Facing AIDS Among
Minorities HIV/AIDS Programs at
SAMHSA Minority Health
Perspective: Prevention Starts With Us Minority Health
Perspective: No Time to Retreat Recognizing the Link
Between Indian Culture and Health American Psychological
Association Addresses Cultural Competency in AIDS Training Getting the Word
Out HRSA Explores Health Care
Access
Issues NIAID Expands Research on
Topical
Microbicides to Prevent STDs in Women Asian AIDS Project Hits
the Street American Indian Health
Care Association
recommendations to OMH IHS AIDS Office Revises
Funding
Plans AIDS Activities Supported
by the Centers
for Disease Control and Prevention (CDC) CSAP Offers Free
Technical Assistance to
Communities Resources: AIDS
Information Funding Alert
When giving workshops to Samoans on HIV/AIDS and other sexually transmitted diseases, Merina Sapolu speaks to men and women separately. "Samoans don't generally talk about such issues within the family setting, especially not to members of the opposite sex. So I have to make sure that brothers and sisters or other relatives aren't in the same workshop," said Sapolu, a health educator at the Kokua Kalihi Valley Health Center in Honolulu.
Cultural sensitivity is an integral part of delivering prevention messages, Sapolu said. It guides her in coming up with the best approaches to reach her target populations--Pacific Islanders and Asians. It helps her determine when to address one large group and when to split it into subgroups. Or whether to make a visit to the community instead of holding the workshop at her clinic. She finds it highly effective to go out and give AIDS workshops to Filipino women when they are already in groups, stringing beads and lace for necklaces. "People will talk about AIDS if they are in the most comfortable setting," she explained.
The fact that Sapolu is Samoan is often a big boost for the comfort-level of her audience. At the intermediate school in her area, there are a lot of Samoan students, but no Samoan teachers. "So when I visit," she said, "the kids come up to me and get so excited because I'm Samoan like them. They accept me and want to hear what I have to say."
Since the AIDS program started at Kokua Kalihi Valley in 1989, Sapolu has watched the number of people in Honolulu who are diagnosed with AIDS climb from approximately 100 to 1,000. The numbers may sound small since Honolulu's total population is about 900,000. But the rate of increase over such a short time is disturbing, and from the OMH perspective, it's reason enough to reach out to Asian and Pacific Islander communities now.
Sapolu's program ventures to break through denial and other barriers to prevention. Some people still have trouble believing that you don't have to be gay to get AIDS or that a long-time lover might be unfaithful. There are others who think AIDS is a joke or something that only happens to "bad" people. Sapolu likes to bring people with AIDS to her workshops so participants can see that the disease and its effects are very real.
A young man named Sean accompanied her on several occasions. The students asked him questions like: How did you get AIDS? How does it feel to wake up knowing you might die soon? Would you like to be hugged? At the end of Sean's talk, they would go to the front of the classroom and embrace him. Their compassion is always unmistakable, Sapolu said. What hits hardest are the times she returns for another visit and the kids ask about Sean. Then, she has to tell them he died.
CDC's most recent HIV/AIDS Surveillance Report indicates that 1994 was the first year that African Americans and Hispanics together made up the majority of all AIDS cases reported among men. On the whole, AIDS incidence rates are six times higher among blacks that whites, and three times higher among Hispanics than whites. Men who have sex with men continue to be the population most affected by AIDS.
According to studies cited in the American Journal of Public Health, researchers have found that contracting HIV infection due to same-sex sexual contact is higher in African American adolescents than Whites. African American and Hispanic adolescents are less likely than whites to use condoms, and more Hispanic adolescents than white adolescents report injecting drugs.
Such reported discrepancies in behavioral factors and the fact that HIV/AIDS is taking a disproportionate toll on minorities, are all grounds for beefing up attention and funding to minority communities, according to Matthew Murguia, AIDS coordinator at OMH. "One problem is that for so long, minorities have had to adapt white models to their needs," Murguia said. "OMH believes minorities should be given the resources to develop new models based on the needs of their specific communities."
