Staffing at the Michigan Department of Health and Human Service Division on HIV and STIs is woefully unrepresentative of those living with or at risk for HIV, new data reveals.
While Black men who have sex with men and transgender women of color continue to shoulder the brunt of the ongoing HIV crisis, data released by the Department in June 2021 shows that the staff running a program set up to administer prevention and intervention programs with federal dollars does not represent the very people the program is intended to help.
This data divulges an immense racial and gender gap between those at risk for or living with HIV and those charged with doling out state and federal cash to organizations and groups that are working on medical care, prevention and intervention activities.
Women were overwhelmingly represented in the state’s HIV workforce, according to the data. Black or African American women represent over 30 percent of the workforce, as do white women, while Hispanic, multiracial and Asian women barely register in the data set.
“The question I think we need to ask, is the Michigan Department of Health and Human Services aware of this disparity?” said Curtis Lipscomb, executive director at LGBT Detroit. “If they are aware, what are they doing to address it? If they are not aware, then we have to raise that awareness and make changes.”
Of the 131 positions in the Division on HIV and STIs:
- 17 are white cisgender men
- 10 are Black cisgender men
- 44 are white women
- 49 are Black women
- Three are Hispanic women
- Three are Asian women
- Two women identify as more than two races
All 131 employees hold at least a bachelor’s degree. State officials said many have additional higher education attainment, from master’s degrees to Ph.D.s. In response to questions sent late last year, MDHSS spokeswoman Lynn Sutfin said State Civil Service rules prohibit them from advertising for entry-level positions using the phrase “or comparable experience and skills.” (That’s a common employee recruitment tactic used to encourage those without college educations to apply and broaden the diversity of employees in a workplace.)
Two positions in the Michigan HIV/AIDS Drug Assistance Program (ADAP), which connects the uninsured and underinsured with federal dollars to pay for HIV medications and co-pays, are currently filled by women. One is a white woman; the other is an Hispanic woman.
Overall, the Division spent nearly $103 million dollars in 2021. Most of that comes from the federal government, which is then distributed to local HIV/AIDS service organizations and health departments under federal funding distributions of Ryan White CARES Act dollars. In 2021, the state received just under $19.5 million in general Ryan White CARES Act funding. It also received just over $8.3 million in federal HIV prevention dollars. MDHHS provides a match in cash for federal dollars. In 2021, that match was just under $5 million.
The city of Detroit receives its own Ryan White CARES Act and prevention funding dollars, as most larger cities in the U.S. do.
According to data released by the state in January 2021, the racial and gender makeup of the employees of the Division are not representative of the demographics most likely to be at risk for or living with HIV:
- Black or African American men have a prevalence rate of 1043.3 cases per 100,000 Black or African American men.
- White men have a prevalence of 138.6 cases per 100,000 white men.
- Black or African American women have a prevalence of 316.9 per 100,000 Black or African American women in the state.
Alfredo Hernendez is the Michigan Department of Civil Rights Equity Officer. He works with various departments in the state, local governments and private entities to develop more inclusive equity driven policies and decision making. He declined to discuss the specifics of the MDHHS racial inequities in the HIV Division, but he did talk in general about the importance of representation in policy making by those impacted by such decisions.
“It is important for organizations that provide services for a community to have representation of that community in the decision-making process,” he said. “Unconscious bias can lead to an unfortunate imbalance in representation in paid positions. Often, policies do not support the hiring of people based on their lived experiences, which can eliminate many more options, perhaps better suited for the position. But that kind of work is long, exhaustive, important work that requires a commitment to being deliberately anti-racist in policy construction and applications.”