay for healthcare services and medicines. Moreover, they can even find it difficult to purchase protection means that can minimalize their chances of having HIV. Even a more critical situation can be observed by those immigrants who already have HIV-positive status. As they do not have all the needed documents, they cannot receive the required antiretroviral treatment. As a result, they tend to infect other people in their community.
The improvement of this situation is likely to be achieved if policymakers make it easier for Latinxs to obtain legal status (Page et al., 2017). This intervention will also improve their access to healthcare services and required treatment. Moreover, it will provide them with an opportunity to use PrEP and other associated preventive measures.
Challenges
Even though interventions to reduce the prevalence of HIV and minimalize risks for the sexual minorities among Latinxs are outlined, this population continues facing barriers that prevent it from obtaining required care. Of course, limitations can be associated with different sources. Nevertheless, immigration status is believed to be the major structural barrier that affects the selected population and reduces its possibility to reach PrEP and policy changes (Page et al., 2017). If Latino immigrants obtain legal status, they will definitively increase their chances of enhancing their living conditions and have more possibilities to get HIV preventive measures.
The majority of the programs that are targeted at the prevention of HIV are funded by governmental bodies. Nevertheless, different communities do not have the same opportunity to cover the annual costs of PrEP, clinical care, and laboratory tests (Page et al., 2017). As a result, some Latinxs have fewer resources than others to improve their health condition and prevent HIV.
Some Latinxs can avoid using PrEP and benefiting from the provided policies even if they can have this chance because of the fear of being humiliated. On the basis of their previous experience in their native communities and knowledge about the way Americans treat the homosexual population, they may try to avoid performing themselves as the representatives of the sexual minority immigrant population. Other individual barriers may also prevent Latinxs from benefiting from HIV prevention measures. For instance, some of them can reveal medical mistrust due to their previous experiences (Page et al., 2017). Homosexuals may also have no enthusiasm and motivation to use available resources because of depression associated with various stressors (stigmatization and discrimination, etc.).
Conclusion
Thus, it can be concluded that even though the whole population of the USA is at risk of suffering from HIV, gender and sexual minorities among Latinxs belong to the most vulnerable population. They are expected to benefit from those policies that can make it easier for them to obtain legal status and from PrEP. However, structural, community, and individual barriers prevent them from reaching these interventions. That is why it is significant to attract additional attention to this issue and the necessity to develop those changes that will affect it positively and reduce the prevalence of HIV among Latinxs.
References
Bingenheimer, J., & Geronimus, A. (2009). Behavioral mechanisms in HIV epidemiology and prevention: Past, present, and future roles. Studies in Family Planning, 40(3), 187-204.
Page, K., Martinez, O., Nieves-Lugo, K., Zea, M., Grieb, S., Yamanis, T.,… Davis, W. (2017). Promoting pre-exposure prophylaxis to prevent HIV infections among sexual and gender minority Hispanics/Latinxs. AIDS Education and Prevention, 29(5), 389–400.