HIV/AIDS is one of the seven critical health problems upon which OMH focuses the majority of its program efforts. One of the first Public Health Service (PHS) agencies to provide direct funding to minority community-based organizations for HIV/AIDS education projects, OMH funded 82 community based projects from 1988 to 1992 through its Minority HIV/AIDS Education/Prevention Grant Program. In 1993, OMH merged this program with CDC's Cooperative Agreement Program for Minority Community-Based Organizations. The expansion allowed minority organizations in areas with a low incidence of HIV/AIDS to apply resources that support prevention activities.
"OMH takes responsibility for tapping into minority needs and conveying information to other federal agencies," said Murguia, who works with departmental agencies to incorporate minority prevention, services, and research needs into federal HIV/AIDS efforts. OMH also facilitates the exchange of AIDS information through the Office of Minority Health Resource Center, reviews congressional reports, supports increased representation of minorities in national AIDS organizations, and make recommendations.
In reviewing an AIDS awareness campaign for a state health department, for instance, OMH pushes for the inclusion of minorities by raising questions such as: Will your promotional materials be in more than one language?
Several significant OMH accomplishments in the area of HIV-related grant activities are outlined in the agency's upcoming, biennial report to Congress. Along with its collaborations to fund HIV/AIDS programs, OMH cites its participation in organizing a PHS conference called "Breaking Barriers, Building Bridges: National Congress on the State of HIV/AIDS in Racial and Ethnic Communities."
Held last September, the conference convened more than 150 federal representatives from 15 agencies, and more than 750 individuals from community-based organizations to develop new strategies. PHS is working on a plan to implement the recommendations from the conference.
"OMH understands that community-focused, community-led efforts are most likely to be successful," Murguia said. "That's why the agency is working so closely with communities to put plans into action and monitor progress."
For more information about OMH AIDS activities, call Matthew Murguia at 301-443-9923.
HIV/AIDS programs at the Substance Abuse and Mental Health Services Administration (SAMHSA) are coordinated through the agency's Office on AIDS. The annual grant-making capacity for HIV/AIDS-specific services is about 24 million. Additionally, SAMHSA's centers--the Center for Substance Abuse Treatment (CSAT), the Center for Substance Abuse Prevention (CSAP), and the Center for Mental Health Services (CMHS)--invest substantial resources in other programs that address the needs of people who have HIV/AIDS or are at high risk for the disease. CSAT, for example, offers grants for "Rural, Remote, and Culturally Distinct Populations" and grants for "Critical Populations." for a list of grants on AIDS available from SAMHSA, call the National Clearinghouse on Alcohol and Drug Information at 1-800-729-6686 or the National Mental Health Services Knowledge Exchange Network at 1-800-789-2647. Contact your state's office on substance abuse or mental health for information about SAMHSA's block grants to states an territories.
In our companion editorial, Patricia Fleming reviews the data for minorities and the tragic story these statistics tell about HIV in our communities.
Our people--African Americans, Hispanics, Native Americans, Asian Americans, Pacific Islanders--know this story in their hearts. We know that AIDS is spreading among children and adults, men and women, straight and gay. We know that AIDS does not "see" race, gender or sexual orientation. But still, too many people think the disease can't affect them.
This attitude of denial must change. Our communities must address AIDS in an informed and collective manner. For those already involved in this effort, we applaud you. For others, we ask that you join us. I know that minority communities receive limited health funding, and that AIDS is not always on the top of the list among people who worry about jobs or housing. Yet, we do have proof that AIDS prevention programs can succeed if they are based on sound scientific and cultural perspectives.
We must recognize that the federal government's role in prevention and service provision is changing. There is a shift to the state level. In the coming months, you will hear more about block grants, or "performance partnerships." This means that states would be able to choose from health objectives suggested by the federal government, or determine their own. State would be relatively free to determine action plans. The federal government would be more concerned with outcomes than strategies.
