1. The Minority AIDS Initiative (MAI): Then and Now Edwin M. Craft, Dr. P
The Minority AIDS Initiative (MAI): Then and Now Edwin M. Craft, Dr.P.H., M.Ed., LCPC Health Systems Branch, Division of Services Improvement Center for Substance Abuse Treatment Substance Abuse and Mental Health Services Administration
September 11, 2015

2. HIV and Substance Use Substance use and abuse are important
factors in the spread of HIV.
Alcohol and other drugs can lower a
person’s inhibitions and create risk factors
for risky sexual behavior and HIV transmission.
Vulnerable populations are more likely to have higher rates of alcohol and substance use.
One of the President’s top HIV/AIDS policy priorities is the development and implementation of a National HIV/AIDS Strategy (NHAS). There are three primary goals for the NHAS:
Reducing HIV incidence
Increasing access to care and optimizing health outcomes
Reducing HIV-related health disparities
Vulnerable populations include:
People who live in poverty
Gay and bisexual men
People with mental illness
People with a history of abuse
CDC Fact Sheet - HIV and Substance use in the US, Mar 2013

3. Substance Abuse and Mental Illness Are Linked
Substance abuse and mental illness share risk and protective factors.
Up to 50% of people with a serious mental illness will develop a substance use disorder at some time in their lives.
Alcohol dependence is four times more likely to occur among adults with mental illness than among adults with no mental illness.
Many health care systems to treat substance abuse and mental illness are disconnected: a missed opportunity.
Substance abuse and mental illness are linked, and they share risk factors. Tackling these common risk factors:
Provides an opportunity for us to change the conversation about how we address prevention in general.
Public perception about substance abuse and mental health is a baseline for targeting our prevention and treatment programming and messaging.
Many Americans are positive about the role and value of prevention. All of us have the power to continue to share these positive messages.
Sources
NAMI: “There are a number of epidemiologic studies that indicate that approximately 50 percent of adults with serious mental illness have a lifetime substance use disorder (abuse or dependence).” (
SAMHSA Science and Service: “People diagnosed with severe mental illness have a lifetime prevalence of substance abuse disorders of between 40%-60% compared to a 17% rate for the general population.” (
The SAMHSA Spotlight report, Alcohol Dependence is More Likely among Adults with Mental Illness than Adults without Mental Illness:
O’Connell, M. E., Boat, T., & Warner, K. E. (Eds.). (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. National Research Council and Institute of Medicine of the National Academies. Washington, D.C.: The National Academies Press.
NIDA Topics in Brief: Comorbid Drug Abuse and Mental Illness:

4. National HIV/AIDS Strategy for the US
National HIV/AIDS Strategy (NHAS) for the US was updated in July 2015.
NHAS is a five year plan outlining priorities, and actions to guide our national response to the HIV epidemic.
The National HIV/AIDS Strategy for the US was updated in July 2015
National HIV/AIDS Strategy for the United States, Updated to 2020, July 2015

5. National HIV/AIDS Strategy (NHAS)
There are four primary goals of the NHAS:
Reducing new HIV infections
Increasing access to care & improving health outcomes for people living with HIV
Reducing HIV-related disparities and health inequities
Achieving a more coordinated national response to the HIV epidemic
One of the President’s top HIV/AIDS policy priorities is the development and implementation of a National HIV/AIDS Strategy (NHAS). There are four primary goals for the NHAS:
Reducing HIV incidence
Increasing access to care and optimizing health outcomes
Reducing HIV-related health disparities
Achieving a more coordinated national response to the HIV epidemic
SAMHSA’s HIV programs address all 4 goals

6. HIV Care Continuum in the USA
According to CDC
data, only 25% of
people currently
living w HIV are
virally suppressed.
SAMHSA’s aim is
to help improve
access to HIV care
at all stages in the
HIV care continuum.
This slide shows the HIV care continuum in the USA.
According to CDC data, only 25% of people currently living w HIV are virally suppressed.
SAMHSA’s aim is to help improve access to HIV care at all stages in the HIV care continuum.
The CoC program was designed to help improve this continuum – to improve the numbers of people who receive appropriate medical care and stay in medical care.
from: White House HIV Care Continuum, 2013

7. CSAT’s MAI GOALS
Increase access to substance abuse (SA) and HIV treatment and prevention services for at-risk and hard to reach racial and ethnic minority populations and communities through:
HIV testing for early detection and diagnosis.
Implementing SA/HIV direct evidence-based practices, and environmental strategies and policies,
Providing referrals to support/care and treatment services (ancillary/community).

