Dr. Ronald Valdiserri

As noted in other blog posts shared here this week, African Americans continue to experience the most severe burden of HIV, compared with other races and ethnicities in the United States. According to the most recent data from CDC, Blacks represent approximately 14% of the U.S. population, but accounted for an estimated 44% of new HIV infections in 2010. They also accounted for 44% of people living with HIV infection in 2009. CDC also reports that, unless the course of the epidemic changes, at some point in their lifetime, an estimated 1 in 16 black men and 1 in 32 black women will be diagnosed with HIV infection.

As we prepare to observe National Black HIV/AIDS Awareness Day (NBHAAD), these sobering statistics and stark disparities are a call to action for all of us. The 2013 NBHAAD theme is “I am my brother’s/sister’s keeper: Fight HIV/AIDS.” This theme highlights the reality that each of us, individually and as organizations from across all sectors, has a critical role to play in carefully focusing our HIV prevention, care, and treatment efforts on populations bearing heavy burdens of HIV infection, including African Americans.

Guided by the National HIV/AIDS Strategy’s (NHAS) call to intensify HIV prevention efforts in the communities where HIV is most heavily concentrated to reduce new infections, improve access to HIV care and health outcomes for people living with HIV, and reduce HIV-related health disparities, numerous initiatives are underway across the U.S. government to specifically address HIV among African Americans. Several of these are being led by or are receiving significant support from the Office of HIV/AIDS and Infectious Disease Policy (OHAIDP), the office that oversees the implementation of the NHAS across HHS and manages AIDS.gov. We wanted to share a few highlights of those initiatives:

• Minority-Serving Institutions Demonstration Project—OHAIDP is wrapping up a 3-year demonstration project with four historically black colleges and three other minority serving institutions of higher education that have been working together to assess and strengthen their campus-wide HIV prevention activities. The four HBCUs—Jackson State University in Mississippi, Southern University at Baton Rouge in Louisiana, Fort Valley State University in Georgia, and North Carolina Central University — have received resources as well as technical assistance designed to increase their capacity to address HIV prevention and sexual health needs of minority college and university students and foster new partnerships to promote these health activities. Such efforts are all the more important in light of CDC’s recent report that about 1 in 4 (26%) of all new HIV infections are among youth ages 13 to 24 years and that nearly 60% of those new infections in youth occur in African Americans.

• Consultation on HIV among African American Gay Men—Recently, OHAIDP convened a two-day consultation on HIV/AIDS among Black gay and bisexual men as part of ongoing efforts at HHS to respond to the NHAS’s call to intensify HIV prevention efforts in the communities where HIV is most heavily concentrated and reduce HIV-related health disparities. OHAIDP engaged a diverse group of 31 community leaders representing local and national organizations, health care providers, researchers, and state and local governments in focused discussions with more than 14 federal partners. Exploring how to best address the HIV prevention, care, treatment, capacity building and research needs of Black gay and bisexual men, the participants developed a number of recommendations that, when finalized, will help HHS and our partners assess and improve policy, rethink and refine priorities, and identify gaps in programs and research for Black gay and bisexual men.

• African American HIV Prevention Programs Inventory—Findings of an interagency collaboration to identify, review, and assess the effectiveness of HHS-funded, discretionary initiatives and programs to reduce HIV infections among African Americans were recently shared in a report developed by OHAIDP. The report describes relevant prevention programs and initiatives, identifies future opportunities, and provides insights that will help inform ongoing and future strategies to reduce HIV infections among vulnerable African-American populations. Summarizing data from 56 HHS-funded HIV prevention programs and initiatives serving African Americans that were active between Fiscal Years (FY) 2009–2011, the report notes that the programs reflect an average annual investment of nearly $293 million in prevention programs and initiatives to reduce HIV infection specifically among African Americans. Of course, racial and ethnic minorities also benefit from other HHS programs that provide HIV prevention, treatment, or care but do not target any single subgroup of the population.

• Secretary’s Minority AIDS Initiative Fund—OHAIDP administers the Secretary’s Minority AIDS Initiative Fund (SMAIF) which annually makes awards to HHS agencies and offices to support HIV prevention, care, and treatment; outreach and education; capacity building; and technical assistance activities in racial and ethnic minority communities disproportionately affected by HIV/AIDS. In this role, OHAIDP has been integrally involved in two significant cross-agency collaborations designed to support communities with heavy burdens of HIV/AIDS among African Americans and other minority communities: the recently completed 12 Cities Project and the new Care and Prevention of HIV in the U.S. (CAPUS) Demonstration Project. Last fall, OHAIDP released an evaluation report on the 12 Cities Project that highlights lessons learned from the project. These will continue to inform implementation of the NHAS in the 12 participating jurisdictions and elsewhere across the United States. Through the CAPUS demonstration, eight states with a high burden of HIV among African-Americans—Georgia, Illinois, Louisiana, Mississippi, Missouri, North Carolina, Tennessee, and Virginia—have been awarded a total of $14.2 million in first-year funding under a new, innovative, three-year cross-HHS demonstration project aligned with the NHAS. The demonstration project is designed to reduce HIV-related morbidity, mortality, and related health disparities among racial and ethnic minorities by addressing social, economic, clinical and structural factors influencing HIV health outcomes. A multi-agency federal partnership is providing leadership for the activities.

These several activities addressing HIV/AIDS in the African American community—both those recently completed and those now underway—are helping advance us toward the NHAS goals. With our attention focused on the heavy burden of HIV/AIDS in the African American community this week, let us renew our commitment to addressing the burden of HIV/AIDS among African Americans and pursuing the goals of the NHAS for all Americans.