by Bob Roehr
The Obama administration held a high profile unveiling of a new HIV/AIDS public awareness campaign in part of the White House compound of buildings on April 7. AIDS advocates were grateful for the symbolism of the event, which far outweighed the content of the program.
The campaign is called Act Against AIDS and "seeks to put the HIV crisis back on the national radar screen," said Melody Barnes, an assistant to the President and director of the White House Domestic Policy Council.
"Our goal is to remind Americans that HIV/AIDS continues to pose a serious health threat in the United States and encourage them to get the facts they need to take action for themselves and their communities."
This first phase of the campaign, "9 1/2 minutes," draws upon the fact that one American becomes newly infected with HIV every nine-and-a-half minutes. The public awareness campaign uses a series of public service announcements and a Web site.
Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, focused on a "leadership initiative," that partners with 14 African American civic organizations to integrate HIV prevention into each organization's outreach programs.
Third is a partnership with the Kaiser Family Foundation to coordinate efforts within the communications and entertainment sectors.
These are five-year programs with annual budgets of $9 and $2 million a year for the first two, and a total of $1 million for the third. It does not represent "new money" but rather pulls from the pool of existing HIV prevention dollars, now some $800 annually. The programs have been in development for some time.
"For those of us who have been living and working with HIV for a long time, this is a cause to shout hallelujah. It has been a long time since we have had something to celebrate," said Jesse Milan, Jr., director of Community Health Systems at the Altarum Institute. "I'm thrilled to be able to celebrate a president who cares about the epidemic at home."
He was ecstatic about the fact that the campaign would focus on the black community. "It will not be afraid to address black youth and black gay and bisexual men.
"I say, it's about time."
Reactions
The materials unveiled at the meeting were decidedly generic and did not seem to be targeted to those under 25, where half of all new infections occur. The dollars committed are small and do not represent new funding. AIDS advocates in the audience, however, reacted not to the specifics of the program but to the hope it has rekindled that meaningful HIV prevention might become possible.
"We are in the first 100 days of the administration, with the leadership of the White House, and we are having this announcement focusing on the domestic AIDS epidemic," said Carl Schmid with The AIDS Institute. "It's a good start."
"It represents the real and genuine commitment of this administration to reverse the neglect of the domestic HIV/AIDS epidemic," said Ronald Johnson, deputy director of AIDS Action.
Cornelius Baker, former executive director of the Whitman Walker Clinic and a consultant on HIV within the black community, added, "They could have waited a couple of months to get everything perfect, but then we would have been sitting around saying, 'why aren't they doing anything?' This is an important beginning and an important evidence of commitment."
"I'm particularly moved by the fact that this campaign is comprehensive and it really follows the data," said Phill Wilson, head of the Black AIDS Institute. "We need to start where the epidemic is worse, which is the African-American community. And we need to engage those people who are in the best position to bring about change."
However, though most opinions were hopeful, some still had problems with the plan. Alexander Robinson, director of the National Black Justice Coalition, had some pointed criticism: "All of these African-American groups, none of them have any capacity to deal with gay men," he said. "Not one of these groups has any significant gay leadership, has ever taken a position on the issues, and the minute you mention it as gay, then it is non-black."
"While I appreciated their historic contribution to all African Americans," he added, "they have not demonstrated a willingness or capacity to seriously address not only HIV but any of the challenges that face the LGBT community."
"I'm frustrated and concerned but I hope that in this new era we will have a change and will actually be able to get a focus on black gay men, who are, after all, the largest percentage of individuals who are infected," Robinson said.
Wilson countered Robinson's sentiments, saying, "We are meeting people where they are, and we are moving them along… . We are opening the door and giving people permission to talk about HIV. I think that is important. I hope that black gay men will feel more included."
Johnson came down between the two. "We hope that there will be more visible involvement of black gay men in this effort," he said. "I remain optimistic that will be addressed as we go forward. We didn't quite see it here today in terms of the national partners in the African American community."
More money
At a congressional hearing last year, Johns Hopkins University HIV prevention researcher David Holtgrave testified that the HIV prevention budget should be increased from $800 million to $1.3 billion a year "to make a big difference in the epidemic in the U.S."
Holtgrave said that the steps that were announced would educate people and help to break down stigma surrounding HIV, but added that more is needed.
Cornelius Baker said, "Unfortunately HIV dollars were not protected in the omnibus bill" passed by Congress. While Wilson made clear, "We do need new money so that we are not robbing Peter to pay Paul."
Both will be looking to the president's budget, due later this month, to see if there will be significant increases in HIV prevention funding during this time of budgetary constraint.
Schmid said that in addition to funding, "It is important for the president and the first lady to speak out on HIV/AIDS, you need role models and leadership."
