Tuesday, April 14, 2009

High profile HIV prevention effort unveiled at White House

The Obama administration on Tuesday, April 7 held a high profile unveiling of a new HIV/AIDS public awareness campaign in part of the White House compound of buildings. AIDS advocates were grateful for the symbolism of the event, though some felt it outweighed the content of the program while others were pleased that the campaign will reach out to many organizations that cater to the black community.
The campaign is called Act Against AIDS and "seeks to put the HIV crisis back on the national radar screen," said Melody Barnes, an assistant to the president and director of the White House Domestic Policy Council.
"Our goal is to remind Americans that HIV/AIDS continues to pose a serious health threat in the United States and encourage them to get the facts they need to take action for themselves and their communities," Barnes added.
This first phase of the campaign, called "9 1/2 minutes," draws upon the fact that one American becomes newly infected with HIV every nine and a half minutes. The public awareness campaign uses a series of public service announcements and a Web site.
Kevin Fenton, the openly gay director of the Centers for Disease Control and Prevention's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, focused on a leadership initiative that partners with 14 African American civic organizations to integrate HIV prevention into each organization's outreach programs.
The third aspect of the initiative is a partnership with the Kaiser Family Foundation to coordinate efforts within the communications and entertainment sectors.
These are five-year programs with annual budgets of $9 million and $2 million a year for the first two, and a total of $1 million for the third. The funds do not represent "new money" but rather pull from the pool of existing HIV prevention dollars, now some $800 million annually. The programs have been in development for some time.
"For those of us who have been living and working with HIV for a long time, this is a cause to shout hallelujah. It has been a long time since we have had something to celebrate," said Jesse Milan, who has worked in the field for decades. "I'm thrilled to be able to celebrate a president who cares about the epidemic at home."
He was ecstatic about the fact that the campaign would focus on the black community.
"It will not be afraid to address black youth and black gay and bisexual men," Milan noted. "I say, it's about time."
The materials unveiled at the meeting were decidedly generic and did not seem to be targeted to those under 25, where half of all new infections occur. AIDS advocates in the audience reacted not to the specifics of the program but to the hope it has rekindled that meaningful HIV prevention might become possible.
"We are in the first 100 days of the administration, with the leadership of the White House, and we are having this announcement focusing on the domestic AIDS epidemic. It's a good start," said Carl Schmid with the AIDS Institute.

"It represents the real and genuine commitment of this administration to reverse the neglect of the domestic HIV/AIDS epidemic," said Ronald Johnson, deputy director of AIDS Action.
Cornelius Baker, former executive director of the Whitman Walker Clinic and a consultant on HIV within the black community, added, "They could have waited a couple of months to get everything perfect, but then we would have been sitting around saying, why aren't they doing anything? This is an important beginning and an important evidence of commitment."
Phill Wilson, head of the Black AIDS Institute, said, "I'm particularly moved by the fact that this campaign is comprehensive and it really follows the data. We need to start where the epidemic is worse, which is the African American community. And we need to engage those people who are in the best position to bring about change."
But Alexander Robinson, executive director of the National Black Justice Coalition, had some pointed criticism.
"All of these African American groups, none of them have any capacity to deal with gay men," Robinson said. "Not one of these groups has any significant gay leadership, has ever taken a position on the issues, and the minute you mention it as gay, then it is non-black."
"While I appreciated their historic contribution to all African Americans, they have not demonstrated a willingness or capacity to seriously address not only HIV but any of the challenges that face the LGBT community," Robinson added, referring to the 14 African American organizations with which the CDC is partnering.

"I'm frustrated and concerned, but I hope that in this new era we will have a change and will actually be able to get a focus on black gay men, who are, after all, the largest percentage of individuals who are infected," Robinson added.

Wilson offered a bit of a counter to that, saying, "We are meeting people where they are, and we are moving them along. ... We are opening the door and giving people permission to talk about HIV. I think that is important. I hope that black gay men will feel more included."
Johnson came down between the two.

"We hope that there will be more visible involvement of black gay men in this effort," he said. "I remain optimistic that will be addressed as we go forward. We didn't quite see it here today in terms of the national partners in the African American community."

More money
At a congressional hearing last year, Johns Hopkins University HIV prevention researcher David Holtgrave testified that the HIV prevention budget should be increased from $800 million to $1.3 billion a year "to make a big difference in the epidemic in the U.S."
On Tuesday, he thought that steps that were announced would educate people and help to break down stigma surrounding HIV. But it is a small step and much more is needed.
Said Baker, "Unfortunately HIV dollars were not protected in the omnibus bill" passed by Congress.

While Wilson made clear, "We do need new money so that we are not robbing Peter to pay Paul."
Both will be looking to the president's budget, due later this month, to see if there will be significant increases in HIV prevention funding during this time of budgetary constraint.
Schmid said, that in addition to funding, "It is important for the president and the first lady to speak out on HIV/AIDS; you need role models and leadership."

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