MIAMI BEACH — Juan Oves and I are standing on the sidewalk outside Score, a beloved gay nightclub on Miami Beach’s Washington Avenue, as he checks his Grindr. But Oves isn’t looking for love tonight. Instead, he has changed his display name on the gay dating app to “Free HIV Testing” so that he can invite patrons and passersby to visit the Pride Community Support Mobile Van, a roving HIV-testing station operated by local nonprofit Latinos Salud that moves between LGBT hotspots in South Florida.
Oves gets his first message of the night: “Every time I get tested, I get very nervous.”
Before he can reply, the same man messages again. Two words: “I’m afraid.”
My eyes start to tear up but Oves is already firing off a reassuring response: “It’s OK. I understand. I’ll be here the whole time. Step by step.”
South Florida is home to the highest rate of new HIV infections in the United States. According to the Centers for Disease Control and Prevention (CDC), there were an estimated 2,500 new infections in the Miami, Fort Lauderdale, and West Palm Beach areas in 2013—a rate of 44.3 for every 100,000 people. The predominantly Latino Miami-Dade County is the epicenter for new infections in Florida with Broward County, its neighbor to the north, coming in second.
For Latinos Salud Executive Director Dr. Stephen Fallon, who has previously consulted for the CDC and a dozen state health departments, HIV in South Florida is a complex and multifactorial problem. Not only does the epidemic already have deep roots here, but over half of Miami-Dade County residents were born outside the United States, with many facing cultural and language barriers in learning about safe sex practices.
“Many of our gay immigrant residents came from countries of homophobic repression, so they arrive without the tools to negotiate safer sex, or even an accurate understanding of what is risky and what isn’t,” Fallon writes in an email.
Although most major U.S. cities have a thriving gay nightlife, Miami’s club scene is set against this backdrop of a large pre-existing HIV-positive population and low awareness of the virus, especially among newcomers. As a result of this “combination,” as Fallon puts it, “lonely (and perhaps boozy) nights can easily turn into new infections.”
That’s where Latinos Salud comes in. Not content with their own suite of internal programs, the small nonprofit takes the fight against HIV directly to the booziest spots on the beach and beyond. In addition to stocking local nightclubs with condoms and lubricant, the organization’s bright-colored testing vans make frequent appearances outside clubs like Twist and Score.
On this particular night outside Score, the van is a party unto itself.
Classic Britney is blasting from a mobile speaker. Oves—along with his colleagues Jose Javier and Jonathan Flores—are handing out safe-sex kits to men heading into or out of the club. Clad in their trademark gowns, veils, and face paint, fabulous queens from the local chapter of charity drag organization The Sisters of Perpetual Indulgence are dancing, posing for pictures with tourists, and, most importantly, recruiting for the van. Occasionally, a parking spot closer to the club’s entrance opens up and we all gallop forward to the clip-clop of the Sisters’ high-heel boots.
One man headed for Score runs headlong into the Sisters, who waste no time selling him on the 20-minute rapid test.
“Can I do it now?” he asks.
Yes, he can, and the Sisters point him toward the van, sending a cheer through their ranks as he enters. The man’s willingness to test at a moment’s notice is not uncommon. As Javier explains, the van is a draw for the same reasons that a food truck is so appealing: it’s there, it’s convenient, and it’s immediate.
“We get more testing in the van than in the office,” he tells me, even when they simply park it outside their own front door.
“You’ll see people pass by and look at the sign and then turn back and keep looking,” adds Flores.
For people who are at higher risk for HIV, testing can be a source of anxiety, especially given the social stigma that can accompany a positive diagnosis. By maintaining a public presence with the van—and such a cheerful one, to boot—Latinos Salud makes it that much easier for people who would not otherwise access free services to get tested.
“Because our van is so visible, we’re now finding that more people are also walking into our office because they saw the van somewhere and developed a rapport with someone on our outreach staff,” writes Fallon.
By coming to Miami Beach’s hot spots, too, the group hopes to break through HIV stigma and send the message that sexual pleasure and safe sex are not incompatible.
Midway through the night, we enter the club and work our way through the dance floor, lights flashing and Latin music pounding. Javier and Oves hand out safe-sex kits to men who mouth a silent “thank you” in return. Introductions are made, cheeks are kissed, but any conversations are drowned out by the live congo drummer on stage. Oves takes a quick SnapChat of the scene, adding the caption “Free testing outside Score!” and, for a moment, we bask in the warmth of the club.
Oves leans over and finds my ear.
“It’s a great job, isn’t it?”
We spot the man that he has been messaging on Grindr and say hello. Throughout the night, as the team juggles half a half-dozen different tasks, Oves never forgets about him, nor about his earlier message: “I’m afraid.”
Conversations around HIV are often caught up in the sweeping public health language of rates and populations but, on the ground, HIV prevention boils down to these local and interpersonal forms of outreach.
By the end of the night, the Latinos Salud team will conduct nine tests, which might seem low but Fallon, who has decades of experience in this work, considers that “a good outcome.” Ultimately, any statistic—like the 24 percent increase in new HIV infections in Miami-Dade County over the last year—is driven by individual people who require personal care. With new infections on the rise while HIV/AIDS funding from the state of Florida remains flat at a reported $30 million annually since 2012, small organizations like Latinos Salud have to take a creative approach to prevention and punch above their weight.
For example, Latinos Salud staff will sometimes message with people on Grindr for two or three weeks before they gather the courage to get tested. During a college visit, they discovered the anonymous messaging service YikYak and now they use that app, too, to advertise testing and field questions about safe sex. Conducting outreach on social media is especially critical because, according to the CDC, an estimated 67 percent of new infections among Latino men occur in those under age 35.
But all of the group’s efforts—whether through the van, their programs, or social media—are designed to guide Miamians toward personal conversations with staff. When a couple stops by the van to ask questions near the end of the night, the team talks with them for nearly half an hour about mitigating risky behavior. The sidewalk seamlessly becomes their office.
Around 2:45 in the morning, my feet are giving out but the Latinos Salud staffers are still going. The man Oves has been messaging on Grindr emerges from the club and walks by the van. He and Oves talk for a moment but the man ends up taking down the address for the office instead of getting a test now.
Not tonight, he says, but soon.