March 18, 2002
Demonstration projects throughout the country are developing what may become models for helping African-American communities build coalitions that link networks of HIV and STD services. Progress is expected to come when health departments and other services collaborate and recognize the "external barriers" faced by African-Americans.
Recognizing that health departments have not adequately dealt with HIV in African-Americans, the National Alliance of State and Territorial AIDS Directors (NASTAD) has set up a task force to provide recommendations, training and support to African-American leaders within health departments and AIDS organizations. In a recent NASTAD monograph intended to help bridge the gap between the public health system and African-Americans, other recommendations to deal with HIV/AIDS health disparities in African Americans include:
As symbolized by the second annual Black AIDS Day on Feb. 7, increased attention is being given to the HIV epidemic in minorities. This has led to more funding and new programs precisely aimed at capacity building. One such program, the CDC Coalition Development Project for African-American Communities, has expanded program grants to 20 agencies. The $3.6 million awarded in 2001 is intended to identify and fill gaps in HIV, STD and TB services in African-American communities.
Many barriers exist to effective collaborations, with many grant-driven programs "torn between their allegiance to their funding support and sustaining collaborative courtesies to other agencies." Other barriers include just getting different groups to come together and agree on a common agenda.
Some programs have had good success in establishing coalitions to reach those at highest risk. In Atlanta, West End Medical Center has teamed up with a new non-profit organization, Making Our Way Better Inc. to convert a large warehouse into a family prevention and job development center.
The coalition has brought together leaders in the African-American community, including a juvenile judge and a state legislator. Through a Kellogg Foundation grant, the new facility would offer health screening and the West End facility would provide treatment.
The NASTAD report urges AIDS directors and health departments not to accept quantitative data at face value and to better understand the environment in which the data are presented. It also recommends convening an African-American HIV epidemiology work group that helps present data that are simple to read and culturally competent. The NASTAD monograph is available at www.nastad.org.