sábado, 6 de febrero de 2016

HIV & AIDS in the United States: Dear Colleague

HIV & AIDS inthe United States
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Dear Colleague,
February 7th is National Black HIV/AIDS Awareness Day (NBHAAD), an annual day when we show support and strengthen our commitment to our responsibility to promote HIV testing and mobilize ourselves, our families, schools, places of worship, and workplaces to take action against HIV among blacks/African Americans. The theme is I Am My Brother/Sister's Keeper: Fight HIV/AIDS.
Blacks make up 12% of the US population, but account for 44% of new HIV diagnoses, the highest rate of all races/ethnicities. Among all blacks, gay and bisexual black men, especially young men, are disproportionately affected. However, we have seen encouraging signs of progress. From 2005 to 2014:
  • New diagnoses among blacks declined by 22%, with a 14% decline from 2010-2014.
  • New diagnoses among black women were cut nearly in half, with a 25% decline from 2010-2014.
  • Black gay and bisexual men ages 13-24 experienced a steep increase in new diagnoses, but diagnoses among this group declined by 2% from 2010-2014.
These trends in new diagnoses suggest that focused HIV prevention and treatment efforts are having an impact, but not enough. A paper in yesterday’s Morbidity and Mortality Weekly Report noted that overall, blacks are less likely to be consistently retained in care than white or Latino Americans.  Only 38% of blacks were consistently retained in HIV care from 2011-2013, compared to about half of white and Latino Americans. Additionally, black men were less likely to be consistently retained in care than black women (35% and 44%, respectively). Among blacks, consistent retention was highest among those whose HIV infections were attributable to heterosexual contact.
Further reducing the disproportionate HIV rates and impact of the disease among blacks will help reach one of the goals of the White House National HIV/AIDS Strategy for the United States: Updated to 2020 (NHAS). But this will require additional efforts to address the social determinants of health, including poverty, discrimination, homophobia, mental health, and substance use, which contribute to HIV-related disparities.
CDC is employing a high-impact prevention approach to maximize the effectiveness of current HIV prevention methods. Some of CDC’s prevention efforts that specifically focus on HIV among blacks include:
  • Providing $339 million annually in funding to state and local health departments to develop and implement HIV prevention programs in their jurisdictions in communities most affected by HIV. Programs include testing, linkage to and retention in care, prevention with positives, and other effective interventions.
  • Funding health departments to collaborate with community-based organizations (CBOs) to implement culturally and linguistically competent demonstration projects for comprehensive prevention programs, behavioral health, linkage to care, and social service models that reach gay and bisexual black men at risk for and living with HIV.
  • Awarding $43 million annually to CBOs to improve HIV outcomes across the continuum of care, including linking to care blacks diagnosed with HIV, helping them stay in care, and providing them with other prevention and support services.
  • Piloting HIV testing programs in pharmacies that serve communities hardest hit by HIV.
  • Implementing Act Against AIDS, a national communication initiative that focuses attention on HIV, through campaigns such as our newly releasedDoing It campaign, designed to motivate all adults to get tested for HIV and know their status.
  • Collaborating with other Department of Health and Human Services agencies to reduce HIV and AIDS-related morbidity and mortality among blacks as part of NHAS, including the Office of the Assistant Secretary for Health (ASH), the Office of HIV/AIDS and Infectious Disease Policy (OHAIDP), the Health Resources and Services Administration (HRSA), and the Substance Abuse and Mental Health Services Administration (SAMHSA).
We have made progress, but there is much left to do. We are our brother’s and sister’s keeper today and every day. Let’s come together to make this a day of energy and further reduce the toll of HIV in black communities. As the President said in the State of the Union Address, “Right now, we’re on track to end the scourge of HIV/AIDS...” in all communities. Thank you for your critical work past, present, and future.

/Jonathan Mermin/

Jonathan H. Mermin, MD, MPH
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention

/Eugene McCray/

Eugene McCray, MD
Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention

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