This is the first in a four-part series examining the strategy's impact on Black communities. This article is cross-posted from the Aug. 31 edition of Black AIDS Weekly_, the newsletter of the Black AIDS Institute._
When the Obama administration released the National HIV/AIDS Strategy (NHAS) in July, the activist group Coalition for a National AIDS Strategy described it as "one of the most anticipated moments" in the domestic fight against HIV/AIDS. The four-part plan refocuses resources on the domestic epidemic and prioritizes Black Americans, which means that Black people stand to gain a lot -- at least in theory. Read on to learn how Black folks may be affected by the first part of the plan: reducing new HIV infections.
The Black Community at the Forefront
Blacks represent only about 12 percent of the nation's population but almost half of the more than 56,000 new infections each year. The strategy will "concentrate HIV-prevention efforts at the highest-risk populations," which includes Black Americans, men who have sex with men (MSM) and injection drug users (IDUs). It will also focus attention on the South and Northeast, the areas of the country with the highest HIV rates, and where Blacks are disproportionately located.
"CDC will have better clarity of purpose toward reducing HIV infection within communities that are at the highest risk," says Kevin Fenton, M.D., Ph.D., director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention (CDC), including more "interventions for the Black community." According to projections, by 2015 the strategy will reduce the annual number of HIV infections by 25 percent -- roughly half of which should theoretically occur among Blacks.
"It's a tall order," says W. Jeffrey Campbell, prevention-development director at the Houston-based St. Hope Foundation, "particularly with the numbers going up the last two years among younger Black MSM. But we need higher goals like that to reach." In 2006 Black gay and bisexual men accounted for one-fifth of new infections nationwide.
Yet some HIV/AIDS advocates have challenged the administration. New York City-based Housing Works calls the NHAS a step backward and asks, "Would President Obama suggest that we only clean up 25 percent of the Gulf oil spill?"
Implementing Interventions That Work
Evidence-based interventions will play an integral role in the plan to reduce new HIV infections. This is a departure from the Bush administration's approach of promoting abstinence, which has proved ineffective.
"It's a great starting point," says Dázon Dixon Diallo, the founder of Atlanta-based SisterLove, the first women's HIV/AIDS service organization in the Southeast. Dixon's organization has been lauded for its community-based risk-reduction strategy. "But I'm concerned it gives short shrift to women's health and reproductive-health issues. That could be very problematic, given the incidence of new cases among Black women."
"The CDC [recently] announced its latest round of HIV-prevention dollars. As much as the strategy wants to focus on the South, or Black women, we didn't see 50 percent of the funding going into that," Diallo added. C. Virginia Fields, president and CEO of the National Black Leadership Commission on AIDS, spoke more bluntly: "The African American implementation steps are extremely weak. The data puts the community in a health crisis with respect to HIV. [But the strategy] talks about compiling and assessing the strength and weaknesses of some of the existing programs, and trying to decide what are the best programs that work. No! We are too far into this epidemic -- 30 years almost, now -- with too many African Americans impacted for that."
Schoolin' the Community
The final platform of the prevention strategy is maximizing education. Research shows a lack of urgency (pdf) about HIV/AIDS among the public at large -- especially among Blacks. Robin Stanback Stevens, Ph.D. M.P.H., of the University of Pennsylvania School of Medicine, presented dissertation research at the International AIDS Conference in Vienna that surveyed television news coverage from 1993 to 2007. The research results found that Blacks "exhibit greater declines in HIV testing in response to news coverage than Whites." There has been a shift to stories about AIDS being an international, rather than an American, problem, and as a result, "Black Americans tend to think 'Africa' and less about their own communities when it comes to HIV," Dr. Stevens explains. "We've emphasized fighting HIV abroad and failed to focus on HIV/AIDS as a national issue and to emphasize the disparities among African Americans."
Rod McCullom has written and produced for ABC News and NBC, and his reporting and analysis have appeared in Ebony, The Advocate, ColorLines and other media.