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Populations of minority races and ethnicities continue to be disproportionately affected by the HIV epidemic. To reduce the incidence of HIV, CDC released Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings in 2006. These new recommendations advise routine HIV screening for adults, adolescents, and pregnant women in health care settings in the United States.

In 2003, CDC announced Advancing HIV Prevention. This initiative comprises 4 strategies: making HIV testing a routine part of medical care, implementing new models for diagnosing HIV infections outside medical settings, preventing new infections by working with HIV-infected persons and their partners, and further decreasing perinatal HIV transmission.

It is important to evaluate the effectiveness of HIV prevention interventions for the US Hispanic/Latino population. Research shows that HIV prevention efforts can reduce risk behaviors and increase protective behaviors among Hispanics/Latinos at risk for HIV infection. One systematic review found that HIV prevention interventions for Hispanics/Latinos increased the use of condoms and reduced the number of acts of unprotected sex, the number of sex partners, the frequency of injection drug use, and the acquisition of STD infections [33].

CDC is engaged in a wide range of activities to decrease the incidence of HIV/AIDS in Hispanics/Latinos. For example, CDC

• Conducts epidemiologic and behavioral research focused on Hispanics/Latinos, including
  • Brothers y Hermanos, a study of African American and Hispanic/Latino MSM conducted in Los Angeles, New York, and Philadelphia that aims to identify and understand risk-promoting and risk-reducing sexual behaviors
  • Women’s Study, a study of African American and Hispanic/Latina women in the southeastern United States that examines relationship, cultural, psychosocial, and behavioral factors associated with HIV infection
• Supports, through the Minority AIDS Initiative, efforts to reduce the health disparities experienced in the communities of minority races and ethnicities at high risk for HIV infection. These funds are used to address the high-priority HIV prevention needs of such communities, including funding community-based organizations (CBOs) to provide services to Hispanics/Latinos.
• Provides effective, scientifically based interventions to organizations serving Hispanic/Latino populations. The following are examples of interventions that have been validated for English-speaking populations and that have been translated or adapted for Hispanic/Latinos.
  • VOICES /VOCES (Video Opportunities for Innovative Condom Education & Safer Sex/Video Oportunidades acerca de Condom Educación y Sexo Seguro), a group-level, single-session video-based intervention designed to increase condom use among heterosexual African American and Hispanic/Latino men and women who visit STD clinics.
  • Safety Counts, an HIV prevention intervention that includes sructured and unstructured educational activities for out-of-treatment drug users (those who inject and those who ingest by smoking, snorting, inhaling). The intervention is delivered in group and individual settings to reduce high-risk drug use and sexual behaviors.
  • Community Peers Reaching Out and Modeling Intervention Strategies (PROMISE), an intervention in which peer advocates (including men who do not identify themselves as gay) help people reduce or eliminate risk factors for HIV infection.
  • Partnerships for Health, a brief, medical provider – delivered counseling program for individual men and women living with HIV/AIDS.
• Has translated the following effective interventions for use with Hispanic/Latino populations:
  • Healthy Relationships, a 5-session, small-group intervention that helps people living with HIV/AIDS to develop self-efficacy and skills in disclosing HIV serostatus and negotiating safer sexual behaviors
  • Many Men, Many Voices (3MV), a group STD/HIV prevention intervention for gay men of color and men who have sex with other men but do not identify themselves as gay or bisexual
  • POL (Popular Opinion Leader), which identifies, enlists, and trains key opinion leaders to encourage safer sexual norms and behaviors within their social networks (adapted for young migrant Hispanic/Latino MSM [34])
  • Street Smart, an 8-session HIV/AIDS and STD prevention program for small groups of runaway and homeless youth
  • Together Learning Choices (TLC), which focuses on young people (aged 13 – 29) living with HIV/AIDS and is delivered through small-group sessions
• Is adapting other effective behavioral interventions for at-risk Hispanic/Latino populations
• Is packaging additional effective behavioral interventions for Hispanics/Latinos (available for use soon):
  • Connect, a 5-session HIV/STD prevention intervention delivered to heterosexual couples or women alone that emphasizes the importance of communication, negotiating safer sex, and problem-solving skills
  • ¡Cuídate! a 6-session intervention that presents sexual abstinence and condom use as culturally accepted ways for Latino youth to reduce their risk for STDs, including HIV
  • PICUSS (Projecto de Intervención, Cuídado y Utilización de Servicios de Salud), a 6-session intervention in which motivational interviewing strategies are used to engage Latino injection drug users in behavior change
• Is working to strengthen and sustain the capabilities of the HIV prevention workforce to conduct effective and efficient HIV prevention services throughout the United States and US-dependent areas by building the capacity of programs that serve Hispanics/Latinos through partnerships with national, regional, and nongovernmental organizations. These capacity-building activities include 12 federally funded programs in health departments and CBOs that provide culturally appropriate capacity-building assistance.
• In 2006, CDC provided 56 awards to CBOs in the United States and Puerto Rico that focus primarily on Hispanics/Latinos. CDC also provides funding through state, territorial, and local health departments to organizations serving this population. The following are examples of CDC-funded programs focused on Hispanics/Latinos:
  • A program in New York that provides multifaceted, integrated prevention and education programs such as Prevention Education; Wellness Program and Support Services; and Research, Policy and Development. The Prevention Education Program promotes increased awareness and knowledge of HIV/AIDS in Latino communities; addresses the attitudes, beliefs, and behaviors that place Latinos at risk for HIV infection; and provides individual and couples risk-reduction counseling. The Wellness Program and Support Services program seeks to ensure that Latinos affected by HIV/AIDS receive the maximum benefit from available resources and services and provides emotional support and empowerment to persons affected by the disease. The Research, Policy and Development program d ocuments the health-related needs of Latinos in order to advocate for and guide the development of public health programs and policies that are responsive to the needs of Latino communities in New York City and nationwide.
  • A program in Puerto Rico that provides community Education; community Development, community health initiatives; individual and family development; and the National Center for Training, Support, and Technical Assistance. The community development program includes transitional housing for HIV/AIDS clients and the development of housing for persons with low-to-moderate income. The community health initiative provides HIV/AIDS case management, HIV/AIDS health education and risk-reduction workshops, HIV/AIDS client support groups, HIV counseling and testing, HIV/AIDS community outreach, and emergency rental, utility, and food assistance, and HIV treatment education, and Individual and Family Development services. The National Center for Training, Support, and Technical Assistance provides services for capacity building, training, and technical assistance in the areas of organizational/infrastructure development, program and curriculum development, and the implementation of HIV prevention interventions.
  • A program in Illinois that seeks to provide culturally competent and language-appropriate services to the Latino community. The program offers training, HIV capacity building and technical assistance, and effective outreach techniques to service providers and administrators, health departments, planning committees, CBOs, and faith-based organizations. This program sensitizes providers to the special needs and social conditions that affect the health of the Latino community.

In addition, CDC provides training for researchers of minority races/ethnicities through a program called Research Fellowships in HIV Prevention in Communities of Color. Recognizing the importance of conducting culturally competent research and programs, CDC established the Minority HIV/AIDS Research Initiative (MARI) in 2002 to create partnerships between CDC epidemiologists and researchers who are members of minority races and ethnicities and who work in communities of color. MARI funds epidemiologic and preventive studies of HIV in communities of color and encourages the career development of young investigators. CDC invests $2 million per year in the program and since 2003 has funded 13 junior investigators at 12 sites across the country [35].