Washington DC's New HIV Epidemic: Latino Men

Q & A With Manuel Diaz-Ramirez, Youth Program Manager

It was in March 2009 when the now-infamous statistics were released that showed at least 3 percent of adult Washington D.C. residents were HIV positive. The District of Columbia's HIV rate was described as the highest in the country, "higher than West Africa and on par with Uganda and some parts of Kenya." The District responded with an aggressive outreach and prevention campaign, primarily targeting Black men and women, who are disproportionately affected in the epidemic.

As a result, the number of new HIV and AIDS cases in Washington D.C. has decreased by as much as 50 percent in the past two years -- but seroconversions are soaring among Latino men in their 20s and 30s, according to the D.C. Department of Health. One out of 36 Latino men will become infected with HIV/AIDS, reports the Centers for Disease Control and Prevention(CDC). In addition, Latino men are also "late testers" and nearly half of those infected progress to AIDS within 3 years of their diagnosis.

The percentage of Latinos among the nation's new HIV/AIDS cases went from about 15 percent in 1985 to 21 percent in 2009, according to the Kaiser Family Foundation. Sex among men who have sex with men (MSM) continues to be the most commonly reported transmission mode.

Manuel Diaz-Ramirez
Manuel Diaz-Ramirez

"Those are among the reasons why the CDC is funding our youth center," says Manuel J. Diaz-Ramirez, and the youth program manager of Mpodérate! The youth center (roughly translated as "empower yourself") was developed to serve young Latino MSM by La Clínica del Pueblo, the well-known clinic that has served the District's Latino population since 1983.

The 41-year-old Diaz-Ramirez is a licensed social psychologist. He is also a native of Peru and helped to create a similar clinic in Lima. "We are probably the only youth center in Washington D.C. to focus exclusively on young Latino men and immigrants who identify as gay, bisexual or transgender," he adds.

Talk to me about the Center. Who are its clients and what are its goals?

We are located in Washington DC's Mount Pleasant neighborhood, which is heavily Latino. The Center serves Latino gay, bisexual and transgender people 29 years old and under. We were serving people under 25 years old, but the new CDC grant allows us to extend the age range of the population that we serve.

We have been here for about 18 months. We are probably the only youth center in Washington to focus exclusively on Latino LGBT youth. The purpose is to provide Latino LGBT youth with access to information, services and education about HIV issues and topics, as well as links to care.

We also provide HIV testing four times per week on a regular schedule, counseling, education and mentoring. There are also HIV prevention outreach activities, both formal and informal. The informal outreach is that you may see around the country -- such as at bus stops, parks and different views. We also empower people to raise their voice in the community regarding their needs about HIV prevention.

How many people do you serve?

The Center receives more than 200 visits per month. We only serve clients from age 18 to 29. We don't see youth under 18. There are infections in that age group, we just can't service them.

We also have about 20 youth leaders who are in charge of developing and implementing programs. These are all volunteers. Also keep in mind that we serve two populations -- Latino gay and bisexual men and transgender Latinas,

The CDC just released new surveillance data that shows young Latino MSM are disproportionately affected by the HIV epidemic. Cases are rising in D.C., too.

Absolutely! We are seeing more young men come in the youth center. They also have many different needs. For instance, there are high rates of STD infections among our Latino and Latino MSM youth. We see that reflected among the walk-in clients. That creates a window for HIV infections, so we try to handle that as soon as we can. We usually refer them to STD clinics in the area.

What are some of the challenges of dealing with Latino MSM and transgender women in D.C.?

Language. We work with many recent immigrants. Many of our clients are from rural areas in Central America, especially El Salvador. Many only speak Spanish. When we can, we refer them to English as Second Language classes or similar services in the community. We are also dealing with illiteracy and low literacy levels. This is why HIV prevention information and materials must be culturally sensitive. It also must be in messaged in a way that people can understand and feel connected to.

Another challenge is addressing the many myths some [may have] regarding HIV facts and information. So we also try to target how Latino men address their general health and sexual health issues. And of course, there is always the problem of the stigma of HIV/AIDS, as well as sexuality.

And then there is the issue of family support -- or the lack of support.. Many Latinos come from very conservative families. And family is very important in our community, so many gay Latino men are rejected by their families -- or feel that they will be rejected if they come out or share their diagnosis.

And finally another challenge is people moving a lot -- whether it's due to work, income or other reasons. So we also have to factor not having a stable home environment when dealing with this population.

And of course, there are few safe spaces for young Latino MSM.

Exactly. The youth Center provides a safe space for minorities among minorities in our community. They generally don't have a space where they can hang out and be themselves. Some of these men go to the parks, but the parks can be dangerous, especially at night. Hanging out on the streets can be a problem, too.

Rod McCullom has written and produced for ABC News and NBC, and his reporting and analysis have appeared in Ebony, The Advocate, ColorLines and other media.