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The CDC says new HIV infection rates among Latinos have fallen with one exception. HIV is increasing among gay and bisexual Latino men. Health officials want to see more high-risk men taking the pre-exposure pill known as PrEP. Just one pill a day is nearly a hundred percent effective in preventing HIV, but it's a tough sell. Adrian Florido of NPR's Code Switch team spoke to several men to find out why. And a warning - this story contains frank language about sex.
ADRIAN FLORIDO, BYLINE: Since the early 1990s, activist Richard Zaldivar has worked with gay Latinos. He operates out of an old two-story house tucked behind a church in Northeast Los Angeles.
RICHARD ZALDIVAR: Hey, guys. How are you? Nice to see you. Make yourself at home.
FLORIDO: On Tuesdays, about 20 guys come over. They bring pizza, salad, eggrolls, and they sit in the living room to talk. Today, the topic is PrEP. Data show it's not reaching gay and bisexual Latinos even though they are at higher risk for HIV than most other groups. Zaldivar says there are many reasons for this. At this point, only one drug, called Truvada, is approved as PrEP, and it costs $1,300 a month without insurance. Latinos are also less likely to see a doctor for preventive reasons. When it comes to gay Latinos...
ZALDIVAR: There's a lot of fear and stigma still around talking openly about sex, their identity.
FLORIDO: Zaldivar says religion and traditional family values play a big role in this. So does machismo, the notion that Latino men should be hyper masculine. Zaldivar says that for the gay guys he works with, these expectations make it hard to be open about their sexuality.
ZALDIVAR: So if they're not at that point, it's hard for someone then to fight for prevention method and then tell the doctor, hey, I need that because I'm an active sexual player.
FLORIDO: One of the guys at this meeting, Victor Barillas, did ask his doctor for Truvada. The 40-year-old started taking it last spring, and he said so on Facebook.
VICTOR BARILLAS: I posted that I was going in for a checkup, and then at the end, I said, and doc, please give me Truvada.
FLORIDO: Within minutes, his ex-boyfriend sent him a message.
BARILLAS: And he said, wow. He's like, really? He's like, you're just being out there and open about, you know, Truvada? You know, that's kind of something private.
FLORIDO: Barillas says that kind of response is typical. One of his friends, Joey Ponce de Leon, used to talk trash about men on Truvada.
JOEY PONCE DE LEON: I kind of thought, like, you know, they were just going to just have sex with everybody. And just being brought up with lots of strong morals and values, you know, I just have my own feelings about it.
FLORIDO: He says that changed during the summer after Barillas told the story.
BARILLAS: Two weeks after being on the medication, I met this man who I began having sex with. And at first, we did use protection, and then we didn't use protection.
FLORIDO: One morning, the man texted him.
BARILLAS: He said, you know, please give me a call when you get a chance. So I called him, and I said, what's going on? And he said, you know, last night when I was hanging out with my friends in West Hollywood, I got tested, and I found out that I'm HIV-positive.
FLORIDO: Barillas rushed to get tested. He was negative.
BARILLAS: I definitely believe that Truvada kept me negative because I honestly believe, thinking about the sex that we had, I would be HIV-positive.
FLORIDO: Ponce de Leon says he cried when he heard that.
PONCE DE LEON: I felt extremely bad because, you know, here I was condemning it, you know? And - but I was just like, wow. You know, I could've lost him. And I apologized to him, and I apologize again to you. And I am so sorry, you know, that, you know, I thought the way I thought. And I would've hate to lose him if anything were to happen.
BARILLAS: Aw, thank you. Thank you.
FLORIDO: Ponce de Leon says he realizes now why he'd been quick to judge. Within his tradition-bound family, he had never felt safe in his sexuality.
PONCE DE LEON: I couldn't be that particular person that I wanted to be, you know? And I knew that I was either going to go to hell or whatever if I did do that.
FLORIDO: In Truvada, he saw a drug that allows gay men to feel more secure than he had about sex.
So you think you felt a little bit bitter?
PONCE DE LEON: I did, and it was mostly out of just being a hater, just jealousy.
FLORIDO: Ponce de Leon is in a committed relationship, so he doesn't use Truvada. But now he understands and supports others who do. Adrian Florido, NPR News.
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