February 14, 2012
The fourth in a series of articles about the Road to AIDS 2012, a 15-city tour that seeks to define the state of the U.S. epidemic and that leads up to the International AIDS Conference in Washington, D.C., in July 2012. The third installment reported on the Chicago meeting.
While the National HIV/AIDS Strategy (NHAS) has facilitated much-needed discussion about the epidemic, it falls short of meeting the needs of local communities and young men at risk of acquiring HIV, according to participants at a town hall meeting held on Jan. 19 in New Orleans.
Almost 70 participants listened to panelists describe government and community efforts to meet the goals of the NHAS: to reduce the incidence of HIV, increase access to care and reduce HIV-related health disparities.
"The main crux we can take away from the strategy is around collaboration, coordination and partnership," said Christopher H. Bates, director of the U.S. Department of Health and Human Services' Office of HIV/AIDS Policy, and a panelist at the town hall. The next major goal will be putting in place systems that are reliable, accountable and responsive to people who live in the local community, he added.
But members of the audience voiced frustration that it's taking too long for that to happen.
Brandi Bowen, program director of the New Orleans Regional AIDS Planning Council, described from the audience how stakeholders in New Orleans are energized and committed to fighting the epidemic, "but that doesn't equal capacity," she said. For example, the local community struggles with an AIDS Drug Assistance Program waiting list, she pointed out.
Another local community member described situations in which promised federal funding did not come through, leaving local organizations struggling to pay their obligations. "When you combine federal incompetence with local incompetence, people don't get what they need," she said.
New Orleans residents also complained about local barriers to fighting the epidemic. For example, one member of a local faith-based organization described how efforts to conduct HIV testing in the schools have been thwarted by local laws.
The Road to AIDS 2012 town hall meeting took place at the New Orleans Marriott, which was also the setting for the National African American MSM Leadership Conference on HIV/AIDS and Other Health Disparities. As a result, participants from that conference were heavily represented, focusing much of the discussion on concerns of Black gay and bisexual men.
One of the biggest concerns was the lack of resources targeting young men. According to the Centers for Disease Control and Prevention, there was a 48 percent increase in new HIV infections among Black gay and bisexual men between the ages of 13 and 29 from 2006 to 2009.
One audience member criticized prevention efforts geared toward that demographic. "We are treating HIV testing as prevention," he said, "but testing is reactive." With the focus on improved treatment rather than on keeping people from acquiring HIV in the first place, "kids are 10, 11 and 12, and we're telling them, 'Welcome to the HIV world, where we have a treatment for you,' " he said.
Another audience member agreed that the NHAS hasn't laid out a plan to reach out to teenagers already engaging in behaviors that are putting them at risk of acquiring HIV. "We wait until they're 18 to talk to them about it," he said. By then it's often too late, he added.
However, panelists stressed that real change starts in the community, and while the NHAS is a major step forward in fighting the epidemic, communities must come up with creative ways to get around their perceived barriers. "The federal government is not going to rescue us," said panelist Phill Wilson, president and CEO of the Black AIDS Institute. In fact, the NHAS came about only because members of the community felt that it was important and pushed for it, Wilson pointed out.
Other panelists at the New Orleans town hall included Dena Gray, HIV-prevention program manager for the Houston Department of Health and Human Services, and Carl Kendall, Ph.D., professor and director of the Center for Global Health Equity at Tulane University School of Public Health and Tropical Medicine.
Despite the frustrations that were voiced, there was a consensus that ending the epidemic would make the struggle worth it. "There is a breaking point for every human being, and what we're hearing here tonight is that a lot of us are fearful that we're at that point," said Wilson. "It's a matter of holding on."
The entire Road to AIDS 2012 tour is a joint effort between the Washington, D.C.-based Community Education Group, the Urban Coalition for HIV/AIDS Prevention Services, pharmaceutical company Merck and AIDS 2012. The Road to AIDS 2012 will seek community input in cities across the country. That input will be shared at AIDS 2012 in Washington, D.C., when the International AIDS Conference is on American soil for the first time in more than 20 years.
Tamara E. Holmes is a Washington, D.C.-based journalist who writes frequently about emotional health and wellness.