1 HIV/AIDS among Hispanics, November 2004

The HIV/AIDS epidemic is a serious threat to 

the Hispanic community. In addition to being a 

population seriously affected by HIV, Hispanics 

continue to face challenges in accessing health 

care, prevention services, and treatment. In 2001, 

HIV/AIDS was the third leading cause of death 

among Hispanic men aged 35 to 44 and the fourth 

leading cause of death among Hispanic women in 

the same age group [1].

STATISTICS

Cumulative Effects of HIV Infection 

and AIDS (through 2002)

• Although Hispanics made up only about 14% 

of the population of the United States and 

Puerto Rico [2,3], they accounted for 18%—

almost 164,000—of the more than 886,500 

AIDS cases diagnosed since the beginning of 

the epidemic [4]. By the end of 2002, nearly 

88,000 Hispanics had died with AIDS [4].

• Among people given a diagnosis of AIDS 

since 1994, a smaller proportion of Hispanics (61%), compared with whites (64%) and 

Asians and Pacifi c Islanders (69%), were 

alive after 9 years. However, the proportion of 

surviving Hispanics was larger than the proportions of surviving American Indians and 

Alaska Natives (58%) and African Americans 

(55%) [4].

AIDS in 2002

• Hispanics accounted for more than 8,000, or 

20%, of the more than 42,000 new AIDS diagnoses in the United States [4]. 

• Of the rates of AIDS diagnoses for all racial 

and ethnic groups, the second highest was the 

rate for Hispanics. The highest rate was that 

for African Americans (76.4 cases per 100,000 

people), followed by the rates for Hispanics 

(26.0/100,000), American Indians and Alaska 

Natives (11.2/100,000), whites (7.0/100,000), 

and Asians and Pacifi c Islanders (4.9/100,000) [4].

• The 76,052 Hispanics living with AIDS accounted for 20% of all people in the United 

States living with AIDS [4].

HIV/AIDS in 2002 

• Hispanics accounted for 13% of new HIV/

AIDS diagnoses reported in the 30 areas with 

long-term, confi dential name-based HIV reporting in the United States [4].

• From 1999 through 2002, the number of new 

HIV/AIDS diagnoses increased 26% among 

Hispanics in the 30 areas [4].

• Most Hispanic men are exposed to HIV 

through sexual contact with other men, followed by injection drug use and heterosexual 

contact. Most Hispanic women are exposed to 

HIV through heterosexual contact, followed by 

injection drug use [4].

HIV/AIDS among

Hispanics

Estimated cases of HIV/AIDS di ag nosed in 2002 

by race
 2 HIV/AIDS among Hispanics, November 2004

RISK FACTORS AND BARRIERS 

TO PREVENTION

A number of cultural, socioeconomic, and healthrelated factors help drive the HIV epidemic in the 

Hispanic community. Because Hispanic Americans 

or their parents have emigrated from many Latin 

countries or regions, there is no single Hispanic 

culture in the United States. Research shows that 

Hispanics born in different countries have different behavioral risk factors for HIV/AIDS. For 

example, data suggest that Hispanics born in 

Puerto Rico are more likely than other Hispanics 

to contract HIV as a result of injection drug use. 

By contrast, sexual contact with other men is the 

primary cause of HIV infections among men born 

in Mexico [4].

Other risk factors and barriers to prevention include the following.

Poverty

More than 1 in 5 (22.6%) Hispanics lives in poverty [5]. Of the Hispanic people with HIV/AIDS 

interviewed in a multisite study, 47% of Mexicanborn men who have sex with men (MSM) and 59% 

of Puerto Rican–born MSM had annual incomes of 

less than $10,000 [6]. A variety of socioeconomic 

problems associated with poverty, including limited access to high-quality health care, directly or 

indirectly increase the risk for HIV infection.

Denial

Although many Hispanics are increasingly engaged in the fi ght against HIV/AIDS, some Hispanic communities have been slow to join the 

effort. In part because of cultural values such as 

machismo (sense of manliness), communities may 

be reluctant to acknowledge sensitive yet risky behaviors, such as homosexuality [7]. Many Hispanic 

MSM identify themselves as heterosexual and, 

as a result, may not relate to prevention messages 

crafted for gay men [8].

