Cedric Whitfield, MPH, CHES Black MSM: Implementing Health Marketing Techniques as a Recruitment Method for HIV Prevention and Care Services Cedric Whitfield, MPH, CHES

Outline Epidemiology of HIV Disease Among African American Men Prevention/Treatment Challenges Define Health Marketing Health Marketing Activities Define Outreach Five Stages of Action in Health Marketing/Outreach Tips and Techniques

Objectives At the end of this presentation participants will be able to: Identify two challenges to prevention and treatment Define health marketing Define outreach Discuss stages of action in outreach Identify two outreach tips and techniques

More than half of the cumulative AIDS cases reported in the United States were cases in persons of minority races/ethnicities. Blacks account for a disproportionate share of AIDS cases. Blacks make up 13% of the U.S. population; yet, from 1981 through 2005, they accounted for 40% of the total number of AIDS cases reported to CDC. From 1981 through 2005, 60% of the women and 59% of the children reported as having AIDS were black. In 2005, 48% of AIDS cases reported among adults and adolescents were in blacks.

The pie chart on the left illustrates the distribution of AIDS cases reported in 2005 among races/ethnicities. The pie chart on the right shows the racial/ethnic distribution of the U.S. population (excluding U.S. dependent areas) in 2005. Blacks (not Hispanic) and Hispanics are disproportionately affected by the AIDS epidemic in comparison with their proportional distribution in the general population. In 2005, blacks (not Hispanic) made up 13% of the population but accounted for 50% of reported AIDS cases in the 50 states and the District of Columbia. Hispanics made up 14% of the population but accounted for 18% of reported AIDS cases. Whites (not Hispanic) made up 68% of the U.S. population but accounted for 30% of reported AIDS cases. More information on the HIV/AIDS epidemic and HIV prevention among blacks and Hispanics is available in CDC fact sheets at http://www.cdc.gov/hiv/pubs/facts.htm.

The distribution of risk factors for HIV infection differs by race/ethnicity. From 2001 through 2005, of white (not Hispanic) men with AIDS, 72% had been exposed through male-to-male sexual contact, and 12% had been exposed through injection drug use (IDU). These proportions were similar among Asian/Pacific Islander men. Of black (not Hispanic) men, 45% had been exposed through male-to-male sexual contact and 24% through IDU. Of Hispanic men, 52% had been exposed through male-to-male sexual contact and 24% through IDU. Of American Indian/Alaska Native men with AIDS, 54% had been exposed through male-to-male sexual contact, 19% through IDU, and 17% through male-to-male sexual contact and IDU.

The estimated number of persons living with HIV/AIDS in the 33 states with confidential name-based HIV infection reporting increased from 383,990 at the end of 2001 to 475,220 at the end of 2005. In all races/ethnicities, the number of persons living with HIV/AIDS increased. The number of blacks (not Hispanic) living with HIV/AIDS increased from 181,469 to 224,815; the number of whites (not Hispanic) increased from 132,892 to 160,746; and the number of Hispanics increased from 63,526 to 81,389. The following 33 states have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2001: Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.

HIV/AIDS In African American MSM 5% - 7% adolescent and adult males identify as MSM 71% of all HIV cases reported in 2005 among this population African American MSM 46% serro-positive 67% unaware of HIV status

Prevention/Treatment Challenges Poverty Denial Sexually Transmitted Diseases Drug Use Homophobia Complacency about Risk Factors Unknown HIV Status Lack of Gay Ghetto

What is Health Marketing? Health Marketing involves creating, communicating, and delivering health information and interventions using customer-centered and science-based strategies to protect and promote the health of diverse populations (CDC, 2005).

Health Marketing Cont’d Health Marketing is: Multidisciplinary practice – public health, education, psychology, research and marketing. A complex framework that provides guidance for designing health interventions, campaigns, communications, and research projects

Health Marketing Activities Social Marketing Health Conferences Public Service Announcements Event Planning Internet Outreach

What is Outreach? The performance of education, assessment and referral to change behavior or increase awareness of public health issue in places target audience is known to congregate. Bar/Club Street

Five Stages of Action in Health Marketing/Outreach Attention – Get clients attention Interest – Use emotional appeal to build interest

Stages Cont’d Desire – Build desire by showing features of product Conviction – Compare health behavior utilization to non-utilization

Stages Cont’d Action – Encourage participant to close deal Direct Close – Simply asking for participation Deal/Concession Close – “By signing up today you will receive…

Stages Cont’d Time-Driven Close – “Spaces are limited for this workshop so you may want to sign up today!” Trial Offer Close – “I can take your name and number and you later to confirm. If you are not interested I will remove you from the list”

Health Marketing/Outreach Tips and Techniques Listen to emotional side of prospect Focus on prospect needs Use language that focuses on prospect Help prospect see bottom line Find out prospects priorities

Tips and Techniques Cont’d Know your prospect (Cultural Competency) Focus on why they should participate and not their objections Marketing the benefits of participation – not the product Never rush prospect

Tips and Technique’s Cont’d Be a resource by knowing your product Follow through with promises Focus on client success Explain rather than make excuses

Question and Answer

Thank You!!!