Visit the National Latino AIDS Awareness Day (NLAAD) site to learn more about NLAAD’s national campaigns and events occurring near you on October 15
In 2000, Latinos became the largest minority group in America, and today they represent 16% of the population. However, many HIV interventions and outreach efforts fail to reach Latinos due to language and cultural barriers, and they are three times more likely to become infected with HIV than non-Hispanic whites in the U.S. The disparity is even sharper among injection drug users (IDUs)—Latinos are five times more likely to contract HIV from a contaminated needle than Caucasians. “Customizing harm reduction strategies for Latinos who have histories of injection drug use is critical,” says Guillermo Chacon, executive director of the Latino Commission on AIDS. “And more access to clean syringes would have a significant effect on HIV infection rates.”
INTERCAMBIOS’ Rafael Torruella speaks at a Puerto Rican Senate hearing on drug policies.
Currently, however, the federal government bans the use of federal funds to support syringe services programs (SSPs). This policy disproportionately impacts minorities, since 26% of HIV infections caused by injection drug use are among Latinos and 50% are among African Americans.
A new short film produced by amfAR, The Exchange: Race and Drugs, shows how SSPs do more than prevent HIV infections through providing clean needles. They are a vital bridge to mental health services, job counseling, and housing assistance that can empower clients—who are often marginalized and uninsured and cannot access them elsewhere—to enter treatment and change their lives. “Syringe exchanges aren’t just about syringes, they’re gateways to healthier individuals, gateways to healthier communities,” says Rosie Perez, who narrates the film.
Robert, a client of the Chicago Recovery Alliance’s syringe exchange program, appearing in the film The Exchange: Race and Drugs.
Among Latinos, Puerto Ricans are the most likely to contract HIV through injection drug use. Approximately 10% of new infections in the U.S. are associated with injection drug use, compared to 50% in Puerto Rico, where an estimated 60,000 people inject drugs, or about 2% of the population (a rate similar to that in the general U.S. population).
What does differ substantially from the mainland is the availability of clean needles and other health services for drug users. “I cannot emphasize enough how little services are provided for injection drug users here in Puerto Rico,” says Rafael Torruella, executive director of INTERCAMBIOS Puerto Rico, one of a handful of small nonprofits providing mobile syringe exchange services on the island. He adds that due to their limited budget, they often cannot buy enough syringes to meet the need.
“We see zero dollars from the government of Puerto Rico. With just a little money from the federal government, we could ramp up our services quite a bit and have an adequate number of syringes on hand, and provide mental health services.” Many IDUs in Puerto Rico report attempting to buy them from diabetics—if they have the means—or sharing needles, and even attempting to sharpen needles dulled from over-use with rocks and coins so they can use them again.
“One of the main issues driving HIV here and across the U.S. is that the U.S. is not addressing issues of poverty,” says Torruella. “The risks associated with HIV often come from poverty and marginalization.”
He adds that poverty not only limits people’s access to health services and clean needles, it contributes to other factors such as unstable housing that often fuel risk behaviors like injection drug use and unsafe sex. The poverty rate in Puerto Rico is 46%, nearly double the rate for Latinos in the U.S. in general, which at 25% is more than double the 10% rate of poverty for non-Hispanic white Americans.
“Latinos have the highest rates of uninsurance compared to all other ethnic and racial groups in the U.S., and while the Affordable Care Act is—theoretically—good for engaging Latinos in care, the uneven state-by-state implementation, particularly around Medicaid expansion, will produce uneven results for Latinos, specifically in states like Florida and Texas and the territories of Puerto Rico and the U.S. Virgin Islands,” says Chacon.