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African Americans and HIV: CA Office of AIDS Response
Michelle Roland, MD
Chief, Office of AIDS
California Department of Public Health
Disproportionate impact of HIV among African Americans in California 6.7% of CA population
17.7% - 19.4% HIV, AIDS and living AIDS cases
20% new HIV diagnoses in 2005
HIV/AIDS rates > 2x any other racial/ethnic group
0
20
40
60
80
100
120
Hispanic Asian AA White Hispanic Asian AA White
Cases
per 1
00,00
0 pop
ulatio
n
HIV
AIDS
California HIV/AIDS Case Registry; data as of March 31, 2006; State of California, Department of Finance, Race/Ethnic Population with Age and Sex Detail 2000-2050, July 2007.
Men Women
HIV risk among African American Men2005 HIV Cases MSM: 54% MSM/IDU: 3% IDU: 8% NIR: 27%
69.3
80.2
56.4
77.4
60.7
8.7
5
3.2
10.5
7.8
10.8
12
5.2
23.8
14.2
4
12.3
14.2
5
19.6
0% 20% 40% 60% 80% 100%
Latino (N=29,611)
White (N=77,168)
African American (N=21,119)
Asian/Pac. Islander (N=3,053)
Native American (N=563)
Percent
MSM IDU MSM IDU Other mode
Cumulative AIDS Cases
HIV risk among African American Women
2005 HIV Cases Heterosexual: 56% IDU: 18% NIR: 26%
55.2
42.6
40.5
58.7
32.2
20.8
40.8
42.5
13.3
55.2
24
16.6
17
28
12.6
0% 20% 40% 60% 80% 100%
Latina (N=3,225)
White (N=3,980)
African American (N=4,409)
Asian/Pac. Islander (N=383)
Native American (N=87)
Percent
Heterosexual Contact IDU Other mode
Cumulative AIDS Cases
Pregnant Women
½ million live births in CA in 2004 Pre-natal care
None: 1.9% Inadequate: 8.98%
Estimates of women without HIV test before labor and delivery 10.85% 55, 000 women
Transgender people
2003 C&T data: 1203 tests among self-identified TG
36 of 126 AA TG tests + positivity 28.6%
Youth
Also a group at high risk…
Selected OA Activities Prevention
Interventions – MSM focus Research – women and MSM focus
Screening and diagnosis Perinatal Medical settings
Care and Treatment Interventions (eg Bridge, Positive
Changes) TA Collaborations
18 local health jurisdictions asked to create “Action Plans” with E & P dollars to: address HIV prevention needs of African
American gay men/MSM Increase HIV testing in this population
Plans currently being evaluated by OA OA staff providing technical assistance,
capacity building
Prevention Interventions
Ongoing prevention research: community collaborative projects FeMAALES: Reducing HIV risk behaviors and
increasing sexual communication skills in African American women with at-risk male partners
HOLLA: Developing a tailored case management intervention for recently incarcerated MSM
BRUTHAS: HIV prevention for African American down low men
MAALES: HIV prevention for African American MSM who do not identify as gay
OA/CHRP partnership
Increase awareness and
understanding of prenatal
HIV transmission
Increase capacity of BIH service
providers to effectively
discuss HIV related issues
(including risk assessments,
risk reduction counseling
strategies) with their clients
Needs assessment, literature
review, training (PTC - 2008)
Perinatal transmission:Step 1 Black Infant Health Collaborative
Perinatal transmission: Step 2 California Perinatal Project Have every pregnant woman, and her
obstetric provider, know her HIV status as early as possible during her pregnancy and no later than when she begins delivery.
Build capacity to provide rapid HIV testing in every California Labor and Delivery Hospital 80 hospitals, representing 36% live births, offer RTLD now With AB682, OA increasing efforts in this area PAETC – Training OA - TA
Screening and diagnosis in other medical settings
STD programs TB programs Emergency departments
CDC funded demonstration project at 3 Bay Area hospitals Provide rapid HIV testing within emergency departments
and inpatient wards serving high rates of African Americans Link those who test HIV positive to HIV services.
Correctional settings
Center of Excellence for Transgender HIV Prevention (COE) State/academic/PAETC partnership to provide:
Leadership capacity building professional training policy advocacy research development resources
To increase access to culturally competent HIV prevention services for transgender people in California.
California African American HIV/AIDS Coalition (CAAHAC) Assembly Bill 1142-Statewide African American HIV/AIDS
Initiative Establishes the administrative, educational, and
communication infrastructure to support the activities of the provider network
Mandates CPDH/OA provides support Initiative until January 1, 2008, when the Initiative would become an independent non-profit organization
Steering Committee
Bay Area
Riverside/San Bernardino
San Diego
Sacramento/Central Valley
Los Angeles
Board of Directors
CAAHAC Structure
Other collaborations
Black Gay Men’s Advocacy Coalition
NASTAD National Medical
Association National Association of
Black Social Workers City of Oakland Black AIDS Institute CHPG
Black Infant Health STD TB Drug and Alcohol Corrections … Mental Health
Contact Information
Reggie Caldwell, LCSW
African American Policy & Program Coordinator
California Department of Public Health
Office of [email protected]
916-449-5811
Michelle Roland, MD
Chief
California Department of
Public Health
Office of AIDS
916-449-5900