But you cannot wait for federal or state government to come to you and ask, "What do you think?" You must go to them and say, "This is what we think!" By participating in planning committees and attending public hearings, you can become a part of developing your state's performance partnership plans.
If you don't know how to contact your state health policymakers, your state minority health office, or your local AIDS service organization, call our OMH Resource Center (1-800-444-6474), and we'll put you in touch with the right people.
HIV disease is devastating our communities and will continue to do so. Today, there is no cure, only prevention. Prevention works, but only if our brothers and sisters hear the message. And the only way they will hear the message is if we all commit to telling and re- telling the prevention story. The future is now.
In June, our nation passed a milestone as we entered the fifteenth year of the AIDS epidemic. We have lost more than 300,000 men, women, and children to a disease that was not even in the medical books in 1980. Among those are more than 100,000 African Americans and more than 60,000 Hispanics/Latinos.
The AIDS epidemic continues to sweep through communities of color. In 1994 alone, African Americans diagnosed with AIDS represented nearly 40 percent of all cases in the United States. Hispanics/Latinos diagnosed with AIDS represented nearly 19 percent of all cases. Nearly three-quarters of women reported as having AIDS were African American or Hispanic/Latino. And seventy-nine percent of the children diagnosed with AIDS were African American or Hispanic/Latino.
Statistics like these demand action. In the last few years, the federal government has been aggressively fighting AIDS in minority communities. In the three budgets he has submitted to Congress, President Clinton has increased AIDS funding by 40 percent, despite the pressures of zero-growth budget. Included in that increase is a 33 percent boost in AIDS research and a 108 percent gain for the Ryan White CARE Act, which delivers primary care services to people living with HIV/AIDS.
But along with funding, we need leadership and vision. That's why we have been working closely with the National Minority AIDS Council to develop new strategies for AIDS prevention. One such program that I am excited about encourages minorities infected with HIV to get early treatment with antibiotics that can prevent Pneumocystis carinii pneumonia, the leading cause of death for people with AIDS.
We must pay close attention to our young people. Recent studies show that half of the new HIV infections in this country hit people under the age of 25, and a quarter affect those under 20. We also must do more for gay and bisexual males. A recent report shows that between 1989 and 1994, the number of cases affecting gay and bisexual African American men rose nearly 21 percent.
We must continue to search for better and less expensive treatments. Providing high-quality, affordable health care must remain a top priority. And as a nation, we cannot afford to slow our efforts to find a vaccine and a cure.
During some Indian ceremonies, a razor blade is used to obtain skin offerings. Sometimes, the same instrument slices the skin of more than one person. It's a dangerous practice given that fact that the human immunodeficiency virus (HIV), which causes AIDS, is transmitted through the exchange of body fluids.
Experts say that the appropriate response to such a risky behavior lies not in criticizing ceremonies that involve skin offerings or questioning their importance, but rather in supporting AIDS prevention activities based on Indian practices. The Minneapolis Indian Health Board, which receives funds from the Indian Health Service (IHS), distributes free, disposable razors and scalpels to discourage their reuse. This way, American Indians can keep cultural traditions intact and still maintain good health, according to Renee Whiterabbit, the AIDS coordinator at the health board.
It is true that the AIDS statistics for this group are discouraging, but some say the specific numbers are debatable. One possibility is that misreporting occurs because American Indians/Alaska Natives are put into other race categories. Still, what we do know is that the disease is burgeoning at rates that make the need for effective AIDS prevention and treatment efforts all the more urgent.
Health educators are discovering that for minority groups, the link between culture and health could be the key. In her work in Minneapolis, Ms. Whiterabbit finds that the traditional value of self-realization underlies successful AIDS education. "Simply talking about HIV and AIDS education is not going to be a catalyst for evoking change in American Indians," she said. "What will evoke change is finding that sense of self. You can have all the education in the world, but until you have that sense of self, that education won't do you a bit of good."
