Hector Salgado is the executive director of the Alliance of AIDS Services – Carolina (AAS-C) in Raleigh, N.C. He is one of the only Latino men leading an HIV/AIDS service organization in the South, and his inventive, out-of-the-box ideas have almost doubled the AAS-C testing rate in his two years with the organization and have strengthened outreach to populations of color and queer people.

Can you tell us about yourself and what brought you into the world of HIV/AIDS Advocacy?

I am actually originally from Puerto Rico, but I was raised in Chicago. And I think one of the unique niches that HIV organizations have are support groups that are for people who identify as LGBT individuals. For a lot of people who are getting their first HIV test and they have their first scare — whether that’s a condom breaking or the first time they engage in sexual activity with someone of the same gender — they end up at a place like the Alliance.

So it is true for me. I went into a health organization, and I didn’t know any other gay people, and that’s where I first came out, and we get a lot of that here as well. So that was my introduction to HIV prevention, being introduced to a support group at an organization in Chicago called Project Vida (Project Life) and met some really amazing people. I started going to their support groups and then volunteering, then got a part-time position and worked my way up to the associate director role.

The passion came in with the support groups because a lot of times people get the idea that if you teach someone how to put on a condom, you can prevent HIV, and that’s just not what we’re seeing. For a lot of individuals, it’s about how do we teach about self-love, how do we talk to them about the isolation and the loneliness that people feel when they’re first coming out of the closet. Having been in the field for so long, I can pick up what people are not telling me without interrogating them. I think just for me personally was finding a place where you just didn’t feel so isolated.

What is different or unique about doing HIV/AIDS advocacy in North Carolina?

It is like night and day. Coming from Chicago and having done work in LA and NY, there was a little bit of a culture shock. [A] part of that was an unwillingness from people to take condoms. There was a lot of hesitance and slut-shaming, and it made doing the education component very different.

How did you work to resolve the hesitance and change your strategy?

In just under two years, we’ve almost doubled our test numbers. Our positive rate is 1.4 percent, double the regional network of care, and that has been by launching a few different campaigns, and that started by asking our support groups why people were hesitant to take our condoms or get tested.

With their feedback, we changed up the design of the package. We started using geo-location apps and dating platforms to tune into the community, and I think that’s led to part of our success. We have also tried really pushing the envelope. For OUTRaleigh! last year, we gave out cum rags. They said “Cum as you are” — people loved them! At OUTRaleigh! alone, we tested 140 people and the nearby health department tested another 35.

Once we understood that we needed a marketing campaign, we understand that the “Take care of yourself message” was not working. Once we had cum rags and raffled off gigantic bottles of lube, we incentivized getting them in the door, and then we can chip away at the other surrounding issues.

In the past, you worked in LGBTQ Cultural Competence. Can you tell us about the ways you’ve brought that into your work?

One of our most common complaints from clients is that if they have to go to a direct health provider, they don’t feel comfortable disclosing [their sexual orientation or gender identity]. When I’d go to a provider for the first time, they’d ask “Are you sexually active?” and I would say, “Yes.” They would ask, “How many female partners have you had?” “None.” Because I may not present as their vision or idea of a gay man, they don’t know how to move forward.

It is in our mission statement to provide non-judgmental care. From clients who are sex workers to people coming in after first sexual experiences, everyone on staff is trained and culturally competent. [These cultural competence trainings] are about genuinely creating spaces for people to ask questions and for it to be okay. One of the things I brought to this space was to allow people to ask questions and make sure we are not including judgment within our conversations.

HIV disproportionately affects black and Latino men. How are you reaching out to these communities?

We’ve actually partnered with El Centro Hispano, El Pueblo and Triangle Empowerment Center (TEC) that works primarily with young black men who have sex with men, to provide testing and education services. We’ve even trained volunteers on how to do the rapid testing. It’s a lot of mothers and grandmothers in the community — we did HIV 101 and STI training and talked about sex and sexuality and creating a safe space. They talked about everything from topics at hand to how to have their husbands give them orgasms. It was an interesting opportunity to see people coaching each other.

We try to create spaces and give organizations, like these, the resources to help them replicate. We invite them to tour our agency to see that it isn’t a scary place — we show them our food pantry for people with low-income status, and that allows us to start the conversation with the food pantry, but also mention [the] opportunity to get an HIV test.

When people see us coming with cum rags and everything else, they clutch their pearls. We’ve heard that we’ve gone too far and need to tone it down, but I’m just getting started. We need to ratchet this up to get rid of the stigma of getting tested.

We looked at the numbers, and in two years, we’ve gone from doing 1,800 to 2,800 HIV tests, 1,500 to 2,500 STI tests, and our food pantry has gone from giving out six tons of food to 26 tons of food. The numbers are hard to argue against as far as how we’re getting out there in the community and how many people we’ve reached. We make people cringe, but we realize that we have to.

You can hear more from Hector Salgado in the piece on mental health entitled “We need to talk about HIV and mental health” online, and you can read more about him and the AAS-C at aas-c.org.