How is the implementation of the National HIV/AIDS Strategy addressing black and Latino MSM?
President Obama launched the National HIV/AIDS Strategy [in July 2010]. What the strategy seeks to do is identify a small number of steps that will make the biggest impact on the HIV epidemic.
There were three goals the president gave us for the National HIV/AIDS Strategy: The first was to reduce number of new infections; the second was to increase access to care and [treatment]; and the third was to reduce HIV/AIDS-related disparities. We added a fourth goal: to increase coordination across federal agencies because we know that coordination is key to addressing the epidemic in the United States.
The strategy identified men who have sex with men, it identified African Americans and Latinos as well as substance users as populations we need to concentrate our efforts on because these are populations [more likely] to become infected with HIV.
A lot of the things we see in terms of combination prevention or in terms of access to care, theoretically, should work for all populations. If you’re able to get people into care in a timely manner once they’re diagnosed, if you’re able to get them virally suppressed, not only do they benefit in terms of clinical outcomes but [so does the entire community], because it means that there’s less virus floating out there and these individuals are less likely to transmit HIV to their partners.
That can happen irrespective of which risk group an individual is in, but why it’s important for black MSM as well as Latino MSM is that in many ways HIV has fallen off the radar in [the lesbian, gay, bisexual and transgender (LGBT)] community. Over the past 30 years, the community that started with a very strong and vigorous response against HIV [has] since become involved in many other issues that are important issues—such as marriage and other civil opportunities.
The problem is that if you look in the [LGBT] medium, you rarely now see studies about HIV/AIDS. And the fact that you rarely see studies about HIV/AIDS is contrary to the fact that when you look at CDC’s HIV/AIDS incidence data you still find that the number of new infections is increasing among young gay and bisexual men—and it’s the only group where the number of new infections is actually [increasing]. So we have a really odd dynamic in the [LGBT] community where the time when we’re really not focusing on HIV/AIDS is the time when we really need to be.
We know from the CDC’s efforts that CBOs [community-based organizations] are perfect places for reaching these communities. Black and Latino MSM are more likely to get tested at CBOs than at a health clinic, and CBOs are uniquely qualified to reach these men. We’re hoping to continue to enlist CBOs in the process of reaching these men and asking these men to bring in their friends to get tested for HIV and to identify individuals with undiagnosed HIV. We’re clear that working with CBOs is essential and integral to making sure we address the epidemic. They can have an impact on our community.
What would you like to see happen in the LGBT community and at the grassroots to address rising HIV rates?
There’s already a lot the federal government is doing. The CDC just released a new cooperative agreement for HIV prevention for young black MSM and transgender individuals. You find HRSA [Health Resources and Services Administration] prioritizing black and Latino MSM and really trying to identify these men and get them linked to care and develop interventions that keep them in care. In terms of the National Institutes of Health, there are a bevy of new studies now trying to take a look at why we’re seeing these disparities among black and Latino MSM and how we can improve clinical outcomes. So there’s a lot taking place on the federal level.
At the community level, there’s a lot that perhaps needs to be done. One of the things is to be sure we educate these men about HIV. We have to be able to tell men in our communities that there’s a greater prevalence of HIV for black and Latino MSM, which means that there’s greater opportunities to come in contact with someone who is HIV positive. That message hasn’t gotten out there as much as it needs to.
There are things that need to be addressed that the CDC or federal government cannot necessarily do on its own. That has to do with HIV/AIDS stigma in black and Latino MSM communities, so that people are able to come out [about their sexuality] without repercussions, as well as disclose their HIV status without repercussions.
We need to be sure that individuals in these communities have access to health care, which is difficult when you have high rates of unemployment in both communities. We need to be sure that people get treatment for STIs [sexually transmitted infections], which we know can facilitate HIV transmission as well as acquisition.
And we need to get social marketing out there [that will lead people to] get tested as often as possible and make sure individuals realize that [HIV] drugs are not as toxic as they used to be and that treatment is incredibly beneficial. That’s a message that really hasn’t permeated in some high-risk communities.
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