At the core of Ms. Whiterabbit's training is a discussion about the four parts of self: mind, body, spirit, and feelings. "In addition to talking about how we can protect both the mind and the body from disease," she added, "we go into loss issues that are specific to our community, like how loss of land and loss of culture affect our attitudes about health."
Jane Wilson, a regional program consultant with the Public Health Service, echoes the strong interrelationship between culture and well-being. "You really have to bring in the whole realm of sprituality when talking about AIDS," she said. "You can't expect Native Americans to look at AIDS as something separate from their religion or history."
Wilson cites the Native Americans Against AIDS Project as noteworthy for employing a cultural approach that worked. The University of North Dakota (UND) received three-year funding from the Bush and Northwest Foundations to provide HIV/AIDS education to tribes in North Dakota. The university awarded five mini-grants of $2,000 to each reservation every year for three years. UND staff trained reservation members to work with project facilitators, lead training sessions, and empower fellow tribe members. These roles as health educators proved central to the project's effectiveness, Wilson said.
Because an Indian person represents each tribe, participants could better relate to messages about AIDS. And each advisor adapted general goals of the project to the specific needs of the tribe, insted of making the common mistake of lumping all communities together. "What works for one tribe might not work for another," Wilson warns. "That's why it's important to get the people affected involved in the problem-solving."
This same philosophy of giving the power to the people is the framework of the National Native American AIDS Prevention Center (NNAAPC), an organization directed and managed by and for American Indians, Alaska Natives, and Native Hawaiians. The center operates a hotline and clearinghouse, maintains statistics compiled by the Centers for Disease Control and Prevention, and conducts training for AIDS trainers. Traditional healing in connection with AIDS treatment was on the agenda of a recent NNAAPC training session held in Hawaii.
The center publishes and distributes several publications. Seasons is the quarterly newsletter, and program guides for health and human service workers and patients are available. One handbook, Living With HIV Infection, covers how to cope after testing positive for the virus and describes the stages of AIDS.
For more information about the National Native American AIDS Prevention Center, located in Oakland, California, call 1-800-283- 2437, 510-444-2051.
Dolores, a Latina, is in recovery after three years of intravenous drug use. She has AIDS and recently has been very sick. Her family members won't take her in because they believe God is punishing her for a shameful life. What would you do if she came to you for help?
This scenario is among those that mental health professionals explore for the ethnic minority portion of an AIDS training curriculum developed by the American Psychological Association's (APA) HIV Office for Psychology Education (HOPE). Since 1991, HOPE has been funded by the Center for Mental Health Services (CMHS), a division of the Substance Abuse and Mental Health Services Administration (SAMSHA).
The entire curriculum consists of a general psychosocial overview and specialty tracks on six populations; ethnic minorities; gay and bisexual men; chemically dependent people; women; children and adolescents; and people who are seriously and persistently mentally ill. The ethnic minority track encompasses African Americans, Hispanics/Latinos, American Indians/Alaska Natives, and Pacific Islanders.
In training psychologists who work with AIDS patients, the HOPE program acknowledges that with AIDS comes a host of complex psychological problems. It's a reality that others have been slow to accept, according to John Anderson, PhD, director of HOPE. "APA sees AIDS as more than a physical disease," he said. "Since the early 80s, the association has been addressing the behavioral and mental aspects." As in the case of Dolores, for instance, stress that can result from rejection by family is often piled on top of a person's physical deterioration. And when your family structure is an integral part of how you define yourself, the combination of physical and mental pain is usually too much to bear alone.
The ethnic minority track was identified by curriculum designers as essential, Dr. Anderson said, "because most of the models developed have been for gay, white men. People are realizing that those models don't work for communities of color." The APA curriculum initiates a discussion about the cultural values that influence assessment of clients and review diverse viewpoints about illness, death, and spirituality.
Participants are challenged to consider the role of such cultural variables as language and sex. They also practice putting information about patients into a variety of contexts--individual, family, community, cultural, economic, and political. The workshop uncovers that pitfalls that decrease cultural competence, such as retaining stereotypes. And it promotes the tools that increase cultural competence, such as using an interpreter in a counseling session if it make a client feel more comfortable.