Heterosexual Risk

Hispanic women are most likely to be infected 

with HIV as a result of sex with men [4]. In a study 

of heterosexual Hispanics living in the United 

States, 16% had sexual risk factors for HIV, including multiple sex partners or high-risk main partners 

[9]. Some women, including those who suspect 

that their partners are at risk for HIV infection, 

may be reluctant to discuss condom use with their 

partners out of fear of emotional or physical abuse 

or the withdrawal of fi nancial support [10].

Substance Abuse

Injection drug use continues to be a signifi cant risk 

factor for Hispanics. Sharing needles is not the 

only HIV risk factor related to substance abuse. 

Both casual and chronic substance users are more 

likely to engage in high-risk behaviors, such as 

unprotected sex, when they are under the infl uence 

of drugs or alcohol [11].

Sexually Transmitted Diseases

Compared with whites, Hispanics are about twice 

as likely to have gonorrhea or syphilis [12]. Sexually transmitted infections increase the likelihood 

of HIV transmission [13].

Cases of AIDS di ag nosed in the United States by 

exposure category in 2002 among Hispanics born 

in different coun tries

Estimated cases of HIV/AIDS di ag nosed in 2002 

among His pan ic adults and adolescents
 3 HIV/AIDS among Hispanics, November 2004

Understanding HIV and AIDS Data

PREVENTION

The annual number of new HIV infections among 

all people in the United States declined from a 

peak of more than 150,000 cases in the mid-1980s 

and has stabilized at approximately 40,000 cases 

since the late 1990s. Minority populations are 

disproportionately affected by the HIV epidemic. 

To reduce further the incidence of HIV, CDC announced a new initiative, Advancing HIV Prevention (http://www.cdc.gov/hiv/partners/AHP.htm), 

in 2003. This initiative comprises 4 strategies: 

making HIV testing a routine part of medical care, 

implementing new models for diagnosing HIV infections outside medical settings, preventing new 

infections by working with HIV-infected persons 

and their partners, and further decreasing perinatal 

HIV transmission.

In the United States, Hispanics are emerging as 

an at-risk group. CDC is conducting demonstration projects on using social networks to reach 

high-risk persons in communities of color. CDC’s 

Minority AIDS Initiative (http://www.cdc.gov/

programs/hiv09.htm) explores the disparities in 

minority communities at high risk for HIV and 

what can be done to reduce these disparities. 

Examples of CDC-funded programs focused on 

Hispanics include a community-based free health 

clinic offering bilingual, bicultural HIV/AIDS 

programs in Washington, DC; one-on-one interventions for transgender people in various California urban areas; and a food bank in East Los 

Angeles that serves persons living with HIV/

AIDS.

 AIDS surveillance: Through a uniform system, CDC 

receives reports of AIDS cases from all US states and 

territories. Since the beginning of the epidemic, these 

data have been used to monitor trends because they 

are representative of all areas. The data are statistically 

adjusted for reporting delays and for the redistribution 

of cases initially reported without risk. As treatment has 

become more available, trends in new AIDS diagnoses 

no longer accurately represent trends in new HIV infections; these data now represent persons who are tested 

late in the course of HIV infection, who have limited 

access to care, or in whom treatment has failed.

HIV surveillance: Monitoring trends in the HIV 

epidemic today requires collecting information on 

HIV cases that have not progressed to AIDS. Areas 

with confi dential name-based HIV infection reporting 

requirements use the same uniform system for data 

collection on HIV cases as for AIDS cases. A total of 30 

areas―the US Virgin Islands and 29 states (Alabama, Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, Iowa, 

Louisiana, Michigan, Minnesota, Mississippi, Missouri, 

Nebraska, Nevada, New Jersey, New Mexico, North 

Carolina, North Dakota, Ohio, Oklahoma, South Carolina, 

South Dakota, Tennessee, Utah, Virginia, West Virginia, 

Wisconsin, and Wyoming)―have collected these data 

for at least 5 years, providing suffi cient data to monitor 

HIV trends and to estimate risk behaviors for HIV infection. Recently, 9 additional areas have begun confi dential 

name-based HIV surveillance, and data from these areas 

will be included in coming years.

