When Oakland resident Eddie Velasquez was growing up, he was frequently taunted by his peers for being gay. They called him derogatory slurs and told him to be a “real man.” He was raised in a traditional Latino household, and his cultural identity made little room for homosexuality. To stop the bullying, Velasquez even dated a woman for a short period of time, but he knew he wasn’t being honest with himself, he said.

Velasquez’s experience is representative of the struggles Latinx people face and one of the reasons why HIV rates among Latinx men who have sex with men are on the rise, experts say.

“Homosexual men are seen not as somebody with a different orientation; they’re seen as failed men,” said Rafael Diaz, a PhD in clinical psychology. Diaz, who is now retired, spent his career researching the barriers Latinx men face when attempting to protect themselves against HIV and other sexually transmitted infections.

New HIV cases among Latinx men who have sex with men have grown faster than any other population between 2011-2015, according to the Centers for Disease Control and Prevention (CDC), increasing 14 percent in that time period. This group now accounts for 23 percent of all HIV cases despite making up only 18 percent of the U.S. population.

Diaz’s studies found that although there was widespread awareness among gay and bisexual Latinx men that unprotected sex put them at higher risk of contracting HIV, they still took part in risky behaviors. He attributes this in part to machismo and a culture that prevents them from being open about their sexuality and relationships.

“This creates a sense of internalized shame, and that leads men to have their sexuality with strangers, strange places, more anonymous,” Diaz said.

Velasquez said he has seen this firsthand.

“I know people that they have to get married for the fact that they want to show their family that they’re not gay, so they live double life,” he said.

And not protecting yourself in those scenarios comes with the territory.

“Sometimes we protect ourself with the guy, sometimes we don’t,” Velasquez added.

On top of cultural stigma, other barriers may be contributing to the rising rates. Hispanics and Latinos have the highest uninsured rates of any other group and also experience high levels of mistrust of the healthcare system, according to the CDC.

