The need for deeper and broader collaboration among HIV advocates and organizations was a key point in the closing plenary session of the U.S. Conference on HIV/AIDS held in New Orleans that concluded on Sunday, Sept. 15.
With the bilingual title of The South Calls, We Respond; El Sur Llama, Nostres Respondemos, the plenary featured Judith Montenegro, program director of the Latino Commission on AIDS’ Latinos in the South initiative, with a panel moderated by Will Ramirez, director of public policy and advocacy at the Southern AIDS Coalition.
Judith Montenegro
“I started working at the commission over 10 years ago in their Latinos in the South program,” Montenegro said, “and at the time, I was a baby organizer, traveling across nine southern states asking, Is this available in Spanish?, a phrase I still have to repeat today. For many of us in the South, the South is full of repetitions—of histories repeated, of lessons relearned and of remembered strategies.
“For Latinx communities in the South, some states became a new destination,” she continued. “For others, it's always been home, and for some, migrating to the South is also a homecoming of land stolen or of borders imposed. The South has shaped me, challenged me, been my teacher, nourished my hopes and dreams for my people and this place that we call home.
“Throughout my years in the field, over the time spent building a life in North Carolina, it's been a gift to witness not only the growth of my Latinx community throughout the region, but to also see so many southern Latinx colleagues increase in number each year. We are slowly chipping away at the physical and metaphorical walls built to keep us out yet and still, we have ways to go... And while the South may put out a welcome mat and hand you a glass of sweet tea, it would also tell you to roll up your sleeves and get to work.”
A succession of Latinx/Latine queer folk introduced themselves to the audience, sharing a part of their lives. Among them:
“I’m Umberto. I am a volunteer for from Atlanta, for a community-based organization called Latino LinQ in Atlanta,” said the first speaker, an immigrant Latino gay man. “In 2008 I was given this life-changing diagnosis. Since then, I have gained a community that embraces me, for all of me, but I have also lost friends who should still be here. They propel me to keep pushing for equity in HIV services for everyone in my community.”
‘We deserve to be seen, heard, lead and have a seat—not at one table, all the tables.’
Carlitos Xavier Díaz Rodriguez,
Making the case for language justice, Carlitos Xavier Díaz Rodriguez, an artist activist in residency and HIV justice program lead artist at QLatinx in Orlando, spoke in a mix of Spanish and English.
“Necesitamos acceso y educación—para personas que se parecen a mí—con recursos en nuestra idioma,” he said. “We need access and education—for people who look like me—with resources in our language.”
As a trans man, Adonis Gutiérrez, co-founder and CEO of Under the Umbrella, a nonprofit serving trans and gender nonconforming folk in South Texas, said he sees firsthand the disparities Latinx people face in PrEP, HIV testing and healthcare, and how stigma exacerbates these gaps. “We deserve to be seen, heard, lead and have a seat—not at one table, all the tables, because representation is important to reach equality,” Hernandez, a “proud Latina and Boricua,” said.
Jean Hernandez
The District of Columbia and 19 states have laws that allow undocumented immigrants to obtain a driver’s license—of those, only Maryland and Virginia are in the South, said Jean Hernandez, program coordinator for AIDS Alabama’s El Centro de Acceso para Latinos de Alabama/The HUB wellness clinic. Without a state ID or social security card, undocumented immigrants are often unable to access medical care or social services, leading to health disparities and social isolation.
“We deserve to be seen, heard, lead and have a seat—not at one table, all the tables, because representation is important to reach equality,” Hernandez, a “proud Latina and Boricua,” said.
Miguel Garcia, advocacy manager for the Southern AIDS Coalition, recounted how he was racially profiled and pulled over under. Border patrol falls under federal jurisdiction, but SB-4 is a state law that empowers Texas police to arrest anyone illegally crossing the Mexico border. Six Texas state trooper vehicles surrounded Garcia’s car on his 56-mile drive to finalize paperwork for Ryan White services. A U.S. citizen, Garcia was told by one officer he was lucky that he was following the law.
“Imagine what is happening to our undocumented brothers and sisters,” he said.
