A review of current strategies to improve HIV prevention and treatment in sexual and gender minority Latinx (SGML) communities

Abstract

Introduction:The HIV epidemic continues to disproportionately impact sexual and gender minority Latinxs (SGML). Several syndemic conditions have been linked with HIV acquisition and transmission among SGML including immigration, discrimination, environmental racism, substance use, and mental health. Areas covered: We provide a summary of biomedical, behavioral, and social/structural interventions to reduce risks for acquiring HIV and improve outcomes along the HIV care continuum among SGML. We also discuss intervention approaches and opportunities that respond at the intersection of HIV and COVID-19 prevention and treatment. Expert opinion: There is a dire need for the combination of biomedical, behavioral, and social/ structural interventions to reduce risks for acquiring HIV and improve outcomes along the HIV care continuum. Interventions and combination approaches should be driven by community-based participatory action research. The inclusion of community members in all stages of the research process can assure successful implementation of program activities and deliverables, including the provision of culturally and linguistically appropriate services. Given the current COVID-19 pandemic, which is disproportionately impacting individuals living with HIV and other comorbidities, the elderly, and under-resourced communities with a ferocity not seen in other communities, intervention approaches that respond at the intersection of HIV and COVID-19 prevention and treatment are also urgently needed.

Behavioral and social interventions to promote optimal HIV prevention and care continua outcomes in the United States

“…The studies included in this review provide evidence for the utility of social and behavioral interventions to address disparities across both the HIV prevention and care continuum. Despite awareness of the upstream factors that shape HIV inequities [18,19], the majority of interventions continue to focus on the individual as the unit of behavior change. Increasing our focus on the structural, environmental, and economic vulnerabilities that shape HIV inequities will require novel multilevel approaches developed in partnership with community settings in order to realize the full potential of existing and emerging biomedical HIV technologies [61].…”

“…Despite this scientific progress, troubling inequities remain across both the HIV prevention and care continua in the United States [11], resulting in continued and disproportionate burdens of HIV risk, infection, illness, and mortality in historically marginalized populations [12][13][14][15]. Persistent challenges to uptake and use of biomedical technologies in the United States as outlined in the Ending the HIV Epidemic initiative [11] include: interlocking systems of oppression and stigma [15,16]; the cooccurrence of intersecting health problems (e.g., mental health, substance use, violence) [17]; and structural vulnerabilities that contribute to HIV inequities [18,19].…”

Psychosocial Determinants of HIV Stigma among Men Who Have Sex with Men in San Francisco, California

“…However, it might be expected that people of color would experience more HIV stigma due to having multiple stigmatized identities [42,43]. It has repeatedly been demonstrated that race has substantial impact on health outcomes [44][45][46][47][48]. People of color living with HIV may also face stressors associated with social inequalities, stigma and racism [41,42], and it is necessary to continue to address individual, societal and structural factors which affect experiences of stigma for people of color living with HIV.…”