By DR. SELENA SEABROOKS
The Dallas Examiner
As of 2019, approximately 1.2 million people in the U.S. live with HIV. Black people account for 13% of the U.S. population but nearly 40% of people with HIV, the Centers for Disease Control estimated. While new infections declined 8% from 2015 to 2019, they remained stable among Black communities. In 2020, African Americans were 7.8 times more likely to be diagnosed with HIV than Whites, according to the US Department of Health and Human Services.
Recently, the Office of Infectious Disease and HIV/AIDS Policy at HHS commemorated National Black HIV/AIDS Awareness Day by hosting a webinar, Live with Leadership: A Conversation Commemorating National Black HIV/AIDS Awareness Day. The conversation highlighted the importance of health equity, community engagement, a syndemic approach to infectious disease, and the point of intersection between mental health and HIV.
The event was moderated by Dr. Timothy Harrison, principal deputy director of the OIDP. Guest speakers included Kaye Haynes, deputy assistant secretary for Infection Disease and director of OIDP; Harold Phillips, director of the HHS Resources and Services Administration’s HIV/AIDS Bureau; and Ashley Cason, creative partner of the I Am A Work of ART campaign – a community-informed campaign designed to encourage people with HIV who are not in care to seek care, stay in care and achieve viral suppression by taking antiretroviral therapy.
Barriers to medical care
Black communities have made significant progress in reducing HIV/AIDS. Despite this, continued concerns with racism, discrimination and mistrust in the health care system still affect whether Blacks seek or receive HIV prevention services. These issues reduce the likelihood of Blacks engaging in HIV treatment and care, according to the CDC.
Phillips recapped the progress made to end the HIV epidemic. He emphasized the importance of getting people with HIV into medical care and treatment. He also discussed the barriers for Black and African American communities to get treatment.
“Things like housing and transportation, mental health, employment and the quality-of-life indicators give us an opportunity to really think comprehensively about things that sometimes get in the way of good medical care,” Phillips said.
Harrison referenced the National HIV/AIDS Strategy Federal Implementation Plan and discussed how it added additional areas of concern, such as racism and other ‘isms,’ and their effects on public health and how they complicate the efforts to end the HIV epidemic.
“Racism is a public health issue,” Hayne added. “Homelessness is an issue that affects our community. Racism, all the isms, sexism. Those are still factors that we work at everyone day.
The disproportionate effects of diseases and viruses on the Black community raise another concern.
“It’s all interconnected when we look at HIV/AIDS, when we look at hepatitis, Mpox, we are very often talking about the same communities,” Hayne stated, “And with Mpox, practically looking at our African American community and Hispanic, Latino community, looking at our communities being left behind.”
Cason stated that it is essential to partner with different organizations from different communities to make resources available to every person of color and cultural background. She emphasized the importance of engaging the community and building a strategy of going to the community directly and getting feedback.
“Them telling you exactly what they need, exactly what they want, and listening and taking that into consideration,” Cason commented, “At the end of the day, HIV is affecting everyone.
“Having all of us come together to represent the variety of the cultures and races and all the isms of people that exist today, that is the only way we’ll be able to bring everyone together to really fight for the cause to end the HIV epidemic and reduce the stigma that is in all of these communities.”
Prioritizing mental health
The panelist talked about the challenges presented by mental health. Mental health has challenged the ability to provide comprehensive HIV prevention services and the willingness of people to receive those services.
“Mental health has been a part of President Biden’s unity agenda and will continue to be a major focus of some of the work the administration does to make mental health services more available,” Phillips explained, “As African Americans in this country, we still have a lot of work to do to recognize the impact of trauma on our everyday lives and how we go about and relate to our lives and navigator through our lives. It’s a world where for 400 years, it was not built for us. It was built to keep us down and limit our access and ability.”
“We still have a long way to go, and we cannot take our foot off the pedal,” Haynes added, “We still have some hurdles and very intentional work to do.”
Cason talked about the importance of prioritizing mental health and shared her story of being diagnosed with HIV at 15.
“I went through a deep depression, and I had suicidal thoughts, and this carried for a few years, and mental health and HIV actually go hand and hand as a lot of people that have been diagnosed with HIV or any other condition start to experience depression, loneliness. You have a lot of different thoughts, thinking that no one wants to be around you, no one will want to be with you, you won’t be able to have kids. All this stigma is literally what sends us into the depression because we start thinking about all of the negative things, which is not even true.”
Hope for the future
Despite challenges, significant progress has been made in the Black community in reducing HIV/AIDS.
“HIV is no longer a death sentence. Thinking about holistically and comprehensively, what does it mean to live with HIV,” Phillips said.
Harrison recognized the passing of Dr. Don Smith and Janet Cleveland from the CDC.
“Two African American women who were warriors in the HIV prevention fight for many years,” he said, “They remind us of the importance of why we’re working toward ending the HIV epidemic and why we’re here today.