Entre Hermanos brings trust into LGBTQ+ care

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Nearly 40 years ago, a group of Seattle friends came together to create a support network for those feeling the impact of the HIV epidemic.

Fast-forward to today: They’re known as Entre Hermanos, and their mission — to promote the health of the Latino lesbian, gay, bisexual, transgender and questioning (LGBTQ+) community — has spread not just city- or statewide, but globally.

The key to Entre Hermanos’ success is a culturally based approach to disease prevention, education, support services, advocacy and community building.

“Most of our Latino community are immigrants. It’s well known that if you change your environment or where you live, there’s a shock,” explains Martha Zuniga, Entre Hermanos deputy director. “We try to keep the cultural part within our care and services, create a sense of family and a place where you can feel safe and express yourself.”

Part of that mission means understanding clients need more than just health care support. People’s priorities are food, housing and keeping their family together — then they start thinking about themselves and health care, Zuniga says.

“When people see themselves reflected in the culture of our space, it builds a sense of trust and comfort. They know when speaking to someone on our team that they share a cultural understanding or very similar life experiences.”

Entre Hermanos provides support across all those key areas, including HIV prevention and education (how and where to receive medication, medical follow-up and testing), connection to food, housing and transportation services, and immigration support through an in-house legal team.

Through these wraparound services, Entre Hermanos reaches more than 7,000 people annually. This includes 1,000 who receive direct intervention through sexually transmitted infection (STI) testing, pre-exposure prophylaxis (PrEP) navigation and HIV medical case management, and 6,000 who receive free condoms through outreach efforts, says Edgar Longoria, Entre Hermanos executive director.

Medical case managers currently support 200 individuals, and the legal team has more than 90 active cases.

Growing the reach of Entre Hermanos

Recognizing these needs expand far beyond King County, Entre Hermanos is expanding to other areas of the state, including the Yakima community.

“Reaching Yakima has been a dream of ours for a long time,” Zuniga says. “We have people coming and driving from Yakima, the Tri-Cities, Spokane and Wenatchee to get services here because on that side of the state, there’s nothing similar for them.”

As of the 2022 census, Hispanic- or Latino-identifying people accounted for almost 53 percent of the Yakima County population, with the vast majority listing Spanish as their first language.

Many may also speak a language other than English or Spanish, as they’ve come from Cuba, Nicaragua, Chile or Colombia, Zuniga adds.

During the COVID-19 pandemic, critical information was available in English and Spanish, but so many people were missed, she says. With the support of the Washington State Department of Health (DOH), Entre Hermanos produced informative videos in numerous languages to ensure everyone had access.

Finding support and services in your language is important because things can easily get lost in translation, explains Eduardo Esparza, a Yakima-based nonmedical case manager with Entre Hermanos.

“I have clients who will call me because the pharmacy tells them they can’t fill their medication. What they think is, ‘They don’t want to give me my medication,’ instead of understanding their coverage is expired,” Esparza says. “So that’s when I make some calls to let their medical case manager know what the situation may be so we can address it to solve the problem.”

Yakima has some resources, but Spanish language may not be an option, he explains. And if people do find providers who speak Spanish, the way services are provided may not reflect their culture, Zuniga adds. Trust may be missing as a result.

Culture is the basis for trust

“When people see themselves reflected in the culture of our space, it builds a sense of trust and comfort,” explains Longoria. “They know when speaking to someone on our team that they share a cultural understanding or very similar life experiences.”

Working with case managers who carry that cultural connection also helps build confidence and understanding of treatment, explains Alejandra Grillo-Roa, Entre Hermanos prevention and care program manager.

“We’ll never ask immigration status or charge for our services. It’s free and confidential and it’s all done with love,” Grillo-Roa says. “They don’t need an interpreter to express how they feel, which, if they’re in crisis, it’s important they don’t have to talk through someone else.”

Entre Hermanos helps clients sign up for all the HIV coverage they’re eligible for with DOH, then schedules their first primary care appointment at a trusted clinic, Grillo-Roa explains. HIV case managers may accompany clients to their first appointment and follow up to ensure they understood everything.

The PrEP navigation program is one of Entre Hermanos’ most utilized — the team connects clients with financial assistance for their medication and gender-affirming care and supports them through name changes and hormone or surgical treatments.

“We want to make sure there’s no lapse in what they need,” Grillo-Roa says. “We don’t have a timeline for how long they stay with us. We’ve had clients for 11 years, and some who need more services and work with a nonmedical case manager as well, while others become more independent and just check in with us.”

Regardless of how much support clients need, Esparza sees his most important role as being a safe person to come to.

“I also work part-time at a retail store and sometimes I get to interact with the community, and they’ll tell me or ask me about my work at Entre Hermanos,” he says. “They start opening up and telling me about their orientation and if we have stuff to help.”

Once a month, Esparza refills his supply of condoms to have on hand when people in the community ask for help. They’re expensive in the store, and many people may be reluctant to go to Entre Hermanos in person because it could raise questions about their sexual orientation, he explains.

“In rural areas there’s definitely a lack of visibility,” Longoria adds. “We know why people are hesitant to be out and proud in small communities, but we bring that sense of community and acceptance with our services. That’s something you can’t replace.”

Leading the change

In addition to providing critical support services and connection, Entre Hermanos is a leader in advocacy and building a better future for the next generation.

“Our visibility is really important, but our needs are also very similar to other large communities and organizations,” Longoria says. “More recently we’ve been focused on our coalition efforts.”

Entre Hermanos works closely with various city and state commissions focused on LGBTQ+, Latino and immigrant issues, and has a presence at many rallies, health fairs and community events.

“Thankfully, in Washington we have a lot of support through partners, funders and donors, which makes a big difference,” Longoria adds. “But we also recognize that the work we do here, in large part due to social media and the internet, reaches places we never thought it would.”

People in Central America are resharing Entre Hermanos’ posts and thanking them, he says. Grillo-Roa adds they’ve had new clients come in who heard about their program before moving to the United States.

Whether it’s through traditional channels like the website and social media, or peer support groups, community events or podcasts, it’s important to continue growing awareness, Grillo-Roa says.

It takes time to build that trust, especially in a new community. She hopes people find them and know they’re a safe place, free of judgment.

“Partnering for healing and a healthy future” is MultiCare’s mission, and it inspires us to form connections that help improve the quality of life for our communities. Community organizations all around us are doing amazing work, and we’re inspired and excited to support that work.

Stories from our Community is an ongoing series conceived to dive into some of these organizations*, bring their stories to life and spread the word about how they are making our communities better.

*Some of the organizations profiled in this series are recipients of MultiCare’s Community Partnership Fund, which awards funds to nonprofit organizations working on initiatives, programs and projects that improve our community.