Arely Westley
Arely Westley is a longtime advocate for immigrants, Latinx and LGBTQ+ communities. Originally from San Pedro Sula, Honduras, she works with organizations in New Orleans and nationwide to uplift LGBTQ+ youth, stop abuse in ICE detention facilities and expand access for migrants to support services. She is a member of the Southeast Dignity Not Detention Coalition, a community advisory board member for the Tulane Total Health Clinic and recently joined the board of directors of Asheboro Latinxs Services and Alianza Trans Latinxs. Earlier this year, she received the Robert F. Kennedy Human Rights Award.
“When I first got Robert F. Kennedy Human Rights Award, I made a clear statement that this award does not only belong to me, it belongs to all the intersectional communities that I represent as a Honduras-born trans woman who grew up in Louisiana,” she said. “I'm not only representing my trans Latina community, I’m also representing the Latinx community in the whole country and the whole migrant community.”
She added, “We need to start working together for real, because it's nice that we see each other every year at this conference, but when each one of us goes back to our towns, we don't hear [from anyone]. We need to stay connected and to actually be in solidarity with each other in order to be able to build power. We can build power together.”
Aubri Escalera is co-founder of Atlanta-based Trans Power in Diversity and the LGBTQ+ liaison for Georgia 58th District state representative Park Cannon.
“As a trans Latina immigrant, I am here to advocate, empower and build collective power,” she said. “Southern power is trans power. Oftentimes, we have the tools to thrive but lack the credentials to work. Inclusive language is important, especially for our +50 immigrant community living with HIV. By bridging legislative efforts with grassroots organizations and health centers, we can create a future where community feels valued, protected and free.”
Gabriella Rodriguez, executive director of QLatinx, pointed out the threats posed in proposed state laws throughout the U.S.
“Over 530 harmful anti-LGBTQ bills have been introduced nationwide, with 251 of those targeting us here in the South,” she said. “These aren't just numbers. They represent a real threat to not only our safety, our mental health, our emotional and physical health, and our very existence, pero I've also seen the strength in the face of adversity, especially in the aftermath of tragedies like Pulse [the nightclub shooting incident in Orlando].
‘It is not enough to simply have people who speak Spanish, they must also understand the language of HIV prevention and be able to communicate that message effectively to our community.’
A nonbinary, indigenous Latino who was born and raised in the Deep South, Christopher Cuevas is senior program manager at AIDS United.
“Over the next 30 years, Latines are projected to be nearly 30% of the total U.S. population, making us the largest ethnic or racial minority group in the nation.” they said. “We also represent nearly 45% of those without health insurance.
They continued, “If every state in the nation expanded Medicaid, the percentage of uninsured Latines would drop by over 16%. We must do everything in our power to ensure every person in this nation can afford quality and affirming health care.”
Andres Acosta Ardila
“There are three things that we need to keep in mind in order to improve health equity and HIV prevention in Latinx communities in the South,” said Andres Acosta Ardila, director of community relations for Pineapple Healthcare in Orlando. “The first is a need for representation and language justice. We know that when organizations that serve our communities have individuals in all levels of the organization that look like us, speak our language, it leads to greater health outcomes.
“But we also need to be mindful of understanding that [Spanish speaking] individuals need support with medical language,” said Acosta Ardila. “It is not enough to simply have people who speak Spanish, they must also understand the language of HIV prevention and be able to communicate that message effectively to our community. That means organizations have to be willing to invest in both training and paying those people properly so that they can do this work.
The second is to create a network of support that goes beyond just HIV services. I am grateful to work for Pineapple Healthcare, which is a 340B [organization], and is able to use those resources not just to ensure that individuals have access to insurance and medication, but also transportation services, mental health and housing referrals for case management. Not only that, but we fiscally sponsor organizations like Abrigado Corazones which collects clothing, hygiene products and some mobility devices and items for children and distributes them to the community, especially the immigrant community... We partner and have sponsored Aguilar Salud, which handles linkage to care for Latinx individuals, and has increased our ability to use telehealth services to link Latinx individuals in rural areas to care. These networks of support are crucial in ensuring our community is linked and stays in care.
“It is not enough to provide HIV services. We have to be willing to collaborate with each other to actually form these networks of support.