After taking the APA "train the trainer" course at regional sessions, HOPE program trainers return to their communities to train at least 30 others. So far, approximately 4,000 mental health workers have been instructed in the curriculum. That number will grow since the contract from CMHS was renewed in January, Dr. Anderson said. Under the new contract, the HOPE program will train past participants in an additional specialty track. APA is also recruiting 50 new regional trainers, especially in states without HOPE representation: Maine, Vermont, Hew Hampshire, Connecticut, West Virginia, South Carolina, North Dakota, South Dakota, Iowa, Wyoming, and Utah.
For more information about APA's HOPE program or an application to be a regional trainer, call 202-336-0657.
As the HIV/AIDS program coordinator at the Mariposa Community Health Center in Nogales, Arizona, Terry Mendez takes pride in the progress she's making to decrease AIDS risk and increase AIDS education among Hispanics and Latinos. The Mariposa center is the lead agency in the Nogales HIV/AIDS Education Coalition, a grantee of the Office of Minority Health. Three times each month, SENY, a Spanish-language station just across the border in Mexico, devotes 15 minutes of air time to a forum on AIDS education coordinated by Ms. Mendez. Hosted by experts and health center staff, the radio program has delved into risk factors and modes of transmission. Guest speakers have run the gamut, from a priest to a dentist. Mendez says she is pleased with the feedback. "When kids tell me they heard me on the radio and ask me for more information, I know that what we do make a difference." To learn more about the Mariposa Community Health Center, call 602-761-2147.
If a person living with AIDS in the United States doesn't speak English very well, describing symptoms and understanding a doctor's diagnosis can be impossible. It goes to show that a desire to receive medical treatment isn't always enough. Cultural factors can strongly influence access to health care, according to the Health Resources and Services Administration (HRSA).
In 1992, HRSA formed work groups that set out to assess factors that affect access to health care and to evaluate the HIV/AIDS services delivered under the Ryan White Comprehensive Resources Emergency (CARE) Act. Groups were asked to identify technical assistance needs and draft evaluation study designs.
Titles I, II, III-b, and IV of the CARE Act, which are administered through HRSA, were passed into law on August 18, 1990, and provide grants to eligible metropolitan areas (Title I), states and territories, and demonstration projects (Title II), medical providers (Title III-b), and maternal and child health programs (Title IV).
Members of HRSA work groups included CARE Act grantees, physicians, social workers, and people with AIDS. Several meetings were convened over a three-year period through the Office of Science and Epidemiology and the Division of HIV Services, both within HRSA.
The populations selected as part of the evaluation are those that have experienced stumbling blocks to receiving health care because of race, ethnicity, gender, and sexual identity. These groups are African Americans, American Indians and Alaska Natives, Asians and Pacific Islanders, Hispanics/Latinos, women, and gay and bisexual men of color.
Problems of access the work groups identified include patients' reluctance to seek care because of the stigma of having AIDS, the failure of program planners to take cultural attitudes into account, and the failure of health professionals to consider the implications of migration, especially for Puerto Ricans and other border groups.
HRSA recently published a summary from the work group that focused on African Americans. That meeting was held in Maryland in 1993. Participants put the evaluation of health care services and beliefs about services into a historical context. The history of discrimination that African Americans have endured was explored in discussing African Americans' attitudes about the government and AIDS. Some African American can't imagine that the government is interested in helping, the summary indicates. And then there are some who have unresolved questions about whether AIDS is a man-made disease that was brought into minority communities as a way to perpetrate genocide.
To prepare medical and social service workers to address these cultural attitudes, work group participants propose increasing training in cultural competency. This would raise the chance that a person living with AIDS will remain in care and experience a higher level of satisfaction with a service provider.
