African Americans and HIV: CA Office of AIDS Response Michelle Roland, MD Chief, Office of AIDS California Department of Public Health

Disproportionate impact of HIV among African Americans in California 6.7% of CA population  17.7% % HIV, AIDS and living AIDS cases  20% new HIV diagnoses in 2005  HIV/AIDS rates > 2x any other racial/ethnic group California HIV/AIDS Case Registry; data as of March 31, 2006; State of California, Department of Finance, Race/Ethnic Population with Age and Sex Detail , July MenWomen

HIV risk among African American Men 2005 HIV Cases MSM: 54% MSM/IDU: 3% IDU: 8% NIR:27% Cumulative AIDS Cases

HIV risk among African American Women 2005 HIV Cases Heterosexual:56% IDU:18% NIR:26% Cumulative AIDS Cases

Pregnant Women ½ million live births in CA in 2004 Pre-natal care  None: 1.9%  Inadequate: 8.98% Estimates of women without HIV test before labor and delivery  10.85%  55, 000 women

Transgender people 2003 C&T data: 1203 tests among self- identified TG 36 of 126 AA TG tests +  positivity 28.6%

Youth Also a group at high risk…

Selected OA Activities Prevention  Interventions – MSM focus  Research – women and MSM focus Screening and diagnosis  Perinatal  Medical settings Care and Treatment  Interventions (eg Bridge, Positive Changes) TA Collaborations

18 local health jurisdictions asked to create “Action Plans” with E & P dollars to:  address HIV prevention needs of African American gay men/MSM  Increase HIV testing in this population Plans currently being evaluated by OA OA staff providing technical assistance, capacity building Prevention Interventions

Ongoing prevention research: community collaborative projects FeMAALES: Reducing HIV risk behaviors and increasing sexual communication skills in African American women with at-risk male partners HOLLA: Developing a tailored case management intervention for recently incarcerated MSM BRUTHAS: HIV prevention for African American down low men MAALES: HIV prevention for African American MSM who do not identify as gay OA/CHRP partnership

Increase awareness and understanding of prenatal HIV transmission Increase capacity of BIH service providers to effectively discuss HIV related issues (including risk assessments, risk reduction counseling strategies) with their clients Needs assessment, literature review, training (PTC ) Perinatal transmission: Step 1 Black Infant Health Collaborative

Perinatal transmission: Step 2 California Perinatal Project Have every pregnant woman, and her obstetric provider, know her HIV status as early as possible during her pregnancy and no later than when she begins delivery. Build capacity to provide rapid HIV testing in every California Labor and Delivery Hospital  80 hospitals, representing 36% live births, offer RTLD now  With AB682, OA increasing efforts in this area  PAETC – Training  OA - TA

Screening and diagnosis in other medical settings STD programs TB programs Emergency departments  CDC funded demonstration project at 3 Bay Area hospitals  Provide rapid HIV testing within emergency departments and inpatient wards serving high rates of African Americans  Link those who test HIV positive to HIV services. Correctional settings

Center of Excellence for Transgender HIV Prevention (COE) State/academic/PAETC partnership to provide:  Leadership  capacity building  professional training  policy advocacy  research development  resources To increase access to culturally competent HIV prevention services for transgender people in California.

California African American HIV/AIDS Coalition (CAAHAC) Assembly Bill 1142-Statewide African American HIV/AIDS Initiative Establishes the administrative, educational, and communication infrastructure to support the activities of the provider network Mandates CPDH/OA provides support Initiative until January 1, 2008, when the Initiative would become an independent non-profit organization

Board of Directors CAAHAC Structure

Other collaborations Black Gay Men’s Advocacy Coalition NASTAD National Medical Association National Association of Black Social Workers City of Oakland Black AIDS Institute CHPG Black Infant Health STD TB Drug and Alcohol Corrections … Mental Health

Contact Information Reggie Caldwell, LCSW African American Policy & Program Coordinator California Department of Public Health Office of AIDS Michelle Roland, MD Chief California Department of Public Health Office of AIDS