“Finally, organizations need to not be afraid to take a stand. We're mindful of our 501(c)(3) [nonprofit] status, but that is not an excuse to not advocate for what is right. Our CEO, Ethan Suarez, openly spoken about the need for providing healthcare services for our undocumented community, and in the face of the ban on trans healthcare, we took all possible steps to ensure that our trans familia was able to access care without facing disruption in services. It's crucial to understand that our organizations represent hope and a lifeline to many, and we cannot stay silent as our Latinx and LGBTQ communities are under attack, especially when those attacks affect their health care. We all have to take a stand and stand up for what is right.”
‘I am a person who used drugs, and I am in recovery, and I hold the role of director of community relations in my organization. This is important because we often talk about people who use drugs as a priority population, but we don't take the steps necessary to hire them, and by doing this, we're doing a disservice to our community.’
Joaquín Carcaño (photo by Sean Black)
A recent graduate of the University of North Carolina-Chapel Hill School of Nursing, Joaquín Carcaño is a queer Mexican American trans man who directs Southern health policy at the Latino Commission on AIDS.
“The highest rates of new HIV transmissions in Central Florida are among the Latinx community, and we know that the highest co-occurring condition in Central Florida for people living with HIV is substance use,” he said. “Harm reduction is a lifeline for those most marginalized and stigmatized in our community, and the principles behind harm reduction need to be applied to all of our outreach and prevention efforts. The key is to understand that we have to meet people where they're at. It is not enough just to offer prevention methods if we don't carefully consider the needs of people who use drugs. In the Latinx community, we see compounding stigma from being at the intersection of Latinx identities, HIV status and drug use.
“I've seen all of those and have experienced all of those stigmas myself, and that stigma keeps people out of care,” he continued, “The more we focus on harm reduction efforts that destigmatize drug use, and the more that individuals who are struggling can feel safe to access care... There is also a need for Latinx communities, especially those of us who identify as people who use drugs or people in recovery, to join planning councils... I want to point out that I am a person who used drugs, and I am in recovery, and I hold the role of director of community relations in my organization. This is important because we often talk about people who use drugs as a priority population, but we don't take the steps necessary to hire them, and by doing this, we're doing a disservice to our community.
“The media has this narrative that is often wrong or not a complete picture,” he continued. “We think of trans care as, here's a surgery, here's an injection. We don't talk about the impact that has on a person and their body and their life, and that's what's really at the depth of this work, at the depth of our access to care. I grew up not knowing what I was suppressing, not knowing what I had hidden away, and unlocking that, and knowing what could exist for me, what possibilities I could access, was groundbreaking for me. And I think a part of trans care is saying, I have a whole other life to live. I have a fullness I haven't yet accessed.
“Restrictions on anti-trans care [are] really hyper-focused on youth right now. What is really happening is they say, you will not be allowed to be a trans adult—full stop. You will not be allowed to exist as a trans adult. We will deprive you of that. Those consequences are huge upon the mental health and wellbeing of our community, of our youth. They say they're trying to ‘protect’ our youth, but these are the same people who will tweet thoughts and prayers after a school shooting; that's not protecting our youth.
“The Texas Attorney General has made requests to Washington, D.C. and Georgia for trans patient records of Texans who have fled their state,” he said. “He's finding loopholes in medical privacy records to get data of former Texans who have fled their state who are trans. The implications of that are huge. We talk about authoritarianism and fascism after this election—it’s here, and we need to do something about it. It's happening. It's active. Why does he need this information? ... [In Alabama, where an anti-trans youth care law was passed,] it was a felony ban against providers. If you were to provide trans care, you will be hit with a felony. They are threatening to revoke medical licenses, of putting doctors in prison. So what do these doctors do? We're seeing doctors flee the South. What does that mean for our entire public health system, the providers who provide trans care are primary care providers and endocrinologists who also work with patients with diabetes. Think about the implications of our entire public health system. We're increasing our loss of primary care providers and providers who can care for diabetes management. That is huge. That's where our cross-solidarity movement needs to come in. [It affects the work of] public health work, of retainment, of our rural healthcare. Who is going to be affected? All of us. It's not just trans care.”
Will Ramirez, the panel’s moderator, teased an upcoming Southern States Manifesto, 2024 Update. “This report is the culmination of work that has taken place over two years that we feel tells a comprehensive story of HIV in the South.” When released, the report will be available at southernaidscoalition.org.