|From The Field: Responding to the National HIV/AIDS Strategy – Women and Girls Still Matter
The National HIV/AIDS Strategy (NHAS) calls for refocusing and prioritizing domestic HIV/AIDS resources and staffing that are already strained to capacity due to the budget crisis and extended economic instability. In the face of these challenges and needs, one might expect that services for some populations will stagnate. However, experience is proving this false as champions for women and girls continue to plan and strategize a vibrant array of programs and interventions that are comprehensive, innovative and cost-effective.
The Centers for Disease Controls and Prevention's (CDC) latest incidence report indicates that women account for 24 percent of all diagnoses of HIV infection among United States adults and adolescents. Black and Latina women are disproportionately affected, comprising 57 percent and 16 percent of new infections in 2009, respectively. Black women rank fourth in terms of new HIV infections, behind white men who have sex with men (MSM), Black MSM and Hispanic MSM. Unfortunately this move from third to fourth place is not indicative of a decrease in annual cases for women and girls, with cases remaining relatively stable. At the same time, the fact that cases among gay men are on the rise is not lost on women and girls, who generally feel a shared responsibility to end the HIV epidemic across all populations in their communities.
The NHAS provides the roadmap to prevent new HIV infection, including among women and girls, as evidenced in the long-term goal to improve "methods to prevent HIV infection among women whose heightened risk for HIV is based on the risk behaviors of their male partners." Although the NHAS calls for more research on the unique issues contributing to women and girls' HIV/AIDS risks, it does acknowledge the impact of HIV/AIDS, in particular for Black women and Latinas. To support state efforts to address the disproportionate impact of HIV/AIDS among Black women, NASTAD hosted three regional forums between 2007 and 2009 in the Midwest, Northeast and Southeast. In 2011, many of the 24 state and city teams formed during these forums report that they are continuing to implement the programs and activities initiated during these regional forums. The following are brief profiles of some of these efforts.
Missouri established the S.U.G.A.R.(Sisters United and Growing as Readers) Book Club, a support group created as an outreach for HIV positive and negative African American women. S.U.G.A.R. offers a safe place to discuss topics around HIV/AIDS, general sexual health, healthy relationships, stigma, sexuality, and domestic violence, and the books chosen for the Book Club may touch on any one or combination of these issues. The Missouri Department of Health and Senior Services partnered with the Office of Minority Health, local hospitals, book stores, and CBOs to implement the program, which will be presented during a roundtable discussion at the United States Conference on AIDS (USCA) on Saturday, November 12.
Following the NASTAD regional forum, the Alabama team received funding from the Office on Women's Health to work with Black women partners of incarcerated or recently released men. The Alabama Department of Public Health and community partners hold a monthly weekend retreat for Black women in the program that includes all five sessions of SISTA, a nutrition and budget cooking class, a parenting class and a session on financial stability. At the end of the retreat, participants receive a certificate and gift bag with meaningful lesson reminders during a graduation ceremony. The women receive follow-up through case management for up to one year. The project is now in its third and final year. In 2010, the Alabama team received funding from CDC to provide the CLEAR EBI for Black women who attend the retreats (and others referred from outside organizations and through counseling and testing) for individualized risk-reduction counseling that addresses high-risk sexual or substance abuse behaviors. The program consists of 11 individual one-hour sessions and utilizes Cognitive Behavioral Therapy.
After participating in the NASTAD regional forum, Iowa formed the Racial and Ethnic Health Disparities (REHD) committee, an ad-hoc advisory committee of their community planning group (CPG). The committee advises the CPG on the disproportionate impact of HIV/AIDS on African American and Hispanic communities in Iowa. In September 2010, REHD participated in Iowa's 11th HIV, STD, and Hepatitis Conference and hosted a panel discussion: Let's Hear It from the Sisters: Laying Claim to Our Spirit. The conference provided an opportunity for the team to recruit additional members to serve on the committee. The health department also supported ten African American women to attend the Laying Claim to Our Spirit: 2011 African American Women's Leadership Conference, hosted by the African American History Museum. The REHD committee recently conducted a survey of over 50 women to assess their knowledge, attitudes and beliefs on sexual health. The results are currently being analyzed and will be incorporated into upcoming activities. The committee members are also conducting the survey within their own social networks.
In partnership with NASTAD, the TB/HIV/STD Unit at the Texas Department of State Health Services (DSHS) hosted their own regional forum titled "Black Women and HIV/AIDS in Texas: Change Begins With Me…HIV Ends With Us"on October 20-22, 2010 in Houston. The goal of the forum was to strengthen the ability of DSHS and their partners to effectively administer and implement HIV/AIDS programs for Black women. DSHS has committed staff time and resources to provide technical assistance and support for the eight Texas regional teams that were formed during the forum. To date, DSHS and NASTAD have conducted technical assistance visits with each team, supported multiple teleconferences and webinars and convened an in-person leadership development summit for team chairs. DSHS recently began receiving monitoring and evaluation capacity building assistance from the American Psychological Association to develop a comprehensive summary of activities and accomplishments for the Texas Black Women's Initiative. The summary report will be available this month.
NASTAD continues to work with these and other states to address the HIV/AIDS and viral hepatitis epidemics among women. These and other programs that received NASTAD TA in 2011 provide excellent examples of how to do more with less; each jurisdiction was able to do outstanding work with just a small amount of money to support their initiative. A summary of those programs is provided here. For more information on these projects contact Michelle Batchelor.
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NASTAD's Focus on Women's Sexual Health
NASTAD recently hosted the Women and Girls Sexual Health Summit: Developing Strategies and Planning for Action, in collaboration with the DHHS-Office on Women's Health (OWH) and the National Black Leadership Commission on AIDS (NBLCA). Over 50 women from federal, state and local levels representing a broad range of public health areas, including HIV/AIDS, STDs, substance abuse, mental health and violence prevention participated in the Summit, which took place in Washington, D.C. in August.
Summit participants engaged in broad discussions on a range of topics, with an overall focus on sexual health and the social determinants of health for women and girls in the context of the impact of HIV/AIDS and other co-morbidities on these determinants. Participants discussed how these issues were reflected in the National HIV/AIDS Strategy, the National Prevention Strategy and the Patient Protection and Affordable Care Act. The conversations were robust and varied given the diversity of perspectives and areas of focus represented by participants. The overall summit objectives were to:
A summary of the summit and priorities for women and girls will be released this month. NASTAD is working to provide resources and assistance to health departments and their community partners and expects to continue working with health departments to identify and highlight new and sustained strategies to respond to the gender-specific needs of the diverse populations of women impacted by HIV/AIDS in the U.S. In addition, NASTAD continues to share best practices and responses via its state profiles, issue briefs, a video series on Black women (Part 1 and Part 2), and a video promoting National Women and Girls HIV/AIDS Awareness Day featuring members of the Congressional Black Caucus.
For more information on NASTAD's work focused on women contact Michelle Batchelor.
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Member and Staff Updates
In member news, Kathy Hafford is retiring and Diana Jordan will replace her as the Director of the Virginia Division of Disease Prevention.
In staff news, Oscar Mairena is joining NASTAD in November as a Senior Associate for Viral Hepatitis/Policy and Legislative Affairs. Also, joint NASTAD-NCSD Health Equity Fellow Justin Hill will be working on the NASTAD Stigma Initiative funded by the MAC AIDS Fund and will be in the NASTAD offices on Wednesdays. In other staff news, Gary Jenkins has left NASTAD to pursue other opportunities to advance public health policy and programs.
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