Still in the Shadows: The Health Crisis of Hispanic/Latinx Communities Aging with HIV/AIDS

Research on individuals aging with HIV/AIDS has revealed a significant truth: for many, HIV itself is no longer the primary concern. Instead, the focus shifts toward managing the long-term health implications stemming from decades of living with the virus and its treatments. This entails grappling with an array of related health challenges such as multimorbidity and polypharmacy.

This journey is particularly arduous for Hispanic/Latinx individuals aging with HIV/AIDS, compounded by feelings of loneliness, depression and social isolation. These struggles have been exacerbated by the relentless onslaught of the COVID-19 pandemic and the pervasive stigma of ageism. Many find themselves uprooted, forced to relocate in search of affordability and support, only to face the daunting task of rebuilding a sense of community and belonging from scratch. In the absence of robust support systems, some resort to substance abuse as a form of self-medication.

In 2017, the groundbreaking study, “Illuminating The Needs Of The Forgotten—‘Olvidados’: A National Health Assessment Of Latinos Growing Older With HIV,” spearheaded by the Latino Commission on AIDS, underscored the urgency of understanding the unique challenges faced by older people living with HIV. It emphasized the imperative of becoming advocates for this marginalized demographic, ensuring their prevention, care, and social needs are met, devoid of stigma and discrimination at every level. The study emphasized the necessity of investigating the structural and social determinants of HIV/AIDS among older Latinos and of developing targeted interventions tailored to their distinct realities, whether U.S.- or foreign-born.

Higher Rates of HIV/AIDS in Latinx Community

Latinx individuals continue to grapple with disproportionately high rates of AIDS cases, progression to AIDS, and HIV/AIDS-related mortality compared to their white counterparts. Despite this stark reality, research fails to adequately address the nuanced needs of older Hispanic/Latinx populations living with HIV. Given the pervasive barriers to healthcare access encountered by Hispanic/Latinx communities, it is imperative to discern whether these obstacles persist throughout the lifespan or intensify among this overlooked and vulnerable subgroup.

Latinx individuals living with HIV constitute a rapidly expanding demographic, facing unique hurdles in managing the complexities of HIV/AIDS. As linguistic minorities, particularly those who are monolingual, Latinx individuals encounter additional impediments to accessing optimal HIV treatment adherence. Statistics reveal that more than 1 in every 5 older adults living with HIV is Hispanic, further underscoring the significance of addressing the specific needs of this population.

‘Retention in care rates are lowest among Hispanic/Latino men, underscoring the urgent need for tailored interventions.’

Despite representing only 19.1% of the U.S. population, Latinx individuals accounted for approximately 25% of new HIV diagnoses. Moreover, older Hispanic/Latinos face a heightened risk of HIV infection compared to non-Latino white counterparts. The persistence of HIV disparities among older Latinx individuals is concerning, particularly amid the intersecting challenges of HIV and aging. While AIDS-related mortality rates have declined overall, they have since 2000 remained stagnant among U.S. Latinx populations, a trend attributed to entrenched social-structural factors fueling stigma and discrimination.

Within Hispanic/Latinx communities, the burden of the HIV epidemic has disproportionately fallen on gay, bisexual and transgender individuals. Data from the Ryan White HIV/AIDS Program (RWHAP) underscores the prevalence of racial/ethnic minority populations among clients, with Hispanic/Latinx individuals constituting a significant portion. Alarmingly, retention in care rates are lowest among Hispanic/Latino men, underscoring the urgent need for tailored interventions.

Prioritizing Unique Needs of Hispanic/Latinx People Aging with HIV/AIDS

Given the multifaceted challenges confronting Hispanic/Latinx individuals aging with HIV, it is imperative to amplify their voices and prioritize their unique needs in the broader discourse on combating HIV/AIDS. Culturally and linguistically responsive programs and interventions are indispensable in bridging existing gaps in healthcare access and support. Healthcare providers must adopt a geriatric/gerontology model to address the complex needs of older Hispanic/Latinx individuals living with HIV.

Despite strides in HIV prevention and treatment, many older individuals, particularly within Hispanic/Latinx communities, feel overlooked and marginalized. This sense of neglect exacerbates feelings of loneliness and depression, emphasizing the need for tailored peer-support programs that empower individuals living with HIV to connect, share experiences, and derive collective strength. Involving long-term survivors in outreach and community support initiatives can harness their firsthand insights and foster a sense of solidarity within the community.

Moreover, individuals grappling with emotional loneliness or substance abuse necessitate access to non-judgmental, culturally appropriate treatment using harm-reduction models. With more than 1 million people living with HIV in the United States today, the majority of whom are older than 50, and a significant proportion identifying as Hispanic/Latinx, it is imperative to prioritize comprehensive support frameworks that enable individuals to thrive as they navigate the complexities of aging with HIV/AIDS.

By elevating awareness, addressing systemic barriers, and fostering inclusive support systems, we can ensure that Hispanic/Latinx individuals aging with HIV/AIDS receive the care and support they deserve, enabling them to lead fulfilling and dignified lives as they navigate the challenges of aging with HIV/AIDS.

It is crucial to continue pushing forward and elevating the voices of Hispanic/Latinx communities in order to incorporate their specific needs into the broader efforts aimed at ending the HIV epidemic and improving health outcomes of all individuals living and aging with HIV/AIDS.

Luis Nava Molero, MS, is director of the National Program Saluds es Vida/Health is Life at the Latino Commission on AIDS in New York City.

Photo credit: UladzimirZuyeu