Hispanics and HIV/AIDS in the United States
People who are Hispanic shoulder a highly disproportionate burden of AIDS in the United States. Many Hispanics face significant barriers to health information, HIV counseling and testing, and care. Poverty, language differences, lack of health insurance, and cultural issues are critical factors.
Surveillance
- Although Hispanics composed just 14 percent of the U.S. population in 2004, they accounted for an estimated 20.4 percent of new AIDS cases reported that year.1,2 Hispanics represented an estimated 20.2 percent of people living with AIDS at the end of 2004.3
- In 2004, an estimated 20.4 percent of all deaths attributed to AIDS were among Hispanics, compared with 17.8 percent in 2002 and 17.6 percent in 2000.4 In 2002, HIV/AIDS was the fourth leading cause of death in the United States for Hispanics ages 35 to 44. For Hispanics ages 25 to 34 and 45 to 54, it was the sixth leading cause of death.5
Men
Among Hispanic men living with AIDS at the end of 2004, men who have sex with men (MSM) was the HIV exposure category in an estimated 51.6 percent of cases.6 Injection drug use (IDU) was the HIV exposure category in an estimated 28.3 percent of male cases.6
Women
An estimated 17,780 Hispanic women were living with AIDS in the United States at the end of 2004.6 Among Hispanic women living with AIDS at the end of 2004, heterosexual contact was the HIV transmission category in an estimated 65 percent of cases.6 IDU was the transmission category for an estimated 32.6 percent of cases among Hispanic women living with AIDS.6
CRITICAL ISSUES
Hispanics often face considerable socioeconomic barriers to health information and care. Only 58.4 percent of Hispanics age 25 and older have a high school diploma, compared with 80.6 percent of African-Americans, 86.8 percent of Asians, and 90 percent of Whites.7 In 2004, 21.9 percent of Hispanics in the United States were living below the Federal Poverty Level, compared with 8.6 percent of non-Hispanic Whites.8
For some subpopulations of Hispanics—such as migrant farmworkers —economic circumstances are especially dire.9 More than 85 percent of all migrant farmworkers are minorities, 95 percent of whom are Hispanic. It is estimated that only 12 percent of this group speaks English and that the median education level is sixth grade.10 Gaining access to health care is difficult for this population.
The female adult and adolescent AIDS rate in the United States for Hispanics (11.1 per 100,000) is second only to that of Blacks (48.2 per 100,000).11 Cultural factors that tend to reinforce traditional gender roles can make communication about sex difficult and ultimately contribute to increased risk for HIV transmission among women.12
In a recent survey conducted by the Henry J. Kaiser Family Foundation, 73 percent of Hispanics reported that they receive most of their information about HIV/AIDS from the media.13 As with other groups, Hispanic awareness about HIV transmission is a combination of accurate information mixed with widely accepted myths. For example, 31 percent of Hispanic survey respondents reported that a person could contract HIV by touching a toilet seat.13 However, 57 percent of Hispanics (compared with 36 percent of Whites) were aware that the presence of a sexually transmitted infection raises a person’s risk of contracting HIV.13 Another obstacle to HIV prevention is that the Hispanic community does not have a cultural tradition of preventive care.12
Hispanics tend to be tested for HIV late in their illness. They are more likely than non-Hispanic Whites to have AIDS-defining conditions at the time of their first test or within the first year after diagnosis.14
Although 59.7 percent of Hispanics living in the United States were born here,15 they face cultural and language barriers that complicate their ability to communicate effectively with health care providers. The medical system in the United States differs from the systems in other countries, increasing the level of frustration for many immigrants—not just Hispanics—who need care. Hispanics often need the help of translators and seek out bilingual caregivers.
Hispanics and the Ryan White CARE Act
Hispanic/Latino(a) clients accounted for 23 percent of all Ryan White Comprehensive AIDS Resources Emergency (CARE) Act clients in 2004. Hispanic populations are served through all CARE Act programs. For example, the Title IV program for women, infants, children, youth, and families has funded programs in South Texas, southern California, Puerto Rico, and sections of New York City, where high concentrations of HIV-positive Hispanic women reside.
The Health Resources and Services Administration has implemented programs that target subpopulations of Hispanics. For example, the CARE Act Special Projects of National Significance Border Health Initiative targeted people living along the U.S.-Mexico Border. The Initiative funded five grantees (and an evaluation center) to develop improved models of community-based health networks for underserved people living with HIV disease. For more information, go to www.hab.hrsa.gov/special/ border_overview.htm.
To increase access to quality care for minorities and respond to the need for additional minority providers of state-of-the-art HIV/AIDS care in underserved communities, the CARE Act funds the National Minority AIDS Education and Training Center program to expand clinical expertise in minority communities. More information is available at www.nmaetc.org.
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References
1 U.S. Census Bureau. 2004 American Community Survey Data Profile Highlights. Available at: http: //factfinder.census.gov.
2 Centers for Disease Control and Prevention (CDC). HIV/AIDS Surveillance Report. 2004;16:12. Table 3.
3 CDC. HIV/AIDS Surveillance Report. 2004;16:20. Table 10.
4 CDC. HIV/AIDS Surveillance Report. 2004;16:16. Table 7.
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6 CDC. HIV/AIDS Surveillance Report. 2004;16:21. Table 11.
7 U.S. Census Bureau. Summary measures of the educational attainment of the population, ages 25 and over: 2004. Table A. Available at: www.census.gov/ Press-Release/www/
releases/archives/ 04eductableA.xls. Accessed December 2005.
8 U.S. Census Bureau. Income, poverty, and health insurance coverage in the United States: 2004. Washington, DC; 2005. Table 3. Available at:
www.census.gov/prod/2005pubs/
p60-229.pdf. Accessed December 2005.
9 Solorio MR, et al. HIV health care
services for Mexican migrants. J Acquir Immune Defic Syndr. 2004;37(suppl 4): S240-51.
10 National Center for Farmworker Health. HIV/AIDS farmworker fact sheet. Available at: www.ncfh.org. Accessed December 2005.
11 CDC. HIV/AIDS Surveillance Report. 2004;16:14. Table 5a.
12 Medina C, Johnson W. HIV/AIDS prevention in Latino and African-American communities. J Natl Med Assoc. 2004;96(suppl 2):959S-11S.
13 Henry J. Kaiser Family Foundation. Survey of Americans on HIV/AIDS. Part Three: Experiences and Opinions by Race/Ethnicity and Age. Menlo Park, CA; 2004. Available at: www.kff.org/hivaids/
7140.cfm. Charts 18, 22, 23.
14 CDC. Late versus early testing of HIV—16 sites, United States, 2000-2003. MMWR Morb Mortal Wkly Rep. 2003;52(25): 581-6.
15 U.S. Census Bureau. The Hispanic Population in the United States. Washington, DC; 2004. Table 7.1. Available at: www.census.gov/population/ socdemo/hispanic/ASEC2004/
2004CPS_tab7.1.html. Accessed December 2005.
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