This session by Marsha Martin, of the Black AIDS Institute, introduced attendees to alternative methods for understanding local epidemic dynamics.

1. Marsha A. Martin, DSW
Urban Coalition for HIV/AIDS Prevention Services
AIDS 2014
Melbourne, Australia
July 22, 2014

2. Human Immunodeficiency Virus
It is a virus
It is the virus.

7.  AA are less than 15% of the U.S. population
 AA represents nearly half of all new HIV infections
 AA women are 15 times more likely to be living
with HIV than white women.
 New infections among young AA gay and bisexual
men rose 48% from 2006 to 2010.
 AA transgender women have the highest
percentage of new HIV-positive test results
 Three in five African Americans know someone
living with or who has died from HIV/AIDS

8.  NYC 2007-2011
 191 new HIV diagnoses among trans people
 99% were among transgender women.
 90% transgender women were blacks/African
Americans or Latinos.
 Over half (52%) of newly diagnosed
transgender women were in their twenties
 Majority of studies report black transgender
women more likely to become infected with
HIV than non-black transgender women.

9. “ The United States will become a place where
new infections are rare and when they
occur, every person, regardless of age,
gender identity or socio-economic
circumstance, will have unfettered access to
high quality, life-extending care, free from
stigma and discrimination.”

10. “..What is sometimes less recognized is
the extent to which the HIV epidemic among
African Americas remains concentrated
among Black Gay Men, who comprise the
single largest group of African Americans
living with HIV.."

11. “Efforts to reduce HIV among Blacks must
confront the epidemic among Black gay and
bisexual men as forcefully as existing efforts
to confront the epidemic among other
groups. These overlapping communities both
need intensive efforts to stem HIV infection”

12.  HTPN 061 - Six Cities 1500+ AA men
 Multiple partners
 51% URAI w/male partner
 75% UIAI w/male partner
 44% sex w/ female partner
 Status unknown partners
 ND - strong gay identity
 ND – unprotective sex
 ND – no female partners
 ND – no trans partners
 Status unknown partners

13. National messages for the community:
 Greater than AIDS
 Get Educated about HIV
 Get Tested For HIV
 Get Treated if living with HIV
 Treatment is Prevention
 It is One Pill A Day
 Let’s Stop HIV Together
 Let’s Raise the Bars
 Start Talking. Stop HIV

15.  The largest number of new HIV infections in
the US occurs among gay, bisexual, other
men who have sex with men, and transgender
women. This is followed by African American
heterosexual women.
 By race/ethnicity overall, African Americans
are the most heavily affected, followed by
Latinos.

16.  African Americans face the most severe burden of
HIV and AIDS in the US. 12-15% of US population,
44% of all new infections and of people living with
HIV.
 Latinos represent 16% of the population, 20% of all
new infections and 19% of people living with HIV.
 Whites represent 65% of the US population, 29% of
all new HIV infections.

17.  In part due to a number of social determinants
and economic challenges, such as lack of access
to care, discrimination, stigma, racism,
homophobia, transphobia and poverty, people of
color have higher rates of HIV infection than
whites.
 These findings underscore the urgent need to
prioritize and target HIV prevention efforts in
disproportionately affected communities, both on
structural and individual levels.

20. Proven HIV Prevention Methodologies:
 HIV testing and linkage to care
 HIV medications and pre-exposure prophylaxis
 Access to condoms and behavioral health
 Prevention programs for people with HIV and their
partners
 Prevention programs for people at high risk for HIV
infection
 Substance abuse treatment and access to syringe
exchange programs and
 STI/STD screening and treatment

21. US CDC says we will:
Intensify HIV prevention in communities most
heavily impacted;
Utilize combination of effective evidence based
HIV prevention interventions; and
Educate about HIV and how to prevent it.

22.  Too few AA and trans people with HIV are
aware they are infected.
 Many are not in regular HIV care and
treatment.
 It is estimated that just under 30% of those in
HIV care are virally suppressed. 70 % are not.
 The diversity of people living with HIV
requires specialty HIV prevention services
tailored to meet myriad needs.
 Yet HIV prevention resources are limited.

23.  “part of the party”
 “just a matter of time”
 “making me afraid to go out”
 “easier to get it over with”

24.  Barriers to care and services: limited skills in
negotiating the system; lack of information,
unaware of HIV status, internalized racism,
homophobia and transphobia
 Facilitators to care and services: expansion
of culturally appropriate services and
messages, ACA LGBT outreach and
engagement, permission and modeling of
resiliency
 CDC's high-impact prevention strategy – does
not address the reality that HIV is part of the
party

25.  Increase socio-cultural sexual health
services for all at risk
 Increase screening for STDs/STIs
 Increase HIV positive persons in care
 Increase linkage of HIV negative persons to
prevention services including PrEP
 Increase on-going supportive services
 Increase health services aimed at socio-
cultural well-being
 Decrease Isolation and discrimination

26. It is the virus

27. Thank you to the folks at the African Diaspora Networking Zone
Thank you to Tim, Kali and Jeremiah for continuing to push all of us
Thank you to everyone at CDC
Thank you to the government and community representatives and
delegation members of the Urban Coalition of HIV/AIDS Prevention
Services from: LA, SF, Chicago, Houston, Ft.Lauderdale, Baltimore,
Philadelphia ,NYC, DC, Atlanta.
Marsha A. Martin, DSW