The Puerto Rican population is 95% Catholic. The Church is strong with a fundamental Christian base to the morals of the culture. In 1964, the Catholic Bishops formed a political party and threatened excommunication for anyone who didn't join their party. Abortion was illegal (until Roe v. Wade) and homosexuality was illegal until the Supreme Court Lawrence decision. Homosexuality is, to quote my mother, "an abomination".
Machismo is the norm - women are secondary and subservient to males. Gay men are well below women in the social structure, where homosexuality is generally equated only with drag queens and effeminate men. We grow up in very close-knit families with the mother as the anchor of the matriarchal hierarchy. Men wear the pants but women are the ones we fear. I remember that my biggest shame when I came out to my mother was that she would not get any grandchildren from me (thank God she already had 7).
Another problem is that you are not supposed to leave your parent's home until you are married, or go to University (unless it is physically possible to commute). So most people live at home and never have a place to make out (this holds for both homosexual and heterosexual couples). That is why cars and public spaces in Latin cultures are so busy.
To speak of a solution to the HIV/AIDS crisis in Puerto Rico, you will need to address two completely different issues, both with distinct stigma: homosexuality and drug addiction.
The homosexuals in Puerto Rico have not been able to achieve a sense of community. Too afraid to “come out of the closet” they do not organize and contribute to eradicate their own problems. African Americans and Latinos have forced the Center for Disease Control to create a new category of people spreading HIV: men who have sex with men. Our religion, machismo, and family ties make us uniquely incapable of preventing the disease, mainly because a lot of gay Puerto Ricans can’t admit that they are gay—they get married, have families, but then go on the down low to get homosexual sex: thus exposing wives and relatives to several diseases.
I fear the only solution to the uniqueness of the Puerto Rican HIV problem will not be undertaken. I hope it will not take a scenario like South Africa where the government waited until one third of the population was HIV positive to finally intervene. The only solution I can see is for us to unite as a country and demand from both the Catholic Church and our dutifully elected officials to implement a campaign to promote prophylactic measures other than abstinence. Otherwise, Puerto Rico will be headed for an HIV disaster.