National Latino AIDS Awareness Day: Breaking down stigma, silence and silos

When Elia Chino, Founder and Executive Director of the Fundacion Latinoamericana De Acción Social (FLAS) Inc., initially approached major HIV/AIDS agencies in Houston, Texas for support in starting an organization tailored specifically to reaching Latino populations, she was met with confusion.

“Why do you want to start a separate organization?” they asked. “We’re here!”

Chino remembers her frustration. “They didn’t understand,” she said. “Our brothers and sisters were dying, and the community needed services that they couldn’t provide.” 

Indeed, in the 1990s, barriers to HIV care and treatment for Latino populations were markedly different from those faced by other populations. Information about the HIV epidemic was largely in English, and inaccessible to many individuals who had immigrated from indigenous Latin American communities and never learned to read and write in their native language, let alone English. When they were able to access treatment, Latino individuals often faced mistreatment at primary care facilities due to a lack of culturally competent care. 

Perhaps most challenging was the culture of silence. Many Latino immigrants living with HIV in the United States fled homophobia, transphobia and stigma in their home countries, and were still grappling with lasting shame and guilt. Despite many people dying, there was little open discussion or education about the cause. In fact, Chino didn’t even know that the HIV epidemic took the lives of some of her best friends until speaking with their families years later. 

“No one was talking about their diagnosis,” says Chino. “People had come to the United States for freedom, but still weren’t ready to talk about who they were. There was a real atmosphere of stigma, taboo, misinformation and fear.”

At the time, Chino was volunteering at a hospital serving communities without insurance. The fourth, fifth and sixth floors were all dedicated to treating people with HIV. Chino began educating herself on this crisis while she volunteered at the hospital, and founded FLAS in 1994 after discovering that the majority of HIV prevention efforts were not reaching Latino individuals. 

In the beginning, without support from other organizations in the area or resources to expand, Chino was a one-woman show, conducting outreach in clubs, cantinas and bars by herself. She hadn’t anticipated the barriers she’d face as a member of the LGBTQ+ community and an immigrant. Horrible discrimination, a language barrier and intense HIV stigma in the communities she was working in made the work challenging, but also emphasized the necessity of what she was doing. 

Over time, with support and funding from organizations like Gilead Sciences, FLAS has been able to expand its services from solely HIV prevention to include HIV testing, behavioral health services, housing and social services assistance, support groups and a food pantry. The organization has started hosting educational events everywhere from churches to street corners, raising awareness about HIV in the Houston community. Chino also started collaborating with the consulate of Mexico to help newcomers navigate U.S. health systems and services when they arrive in the United States. Next year, the organization will start offering mobile HIV testing clinics for communities in need. 

Since its launch, FLAS has been able to expand its initial focus to address the holistic drivers of this crisis, moving beyond medical determinants of health to tackle the social and structural barriers that perpetuate the HIV epidemic and prevent Latino populations from accessing comprehensive treatment. 

“Everyone keeps telling Latino individuals to get tested, but this does nothing unless you actually incentivize people to do so,” says Chino. “People have to go to work. They have to pay their rent. They have to buy food. Many can’t afford to lose their salary and spend a full day coming in to do a test or get treatment. We have to make it easier to access HIV prevention and treatment, and we have to provide incentives.” 

This year marked FLAS’s 30th anniversary, which the organization celebrated with a gala in August. They have made a huge impact in Houston since their launch – providing HIV and STD education to over 500,000 Latino people, distributing over 20,000 HIV tests, referring over 40,000 people for social services and hosting over 6,000 educational events and health fairs in English and Spanish. However, many of the challenges for HIV prevention and treatment for Latino populations remain. 

“We have over 30,000 individuals living with HIV in Houston, yet when we ask for people to talk about their status, no one comes forward to tell their stories. HIV is a chronic disease, but stigmatization is still so strong in the Latino community,” says Chino. “You can say you have cancer, high blood pressure, diabetes, whatever – but nobody says I have HIV. There is still so much work to do.” 

As a testament to their important programming, FLAS is a recipient of funding through Gilead Sciences’ TRANScend® Community Impact Fund, a program aimed at empowering Trans-led organizations working to improve the safety, health and wellness of the Transgender community. Since its inception in 2019, TRANScend has awarded more than $9.2 million in grants to 26 community organizations across 15 U.S. states and territories.

TRANScend support has been critical to helping FLAS maintain its services. In 2020, in the midst of the COVID pandemic, Gilead’s funding helped FLAS continue to offer virtual behavioral and mental health services to the community when their physical offices had to close. 

According to Chino, this type of partnership is critical to ending the HIV epidemic in Latino communities, especially for meeting communities where they are. 

“Communities trust their grassroots organizations, and grassroots organizations provide for their communities,” she says. “At the end of the day, we need to continue to support the groups doing the difficult work on the ground with the people they’re serving, especially those breaking down stigma and lasting barriers to care for Latino communities.”