8. Beginning of the MAI MAI begin in October of 1998
Result of March 1998 meeting between CDC official and African American community service providers.
African American community leaders declared State of Emergency.
Congressional Black Caucus (CBC)Primary Supporter.

9. Beginning of the MAI
White House ceremony to launch the MAI in October 1998.
Targeted funding begin with the Appropriations Act of 1999.
MAI funds to complement, not replace other federal HIV/AIDS programs.
Initially referred to as the CBC initiative.

10. Expansion of MAI
June 2001 CBC, Congressional Hispanic Caucus, and Congressional Asian Pacific American Caucus held joint hearing on early implementation of the MAI.
First time three Caucuses met on any topic.

11. Goals of MAI
Develop and improve the capacity of existing and new minority CBOs.
Provide TTA in financial mgt., program development, administration, and planning and development.
Expand Research.
Ongoing community input.
Coordination of federal efforts.

12. Secretary’s Minority AIDS Initiative Fund
Special Congressional Appropriation of $50 million for DHHS.
Allocated competitively across agencies of DHHS for short-term projects.

13. SAMHSA Minority AIDS Initiative Funding-CSAT
PPA
FY 2015 Grant Cohorts - ACTIVE
RFA
Acronym
Number of Grants Per Cohort
Grant Period
Grant Years
Grant Period of Performance
FY 2015 Total Amount of Funding 1
MAI
Targeted Capacity Expansion Program: Substance Abuse Treatment for Racial/Ethnic Minority Populations at High-Risk for HIV/AIDS Ti
TCE-HIV 39
Cohort FY12-FY16
5 YRS
9/30/12-9/29/17
$19,036,819 2
Targeted Capacity Expansion: Substance Abuse Treatment for Racial/Ethnic Minority Women at High Risk for HIV/AIDS (TCE-HIV: Minority Women) Ti 35
Cohort FY13-FY15
3 YRS
9/1/13-8/31/16
$17,771,242 3
Minority AIDS Initiative Continuum of Care Pilot - Integration of HIV Prevention and Medical Care into Mental Health and Substance Abuse Treatment Programs for Racial/Ethnic Minority Populations at High Risk for Behavioral Health Disorders and HIV TI
MAI-CoC 34
Cohort FY14-FY17
4  YRS
9/30/14-9/29/18
$6,630,141 4
Target Capacity Expansion: Substance Abuse Treatment for Racial/Ethnic Minority Women at High Risk for HIV/AIDS TI 5
Cohort FY14-FY16
9/30/14-9/29/17
$2,600,000
Target Capacity Expansion: Substance Use Disorder Treatment for Racial/Ethnic Minority Populations at High Risk for HIV/AIDS TI 24
Cohort FY15-FY17
9/30/15-9/29/18
$11,806,622 6 TI
ATTC-CoE
$576,875
TOTAL
138
$58,421,699

14. SAMHSA Minority AIDS Initiative Funding-CSAP
Year
# Grants
# Years
Award
2010
Sept Sept. 2015 36 5
$300,000 27
2013, 2014,
2015
Sept Sept. 2016
Sept Sept. 2017
Sept – Sept. 2018
29 – 2013
21 – 2014
34 – 2015 3
2014
Sept Sept. 2015 1
$125,000
Sept Sept. 2018 4
$500,000
Sept Sept. 2020
$283,875
Total number of grants funded is Total amount of funding is $1,808,875.

15. SAMHSA Minority AIDS Funding-CMHS
Cohort #
Year
# Grants
# Years
Amount of Funding
Minority AIDS Initiative Continuum of Care Pilot
2013, 2014, 2015 34 3
$7,751,913

16. Total Minority AIDS Initiative Funding for SAMHSA
Total # Grants Funded = 424
Total amount of funding = $67,982,487

17. Thank You and Questions - Contact Me If You Need Help
Thank you for your time today.
I would be happy to answer any questions
Edwin M. Craft
Health Systems Branch
Division of Services Improvement
Center for Substance Abuse Treatment, SAMHSA