Failures of HIV Services for Latinx Communities: Preventing and Treating Racism

Miguel Garcia
Miguel Garcia
Selfie by Miguel Garcia

When we -- queer and poor people of color -- speak on behalf of our communities, we carry both the guilt associated with privilege and the burden of harboring so many voices in our throats. Nonetheless, we stand on the shoulders of giants such as Audre Lorde who teach us the importance of speaking even when the pain feels inaudible -- otherwise we risk being defined by others to our detriment. I recognize the unfair responsibility placed on victims of systemic oppression when we are expected to fix problems we did not invent. In HIV work, this involves reminding well-respected CEOs and directors that solutions crafted and executed by us -- queer people of color -- will prove most effective in addressing the issues in our community. Why, I wonder, does this seem to be so threatening to leaders in the HIV-service field?

Recently, I have been reflecting quite a bit about the ways in which I've seen HIV service organizations respond to their failures in addressing the needs of people of color. I've repeatedly witnessed the same reaction: When prevention and treatment campaigns fail in our communities, we are the first to be blamed. They blame our youth by saying they need more jobs and less drugs. They blame our parents by pointing to their homophobia and machismo. They blame our religion for spreading stigma and hate. They blame us for our sex and spreading illness. And in doing all of this, they conveniently have no blame left for themselves. As long as this lack of self-awareness continues among service organizations, as long as outsiders maintain the power to make decisions for us, our bodies and livelihoods will continue to serve as collateral damage.

As someone involved in HIV-related advocacy, I am constantly asked to serve as a cultural informant. I have found this middle-man role to be exhausting and tokenizing. And, yet, many of us who are members of "at-risk" or "impacted" communities make our voices heard so that others, especially heterosexual and white individuals, will confront the trauma and violence that we disproportionately experience. Our voices, our presence, are reminders that another reality exists and is within reach. However, recent events have led me to think more critically about my role as a queer person of color working in HIV prevention and advocacy.

Last month, the Centers for Disease Control and Prevention released its most recent HIV infection rate data and celebrated the "success" of its prevention campaigns. According to the data, new HIV infections dropped 18% overall in the most recent six-year period. Less highlighted was the fact that gay and bisexual Latino men experienced a 20% increase in infection rates from 2008 to 2014.

The data is depressing and infuriating, especially for those of us working in the field who know how often our voices are summoned but not heard. We know that in moments such as these, many agencies and nonprofits will make agendas at board meetings to discuss us as a problem, brushing off complicity with statements like "we are doing the best we can but some populations are impossible to reach." I know, however, that we cannot begin to look at each other with questions of blame before holding HIV non-profit agencies and organizations accountable. I remind myself of this whenever I'm asked to advise on the troubling HIV rates among queer men of color.

Dismissed and Oftentimes Bluntly Ignored

Last year, I was invited by the state of Michigan to contribute to an HIV-prevention campaign targeting people of color in Detroit. Though not explicitly stated, it became clear to me that my task was to assess materials and messaging with regard to "sensitivity" and "cultural competency." While I remember engaging with the courteous white representatives with a degree of skepticism, I was not prepared to find my input and that of other people of color dismissed and oftentimes bluntly ignored.

Our suggestions about campaign slogans were deemed too provocative; our advice on sex-positive visuals was considered "catchy," yet over the top; our remarks regarding stigmatization and undertones of racism seemed to be perceived as roadblocks for working towards shared goals. I specifically remember being called upon to deliver the Latino perspective when funding was at stake and when "diversity" was to be paraded. Needless to say, the resulting prevention campaign billboards and commercials mirrored previous failed campaigns, presenting sanitized messages at best and appallingly stigmatizing ones at worse. The campaign coordinators failed to appreciate the relevance and affirming qualities of successful prevention campaigns, such as those put forth by Harlem United or the AIDS Foundation of Chicago.

I know from speaking to peers who do similar work in other states that my experience is not unique. And, yet, when new statistics are released demonstrating widespread failure in servicing the most vulnerable among us, those of us who feel the weight of the news are the ones most expected to provide solutions.

Many agency leaders and nonprofit directors will use their awards and personal lives to vouch for their investments in our survival and livelihoods. This is not enough. It is not enough that you employ black and brown people, especially when we are relegated to front-line positions far from the boardroom; it is not enough that you create hashtags and flyers using our names and pictures, especially when this does not translate to direct action or meaningful programming; it is not enough that you advocate against racism, especially when the same individuals gatekeeping the boardrooms during the day request entry into our bedrooms in the evening; it is not enough that you create non-discrimination policies for your agencies, especially when you remain silent when transgender women of color and our children are killed in the streets.

It is not our culture, our machismo or our gay sex that requires your immediate attention. If nonprofits and service agencies were to shift their deficiency-based gaze on our communities and apply it to themselves, they would find enough work to warrant overtime and new hires. What does it say about your organization that a framed picture of your board of directors can be confused for one of the Republican National Committee? Do you recognize the ignorance and inherent bias present when you state that you "simply cannot find qualified minorities to fill the position"? How do you manage to appear confused when people of color do not attend your events or come in for services? Why are the few staff members of color you employ tasked with addressing racism and your white staff not trained as antiracism allies?

I know that my questions and criticisms can jeopardize my own pocketbook and employment. I cannot, however, invest physical and emotional labor in spaces that require me to be numb and silent. I cannot be seduced by the false comforts that accompany membership into majority-white spaces and some financial security. Those of us who choose to do this work and speak up carry with us the memories of queer torchbearers whose presence we have been robbed of and whose voices gave birth to our own. I am reminded that though some of us are suffering and breathing heavy, we are breathing nonetheless; too many of our own did not survive, and so our work must honor their absences.

Audre Lorde once wrote, "One tool of the Great-American-Double-Think is to blame the victim for victimization." Society and institutions have succeeded in blaming gay and bisexual men of color for the illnesses that ail our communities. It shows in the way we interact with one another and in the ways we treat our own bodies. But, many of us are also deeply aware that our health outcomes are inextricably connected to our history of social exclusion, which in turn is used to rationalize widespread health disparities. This phenomenon of institutional erasure and revictimization is something nonprofits still have a hand in. I deal with this reality in both my professional and private life.

I know that in coming weeks I will be asked by non-profit leaders to speak about the Latino gay community's predicament -- something I am willing to do. However, I hope they are prepared to first answer for their own irresponsible choices and unsafe behavior.

Miguel Garcia is a native Detroiter and Chicano queer mental and sexual health advocate. He currently works for a community health agency based in Detroit and is completing his degree in Boston.