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African Americans and HIV: CA Office of AIDS Response

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

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African Americans and HIV: CA Office of AIDS Response

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  1. African Americans and HIV: CA Office of AIDS Response Michelle Roland, MD Chief, Office of AIDS California Department of Public Health

  2. 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 Men Women 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.

  3. HIV risk among African American Men 2005 HIV Cases • MSM: 54% • MSM/IDU: 3% • IDU: 8% • NIR: 27% Cumulative AIDS Cases

  4. HIV risk among African American Women 2005 HIV Cases • Heterosexual: 56% • IDU: 18% • NIR: 26% Cumulative AIDS Cases

  5. 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

  6. Transgender people • 2003 C&T data: 1203 tests among self-identified TG • 36 of 126 AA TG tests + • positivity 28.6%

  7. Youth Also a group at high risk…

  8. 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

  9. Prevention Interventions • 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

  10. 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

  11. Perinatal transmission:Step 1 Black Infant Health Collaborative 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)

  12. 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

  13. 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

  14. 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.

  15. 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

  16. 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 Other collaborations

  17. Reggie Caldwell, LCSW African American Policy & Program Coordinator California Department of Public Health Office of AIDS Reggie.caldwell@cdph.ca.gov 916-449-5811 Michelle Roland, MD Chief California Department of Public Health Office of AIDS Michelle.roland@cdph.ca.gov 916-449-5900 Contact Information

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