One Man's Fight Against HIV Infections Among Latinos

Getting Latino men tested for HIV and those infected into care earlier is a day and night task for Mario Villeda Maldonado, an outreach worker for West Side Community Health Services. The Hispanic HIV rate in Minnesota is triple the state's overall rate, and 58 percent of Latino men diagnosed with HIV had already progressed to AIDS. The average for simultaneous diagnoses among other ethnic groups is 46 percent.

On a recent Tuesday near midnight, Villeda visited the Saloon club in Minneapolis, where about 30 Latinos, most of them openly gay, were pairing off to dance. Almost everyone there knew Villeda, who placed on a table packets containing condoms and lubricant.

Since the state first awarded a grant to West Side's "No Tengas Miedo" ("Don't Be Afraid") HIV prevention program, Villeda has distributed thousands of condoms at bars, clubs and health fairs. He also encourages the men to seek free rapid HIV screening at the St. Paul clinic on Mondays and Tuesdays. A key portion of the grant subsidizes the cost of testing, which is a significant barrier for low-income Latinos. No Tengas Miedo is a "one-stop shop" for HIV patients, offering testing, primary care, mental health counseling, and nutritional education, among other services. Latinos and African-born immigrants comprise 85 percent of the clinic's HIV patients.

Many Latino men who have sex with men live in secrecy, afraid to test even when they are at risk, Villeda said. Social pressures, machismo, and strong Catholic beliefs against condoms and homosexuality also prevent many Latinos from seeking early testing and treatment.

While Latinos born in the United States, Mexico, or South America who acquire HIV are more likely to have become infected through sex with men, those born in Central America and the Dominican Republic are more likely to transmit HIV within heterosexual relationships. And sharing needles is most commonly responsible for infections among Puerto Ricans. The prevention message "is just not being delivered in a culturally appropriate way for Latinos, who are so diverse," said Maria Alvarez, who helps direct CDC's HIV prevention efforts among Latinos.

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