African American Women and HIV/AIDS: Confronting the Crisis and Planning for Action Kellye McKenzie, Senior Program Manager, Racial & Ethnic Health Disparities Joy Mbajah, Program Manager, Prevention
Presentation Overview Introduction NASTAD Overview Overview of National Epidemiology Examination of Risk Factors NASTAD Regional Forum Series to Address HIV Among African American Women Next Steps
NASTAD Overview The mission of NASTAD is to strengthen state and territory-based leadership, expertise and advocacy and bring them to bear on reducing the incidence of HIV infection and on providing care and support to all who live with HIV/AIDS. The vision of NASTAD is a world free of HIV/AIDS. Impacting National Polices and Programs NASTAD staff develop policy/program recommendations based on input from the Executive Committee and members. Work groups of AIDS directors/their program staff guide programs and ensure products reflect needs/concerns of members. Use peer technical assistance model to link AIDS directors and to share expertise across jurisdictions.
NASTAD Programs Government Relations Prevention Viral Hepatitis Youth IDU Racial & Ethnic Health Disparities Care & Treatment Global
NASTAD Prioritization of Racial and Ethnic Health Disparities Overarching priority of NASTAD s strategic map African American Portfolio Leadership development African American Leadership Team (AALT) African American Advisory Committee Increase committee representation to include cities and low incidence jurisdictions Subcommittees: Policy Education, Research, Strategic Prioritization and Coalition Building Priority focus on African American women, Black gay men and youth Youth Liaisons Updated African American Monograph to enhance response of health departments
New HIV Diagnoses Among Women: 33 States, 2001-2004 <1% 15% 16% Black White Hispanic Asian/Pacific Island American Indian 67% Source: Centers for Disease Control and Prevention. Trends in HIV/AIDS Diagnoses 33 States, 2001-2004 MMWR 2005;54:1149-1153.
New HIV Diagnoses, Black Females: 33 States, 2001-2004 21% 3% Heterosexual African American Women are at Exceptionally High Risk for HIV Heterosexual IDU Other 76% Source: Centers for Disease Control and Prevention. Trends in HIV/AIDS Diagnoses 33 States, 2001-2004 MMWR 2005;54:1149-1153.
HIV Risk Factors For African American Women STD s : In 2005, blacks had higher rates of gonorrhea, chlamydia and syphilis Socioeconomic status: In 1999, 1 in 4 blacks were living in poverty. Childhood Sexual Abuse: HIV positive women were 2.5 times likely to report sexual abuse before age 18 than a HIV negative women. Intimate Partner/Domestic Violence: 5.3 million incidents occur each year for women ages 18 and older. Sexual victimization is generally associated with early sexual debut sexual risk, lower condom self-efficacy and less frequent and inconsistent use of condoms. Other overlapping factors such as unemployment, bring younger than 30 years and homelessness.
HIV Risk Factors For African American Women
There is no such thing as a singleissue struggle, because we do not live single-issue lives Audre Lorde
Overview of NASTAD Regional Forum Series Series launched in October 2006 to bring together regional state clusters to address issues impacting racial and ethnic health disparities Current issues/priority areas Black Gay Men African American Women Youth Central focus: Power and Privilege Racism, classism, and socio-economics (2008) Gender and sexuality (2009) Addressing structural factors/barriers including racism, socioeconomics, issues of access, etc. Investigating resiliency and successful strategies
Regional Forum Series Addressing HIV/AIDS Among African American Women Provide participating teams the opportunity to examine and prioritize the barriers to providing programs and services targeting African American women in their jurisdiction. Support participating teams with the development of a year long action plan to strategically address. Provide technical assistance to jurisdictions on issues impacting the implementation of their action plans. REGIONAL FORUM SERIES ADDRESSING RACIAL AND ETHNIC HEALTH DISPARITIES African American Women and HIV/AIDS: Confronting the Crisis and Planning for Action Chicago, IL March 29 & 30, 2007 Participating Health Departments City of Chicago, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Wisconsin There is no such thing as a single-issue struggle because we do not live single-issue lives. -Audre Lorde
Participants / Team Composition NASTAD supported travel for up to four state/city team participants (teams were able to bring up to four additional participants at their own expense) Team Composition AIDS Director or Designee Health Department staff tasked with addressing HIV/AIDS among African American women Directly funded CBO providing services to African American women Female African American clients/consumers (2 per team required)
Participating Jurisdictions AK WA OR NV CA ID UT AZ HI MT WY CO NM ND SD NE KS OK TX MN WI IA MO AR LA IL MS MI IN OH WV KY TN PA VA NC SC AL GA FL VT NH NY ME MD DC DE NJ MA RI CT March 2007 Midwest Regional Forum Participants (Including City of Chicago) March 2008 Northeast Regional Forum Participants (including New York City and Philadelphia)
Forum Structure: Breakout Tracks Track 1:The intersection of HIV/AIDS, mental health and substance use Track 2: African American women and relationship dynamics: sexual communication, abuse, and violence Track 3:Cycling through the criminal justice system: the impact of HIV on African American women Track 4: The role in policy in shaping a comprehensive response for African American women
NASTAD Year Long Technical Assistance Timeline June 2008 September October 2008 November 2008 3 month follow-up conference call with individual state teams 6 month follow-up conference call with individual state teams Joint conference call with all state teams. Opportunity for states to share successes and solicit feedback January-February 2009 March 2009 10 month follow-up conference call with individual state teams NASTAD provides TA to states to replicate regional forum at local level Follow-up interviews with representative(s) from each participating jurisdiction Implementation of a survey (process and outcome assessment) State team report (compilation of final outcomes and lessons learned)
Immediate Outcomes Development of state-wide needs assessment tool focused on African American women Presentation of action plan activities to CPG and subsequent formation of African American women s CPG subcommittee Commitment to replicate regional forum locally Brown bag series to address health and wellness, including HIV/AIDS, among women of diverse racial and ethnic backgrounds Rap session and reception for African American sororities Multiple presentations on issues related to African American women and HIV/AIDS at statewide health conference
Emerging TA Themes and Trends Advocacy Training NASTAD will host a conference call around advocacy training in early 2008. Development of comprehensive resource guide Funding Jurisdictions will work with their Community Planning Groups (CPGs) during the next funding cycle to allocate $ to support activities; NASTAD will offer jurisdictions TA on soliciting money from diagnostic and pharmaceutical companies.
Next Steps Release of three-part African American Women s issue brief series (first document slated for May 2009 release) Conduct African American women s focus groups in the Northeast Establish peer mentorship opportunities between 2007 and 2007 regional forum participants Explore opportunities to conduct third regional forum in the Southeast
Resources CDC. A Heightened National Response to the HIV/AIDS Crisis Among African Americans. March 2007. CDC. CDC HIV/AIDS Fact Sheet. HIV/AIDS among African Americans. Revised June 2007. Andriote, John Manuel. HIV/AIDS and African Americans: A State of Emergency. Population Reference Bureau. Wyatt, Gail et al. HIV-Positive Women with Histories of Childhood Sexual Abuse: Patterns of Substance Use and Barriers to Health Care. Journal of Health Care for the Poor and Underserved 16(2005):9-23. Zieler, Sally et al. Violence Victimization After HIV Infection in a US Probability Sample of Adult Patients in Primary Care. American Journal of Public Health. February 2000., Vol.90, No 2.
Contact Information Kellye McKenzie, MPA Senior Program Manager, Racial & Ethnic Health Disparities 202.434.8007 kmckenzie@nastad.org Joy Mbajah, MA Senior Program Associate, Prevention Program 202.434.7133 jmbajah@nastad.org www.nastad.org