November 24, 2010
Gay and bisexual men have comprised the largest proportion of the HIV epidemic in the United States since the first cases were reported in the 1980s, and that has not changed. They still comprise the greatest proportion of infections nationally. (For more details on HIV/AIDS among gay and bisexual men, see CDC's fact sheet (PDF 263 KB) and latest surveillance data.) As with gay and bisexual men, transgender individuals are also at very high risk for HIV infection.
The National HIV/AIDS Strategy (NHAS) states: "Given the starkness and the enduring nature of the disparate impact on gay and bisexual men, it is important to significantly reprioritize resources and attention on this community. The United States cannot reduce the number of HIV infections nationally without better addressing HIV among gay and bisexual men. Our national commitment to this population has not always reached a level of HIV prevention funding reflective of their risk." (p. 14)
The NHAS, its Federal Implementation Plan, and the Department of Health and Human Services (HHS) Operational Plan (in development at the time of this writing) identify a number of specific goals and activities related to various MSM (men who have sex with men, including both those who identify as gay and those who do not) and transgender populations. Among the actions assigned to HHS in the NHAS Federal Implementation Plan is convening a consultation with national Lesbian, Gay, Bisexual, and Transgender (LGBT) organizations to "re-engage LGBT community leadership in health promotion." We are hopeful that these efforts will also result in the identification of specific strategies for the Federal government and LGBT communities to work together to achieve the important health goals of the NHAS.
To inform our planning for that 2011 consultation, my colleague Christopher Bates and I convened an initial planning meeting on November 9, 2010 with representatives (PDF 66 KB) of several LGBT organizations representing associations, national membership and advocacy organizations as well as community-based programs.
During the meeting, Jeffrey Crowley, director of the Office of National AIDS Policy (ONAP) at the White House, acknowledged that the upcoming consultation is an important opportunity for the LGBT community. For many years, he noted, some in the community have voiced concerns about feeling lost or ignored in responses to the epidemic. The NHAS presents an opportunity to come togethergovernment and non-government partnersand focus on how we can prevent HIV infection and promote the health of gay and bisexual men and transgender people. Mr. Crowley observed that though he receives many daily news clips from LGBT media, only once or twice a month does one of these stories address HIV/AIDS. Concerned that some in the LGBT community have moved on from HIV/AIDS as a priority issue, Mr. Crowley wondered how, without turning away from other important issues, could the LGBT community also appropriately focus on HIV/AIDS and supporting people living with HIV/AIDS. Rekindling and continuing those efforts, he pointed out, is important since the job of achieving the NHAS goals the does not fall to the Federal Government alone and success will require the commitment of all parts of society, including the LGBT community.
In the discussion that followed, the participants offered many valuable suggestions about how the consultation could be structured, issues that should be addressed, and types of voices that should be part of the conversations.
Participants concurred that it will be important to bring voices from many sectors of the LGBT community to the table, including advocacy organizations, professional networks, media outlets, faith-based organizations, social groups, and business organizations, among others. Some also noted that it will be particularly important to engage segments of LGBT community that have not traditionally been involved in HIV/AIDS or health issues since an important dimension of this effort is to expand the number and variety of influences across LGBT communities addressing HIV/AIDS prevention, treatment and care issues. To be clear, we are not suggesting that these LGBT organizations become AIDS Service Organizations! Instead, we want to identify ways that HIV/AIDS issues can be thoughtfully and creatively addressed across a spectrum of LGBT organizations so that even more gay and bisexual men and transgendered people are reached with accurate, culturally appropriate, and effective HIV prevention, testing, care and treatment information and services from a broad variety of sources including messengers who are deemed both credible and trustworthy.
What are your ideas about re-energizing LGBT community and Federal efforts around HIV/AIDS and health promotion for gay, lesbian, bisexual, and transgender persons? Share your thoughts in the comments section below.
If the thoughtful dialogue that took place on November 9 is any indicator, the consultation will be a most valuable endeavor in helping the nation achieve the goals of the strategy. We have not yet selected a date for the consultation, though it will likely take place in early Spring 2011. Once the consultation does take place we will share one or more blog posts featuring important information obtained from our partners both outside of and inside of government.
Ron Valdiserri, M.D., M.P.H. is the Deputy Assistant Secretary for Health, Infectious Diseases at the U.S. Department of Health and Human Services.