The current HIV/AIDS epidemic represents a very serious threat to the U.S. Hispanic community. Although Hispanics comprise 12.5% of the population in the United States, they account for nearly 20% of people with AIDS.³ In addition to being a population disproportionately affected by HIV disease and AIDS, Hispanics in the United States continue to face major challenges in accessing health care, in securing health-related prevention services, and
in receiving effective antiretroviral treatment. In 2001, HIV disease/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.³ Survival rates in Hispanics with AIDS are significantly lower (61%) than in Whites (64%) and Asians/Pacific Islanders (69%). Only Native Americans/Alaskan Natives (58%) and African Americans (55%) had lower survival rates.⁴ Hispanics also have the second highest rate of new AIDS cases in the United States compared to other racial and ethnic groups, with the African-American community being the highest. Table 20.1 denotes the estimated number of cases with HIV disease or AIDS diagnosed in 2002 according to race.⁴

As depicted in Table 20.1, Hispanics accounted for 13% of new HIV infection or AIDS cases diagnosed in 2002. Among Hispanics, from 1999 to 2002, the number of new HIV infection or AIDS cases diagnosed increased 26%.⁴ Table 20.2 shows the rate of AIDS cases in the United States in 2003.⁵

Table 20.3 depicts the percentage of AIDS cases in Hispanics from the 859,000 AIDS cases reported to the Centers for Disease Control and Prevention (CDC) through 2002.⁵

In 2003, an estimated 11,498 women had a diagnosis of AIDS; this number represented 27% of the 43,171 AIDS cases diagnosed in that year.⁶ The rate of AIDS diagnosis for Hispanic women in 2003 was 12.4/100,000; this rate was higher than the rate for White women (2/100,000) and second only to that of African-American women (50.2/100,000).⁶ African-American and Hispanic women make up 83% of all AIDS cases diagnosed in 2003, with African-American women having a risk that is 16 times that of White women.⁶ Thus, HIV infection and AIDS among U.S. Hispanics present a major health/mental health challenge.

The primary risk factor for exposure to HIV in U.S. Hispanics varies for different groups. It is therefore imperative to be fully aware of these risk factors in order to attempt to deal with the diversity pertaining to age, gender, nationality, migratory experience, and acculturation as it relates to medical, psychiatric, and public health perspectives. For example, the Hispanic migration to the United States originates from many countries and varying regions therein. Thus the Hispanic community in the United States is not a culturally homogeneous group. This fact needs to be taken into consideration when discussing these risk factors related to HIV disease and AIDS.

Research and investigational efforts have demonstrated that Hispanics born in different countries and regions may depict different behavioral risk factors for HIV disease and AIDS. For example, it has been documented that Hispanics born in Puerto Rico or who are of Puerto Rican descent are more likely to become HIV infected as a result of injection drug use than any other subgroup of Hispanics. By contrast, men who have sex with men (MSM) are
considered the primary route of HIV transmission among men born in Mexico or who are of Mexican descent.⁷ Table 20.4 denotes the 2002 exposure category for Hispanic countries and regions compared with that of the United States.⁵