HIV/AIDS: This term includes persons with a diagnosis 

of HIV infection (not AIDS), a diagnosis of HIV infection 

and a later diagnosis of AIDS, or concurrent diagnoses of 

HIV infection and AIDS.

REFERENCES

1. Anderson RN, Smith BL. Deaths: leading causes for 

2001. National Vital Statistics Report 2003;52(9):51,53. 

Available at http:// www.cdc.gov/nchs/data/nvsr/nvsr52/

nvsr52_09.pdf. Accessed October 26, 2004. 

2. US Census Bureau. Annual estimates of the population by sex, race and Hispanic or Latino origin for the 

United States: April 1, 2000–July 1, 2003. Available at 

http://www.census.gov/popest/national/asrh/NC-EST2003/

NC-EST2003-04-12.pdf. Accessed August 30, 2004. 

3. Annual estimates of the population for the United States 

and States, and for Puerto Rico: April 1, 2000–July 1, 

2003. Available at http://www.census.gov/popest/states/

NST-EST2003-ann-est.html. Accessed August 30, 2004.

4. CDC. HIV/AIDS Surveillance Report 2002;14:

1–40. Also available at http://www.cdc.gov/hiv/stats/

hasrlink.htm. Accessed July 26, 2004.

5. US Census Bureau. Poverty 1999: Census 2000 Brief. 

Issued May 2003. Available at http://www.census.gov/

prod/2003pubs/c2kbr-19.pdf. Accessed August 30, 2004.

6. Diaz T, Chu S, Buehler J, et al. Socioeconomic differences among people with AIDS: results from a multistate surveillance project. American Journal of Preventive Medicine 1994;10:217–222.

7. Diaz R. Latino gay men and psycho-cultural barriers 

to AIDS prevention. In: Levin MP, Nardi PM, Gagnon 

JH, eds. In Changing Times: Gay Men and Lesbians 

Encounter HIV/AIDS. Chicago: University of Chicago 

Press; 1997.
 4 HIV/AIDS among Hispanics, November 2004

For more information...

CDC National STD & AIDS Hotlines:

1-800-342-AIDS

Spanish: 1-800-344-SIDA

Deaf: 1-800-243-7889

CDC National Prevention

Information Net work:

P.O. Box 6003

Rockville, Maryland 20849-6003

1-800-458-5231

Internet Resources:

NCHSTP: http://www.cdc.gov/nchstp/od/

nchstp.html

DHAP: http://www.cdc.gov/hiv

NPIN: http://www.cdcnpin.org

8. CDC. HIV/AIDS among racial/ethnic minority men 

who have sex with men—United States, 1989–1998. 

MMWR 2000;49:4–11.

9. Sabogal F, Catania JA. HIV risk factors, condom use, 

and HIV antibody testing among heterosexual Hispanics: the National AIDS Behavioral Surveys (NABS). 

Hispanic Journal of Behavioral Sciences 1996;18:

367–391.

10. Suarez-Al-Adam M, Raffaelli M, O’Leary A. Infl uence 

of abuse and partner hypermasculinity on the sexual 

behavior of Latinas. AIDS Education and Prevention 

2000;12:263–274.

11. Leigh B, Stall R. Substance use and risky sexual 

behavior for exposure to HIV: issues in methodology, 

interpretation and prevention. American Psychologist 

1993;48:1035–1045.

12. CDC. Sexually Transmitted Disease Surveillance, 

2002. Atlanta: US Department of Health and Human 

Services, CDC; September 2003. Also available at: 

http://www.cdc.gov/std/stats02/. Accessed 

July 26, 2004. 

13. Fleming DT, Wasserheit JN. From epidemiological 

synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual 

transmission of HIV infection. Sexually Transmitted 

Infections 1999;75:3–17.