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What the updated National HIV/AIDS Strategy means for Black America

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“We’ve come a long way in the fight against AIDS, and we can’t let up now,” said President Obama.

In 2010, President Barack Obama made history by releasing the first National HIV/AIDS Strategy to provide a blueprint for the U.S. response to the HIV/AIDS epidemic. Now, five years later, the White House has released an update to the strategy, taking special care to address the unique needs of the Black community.

Several transformative events have occurred since the strategy was first released in 2010, such as the implementation of the Affordable Care Act and the introduction of pre-exposure prophylaxis (PrEP). The “National HIV/AIDS Strategy for the United States: Updated to 2020” builds upon that foundation.

“We’ve come a long way in the fight against AIDS, and we can’t let up now,” said President Obama when he released the strategy. The president went on to say that the updated strategy “focuses on making sure every American, no matter who you are, where you live or how much money you’ve got, can get access to life-extending care.”

The updated strategy was launched in July at an event at Morehouse School of Medicine in Atlanta. Key throughout the document is the notion that certain populations bear a disproportionate HIV burden. Black Americans accounted for 45 percent of HIV diagnoses in 2013; whites accounted for 27 percent of diagnoses. Sixty-five percent of diagnoses resulted from male-to-male sexual contact. Fifty-one percent of those diagnosed live in the South. In 2010, the rate of new HIV infections among Black women was 20 times that of white women, according to the Centers for Disease Control and Prevention.

Responding to the Black community’s needs

The updated strategy mentions the Black community 41 times, calling on federal agencies to allocate funding to the communities that are affected by HIV the most, including Black MSM, heterosexual Black men and women, and Black transgender women.

In addition to recognizing that there are social determinants that can play a role in higher HIV rates in the Black community, such as housing, education and employment, the strategy advocates for more efforts to test new health care service-delivery models in different settings. Stigma also plays a role, so the updated strategy promotes confronting it while enforcing civil rights laws and helping states protect people living with HIV/AIDS (PLWHA) from violence and discrimination associated with their HIV status.

The strategy has four key areas of critical focus over the next five years:

  • Widespread testing and linkage to care
  • Keeping PLWHA in care
  • Universal viral suppression
  • Full access to comprehensive PrEP services

Ten indicators, among them the following, will be used to mark progress and ensure that the strategy is doing what it sets out to do:

  • The percentage of PLWHA who know their serostatus will be at least 90 percent.
  • The number of new diagnoses will be reduced by at least 25 percent.
  • The rate of new diagnoses among gay and bisexual men, young Black MSM, Black women and people who live in the South will be reduced by at least 15 percent.

Assessing the strategy’s promise

Although it’s important to have a national plan for addressing the HIV/AIDS epidemic, it is even more crucial that the plan be effective. Many HIV/AIDS activists voiced optimism that the strategy will address the unique needs of the Black community.

“When you look at the current epidemic, it’s Black,” says Barbara Joseph, chair of the National Black Women’s HIV/AIDS Network Inc. based in Houston. “As a Black woman who has lived with this disease for over 30 years, I know that we cannot continue to nod and wink about what’s going on in our communities. It’s time we focus our collective will on combating this epidemic.”

Vanessa Smith, executive director of South Side Help Center in Chicago, agrees, saying, “We’re dealing with unprecedented health disparities in regards to HIV/AIDS in African-American communities.” The updated strategy and other federal government efforts “speak to the need to provide treatment and education to African-Americans,” she says.

Some HIV/AIDS advocates have also lauded the updated strategy for addressing concerns that were not adequately addressed in the original document.

“This new version of the strategy corrects a number of the missions pointed out in our gender audit of the initial version of the strategy,” says Naina Khanna, executive director of Positive Women’s Network USA, based in Oakland, California. Khanna was referring to a report the organization produced that found that the original strategy failed to do enough to address the needs of women living with and affected by HIV.

In a blog post about the updated strategy, Douglas M. Brooks, director of the Office of National AIDS Policy, wrote, “community organizations from around the country have expressed steadfast support of the updated Strategy.”

He also expressed the administration’s willingness to partner with the community to make it work, writing, “We look forward to working with stake-holders across sectors and around the country to implement the updated Strategy and achieve its 2020 goals.”

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