SEXUAL HEALTH

Successes:

• Reduced Uninsured Rates: The ACA significantly reduced the uninsured rate among Latinos—from 32% in 2010 to 19% in 2016. KFF: Racial Equity and Health Policy, KFF: Health Coverage by Ethnicity
• Preventive Services Coverage: The ACA requires coverage of preventive services (e.g., HIV screening, STI testing, HPV vaccines) without cost-sharing, benefiting Latino populations. Healthcare.gov Preventive Services

Challenges:

• Medicaid Expansion Gaps: As of 2024, 10 states—many in the South—have not expanded Medicaid, disproportionately affecting low-income Latinos. KFF Medicaid Expansion Status
• Immigration Status Exclusions: Undocumented immigrants remain ineligible for ACA coverage, contributing to the Latino community’s high uninsured rate. KFF: Health Coverage for Immigrants

Successes:

• Serving Underserved Communities: A significant portion of Title X patients are Latino, helping reduce access barriers to reproductive health and preventive services. HHS OPA Title X Facts

Challenges:

• Funding Cuts & Policy Restrictions: Between 2019 and 2021, funding cuts and policy changes led to a 63% reduction in Title X clinic sites, limiting access in many underserved Latino communities. Guttmacher Institute  

Successes:

• Improved HIV Care Access: In 2019, over half of Latinos diagnosed with HIV received services through the program, improving linkage to care and access to antiretroviral therapy.
  HIV.gov Ryan White Data  

Challenges:

• Disparities in Outcomes: While access has improved, racial and ethnic disparities in viral suppression persist, particularly among multiracial and Black Latino populations. HRSA 2020 RWHAP Annual Client-Level Data Report

Successes:

• Let’s Stop HIV Together: A national campaign aimed at raising awareness, reducing stigma, and promoting HIV testing and PrEP—particularly in communities of color, including Latinos. Visit campaign
  
• ¡Cuídate! : An evidence-based HIV/STI prevention curriculum designed for Latino adolescents. It emphasizes cultural values and personal responsibility and has been shown to increase condom use and improve HIV/STI knowledge. Learn more  

Challenges:

• Language & Cultural Barriers: Despite these efforts, many Latino communities still face barriers due to limited bilingual outreach and cultural tailoring. Stigma surrounding sexual health topics in families can discourage open dialogue and engagement. Explore the Hispanic/Latino Toolkit

Expand Medicaid in States with Large Latino Populations

Many states that did not expand Medicaid under the ACA have significant Latino populations with unmet healthcare needs. More than half (55%) of the U.S. Hispanic population resides in three states: California, Florida, Texas. Some other states with large Latino populations include New York, Illinois, Arizona, New Jersey, and Colorado (Korhonen, 2024).

• Recommendation: Advocate for Medicaid expansion in states like Texas and Florida, where many low-income Latinos remain uninsured.
  • Advocate for Medicaid expansion in states like Texas, Florida, and New York, where a large number of low-income Latinos remain uninsured.
• Advocacy Focus: Engage with local governments and healthcare providers to push for Medicaid expansion as a means to reduce sexual health disparities in Latino communities.

Evidence:

• States that haven’t expanded Medicaid include those with large Latino populations.
• Medicaid expansion has improved access to reproductive and preventive health.

Increase Funding for the Ryan White HIV/AIDS Program

While the Ryan White program has been successful in helping Latinos with HIV, more resources are needed to close gaps in care for Black and multiracial Hispanic/Latino populations.

• Recommendation:  Allocate targeted funding to reduce HIV disparities among Black and multiracial Hispanic/Latino individuals.
  1. Advocate for targeted funding within the Ryan White program to address disparities in viral suppression rates among Black and multiracial Hispanic/Latino individuals.
• Advocacy Focus: Push for state and federal policies that allocate additional resources to community health programs addressing HIV in minority groups.

Evidence:

• The Ryan White Program supports over 50% of Latinos living with HIV.
• HRSA data show persistent disparities in viral suppression by race/ethnicity.

Increase Funding for Title X Clinics in Latino Communities

Title X clinics are vital to providing affordable reproductive health services, but funding cuts have reduced their availability in some areas.

• Recommendation: Secure greater funding for Title X clinics in Latino-majority areas, especially those with high STI/HIV rates.
  • Advocate for increased funding for Title X clinics in Latino-majority areas, particularly in states with high rates of STI and HIV infections. More funding will enable clinics to offer expanded services, such as comprehensive sexual health education, testing, and contraception.
• Advocacy Focus: Partner with reproductive justice organizations to campaign for greater state and federal funding for Title X programs.

Evidence:

• Funding cuts reduced Title X’s national reach by 63%
• Title X is a key resource for Latinos seeking reproductive care.

Implement More Pop-Up Clinics in Latino Neighborhoods

Pop-up clinics can help provide convenient and affordable healthcare to underserved Latino communities.

• Recommendation: Expand mobile sexual health services in trusted community locations.
  • Encourage healthcare systems and public health departments to set up more pop-up sexual health clinics in areas with high Latino populations. These clinics should offer bilingual services and partner with trusted community spaces like churches and schools to provide STI testing, contraception, and health education.
• Advocacy Focus: Secure funding through federal programs like Title X or local grants to support mobile health clinics in high-need areas.

Evidence:

• Mobile clinics improve access to STI and preventive services.
• Partnering with trusted spaces boosts community health engagement.

Improve Outreach for Undocumented Latino Immigrants

Undocumented immigrants face significant barriers to accessing affordable healthcare.

• Recommendation: Create and expand programs offering low-cost or free sexual health care regardless of immigration status.
  • Expand community health programs to specifically target undocumented immigrants for sexual health services, regardless of their insurance or immigration status. This includes providing access to free or low-cost HIV/STI testing, contraception, and health education.
• Advocacy Focus: Collaborate with non-profit organizations, such as the National Latina Institute for Reproductive Justice, to lobby for policies that provide undocumented individuals access to basic healthcare.

Evidence:

• Undocumented immigrants face significant barriers to accessing care.
• Effect of a Community Health Worker Intervention Among Latinos With Poorly Controlled Type 2 Diabetes: The Miami Healthy Heart Initiative Randomized Clinical Trial

Enhance Cultural Competency in Sexual Health Campaigns

Many Latinos face cultural stigmas that prevent them from accessing sexual health services.

• Recommendation: Launch bilingual, stigma-reducing campaigns that reflect Latino cultural values.
  • Design more culturally relevant sexual health campaigns, specifically targeting Latino families. These campaigns should address the cultural stigmas surrounding sexual health and be delivered in both Spanish and English, with a focus on reducing barriers to open discussion.
• Advocacy Focus: Work with Latino community leaders, healthcare providers, and media outlets to create and disseminate bilingual educational materials that promote sexual health services.

Evidence:

• Programs like ¡Cuídate! have improved sexual health behavior among Latino youth.
• Cultural and linguistic competency boosts patient trust and participation.

Invest in Peer Education & Promotores de Salud Models

Promotores de salud (community health workers) are trusted messengers in Latino communities. They help overcome barriers like stigma, fear, and low health literacy by providing culturally relevant, peer-led education and navigation support. Promotores have proven success in increasing HIV/STI testing and promoting healthy sexual behaviors.

• Recommendation: Encourage healthcare systems and public health departments to set up more pop-up sexual health clinics in areas with high Latino populations. These clinics should offer bilingual services and partner with trusted community spaces like churches and schools to provide STI testing, contraception, and health education.
  • Expand investment in community-based peer educator programs that employ promotores to deliver bilingual, culturally relevant sexual health education and link individuals to services.

Evidence:

• Promotores improve health behaviors and trust in underserved Latino communities.
• Peer-led HIV/STI education increases testing and reduces transmission risk.

Expand Digital Health Interventions (Texts, Apps, Social Media)

Latinos, especially youth, have high mobile phone and social media use, but often lack access to traditional health services. Digital tools like apps and text reminders have been shown to improve HIV/STI prevention knowledge, increase condom use, and encourage clinic visits.

• Recommendation: Develop mobile-friendly bilingual platforms and use text-message or app-based reminders to promote STI testing, contraception use, and sexual health education.

Evidence:

• SMS interventions are effective in encouraging HIV/STI prevention behaviors.
• Mobile apps improve contraception use and sexual health literacy.

Strengthen School-Based Health Education in Latino-Majority Districts

Many Latino adolescents attend schools that provide limited or abstinence-only sex education. These programs often lack cultural relevance and multilingual support, leaving youth underprepared to make informed decisions about sexual health.

Evidence:

• Latino teens are less likely to receive comprehensive sex ed, but benefit from culturally tailored programs.
• Comprehensive sex education is linked to reduced STI rates and teen pregnancies.

Integrate Mental Health with Sexual Health Services

Latino youth, LGBTQ+ individuals, and those experiencing trauma face intersecting challenges in mental and sexual health. Poor mental health is associated with risky sexual behaviors and lower use of preventive services, yet mental and sexual health care are often siloed.

• Recommendation: Integrate trauma-informed, culturally competent mental health support within sexual health services—especially for vulnerable subgroups—either by co-locating services or through warm referrals.

Evidence:

• Integrated care models improve outcomes in youth with overlapping mental and sexual health needs.
• Latino youth benefit from culturally relevant, trauma-informed care.