HRSA staff members reported learning that reducing barriers to HIV care or any health care is more than just increasing access to treatment. It requires developing strategies that create services deemed acceptable by the people who use them.
To request a copy of the "Work Group on Health Care Access Issues for African Americans," call 301-443-6560.
The National Institute of Allergy and Infectious Diseases (NIAID) has announced the launch of three new research projects to develop topical microbicides that prevent the spread of sexually transmitted diseases (STDs), including AIDS, in women.
Topical microbicides are chemicals that a woman can insert in her vagina before sexual intercourse to thwart infectious microbes that cause diseases such as gonorrhea, syphilis, and HIV infections.
NIAID notes that the products on the market that aim to prevent STDs have limitations, and the cultural issues are among the factors that affect a woman's ability to successfully use protection.
NIAID is part of the National Institutes of Health, U.S. Public Health Service. For more information about these projects, write to the NIAID Office of Communications, Bldg. 31, Room 7A-50, Bethesda, MD 20892.
There are times when staff members at the Asian AIDS Project roam the streets of San Francisco until 7:00 in the morning delivering AIDS education. "Working odd hours is our way of adjusting to community needs," said Dominic Perez, a program coordinator with the project. It also affirms his team's commitment to reducing the spread of AIDS.
The Asian AIDS Project, an OMH grantee, carries out an AIDS case management and education program that targets limited-English- speaking Asians and Pacific Islanders. Through outreach and the distribution of education materials, the project targets four groups: men who have sex with men, women working in massage parlors, youth in detention, and transgenders.
Peer education has been particularly successful at the Asian AIDS Project because of its snowballing effect. "Our audience has really expanded because people are talking to friends who in turn talk to friends," Perez explained. Peer education has also served as a good forum for exploring cultural issues. The Asian AIDS Project mainly works with recent immigrants. The program sets up opportunities for interaction between people who know how it feels to deal with AIDS while also dealing with assimilation.
Proof that such incorporation of cultural sensitivity in health programs is necessary can be found in feedback clients give the Asian AIDS Project. "Some feel that they can't seek medical help at a certain place because their English skills aren't good enough," said Perez, who noted that his project offers translation services in several languages.
Other barriers to health care are rooted in health professionals' lack of cultural knowledge, he added. "Some Asians and Pacific Islanders speak softly as a sign of respect, and they're put off when a doctor yells at them to speak up." To help eliminate the factors that impede access to care, staff members at the Asian AIDS Project provide linkages between their target populations and health service providers.
For more information about the Asian AIDS Project, call 415-227- 0946.
The Public Health Service's National AIDS Program Office is now called the Office on HIV/AIDS Policy (OHAP). OHAP is located at Room 733E, Hubert H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201. 202-690-6248.
In March, the American Indian Health Care Association submitted a paper on HIV/AIDS to the Office of Minority Health. Some of the points and recommendations:
The National AIDS Office of the Indian Health Service (IHS) is committed to blending AIDS prevention and treatment with Indian culture, according to Emmett Chase, M.D., M.P.H., the AIDS Coordinator. The office contracts with tribal organizations and tribal health boards, he said, with goals of decreasing high-risk behavior and delivering AIDS education at the community level. The office distributes funds to 12 area regional coordinators who run prevention and treatment programs. "We want to make sure that service provided by these coordinators is efficient and fair," said Dr. Chase. Working toward this end, the National AIDS Office is in the midst of assessing and revising the way it distributes funds. "Previously, funding was divided equally among the 12 regions," Dr. Chase explained, "but concern was raised about whether this was fair since so many things factor into funding needs." So in its new funding formula, the AIDS Office plans to take several variables into account, such as the size of the service population and travel costs for coordinators who have larger regions to cover.
For more information on the IHS National AIDS Office, call 505- 837-4116.
Drs. John and Loretta Jemmott, an African American husband and wife team, created and evaluated a six-hour intervention called "Be Proud! Be Responsible!"
African American males, ages 12-19, participated in the program and reported less risky behavior than did those in the control group three months after the program began.
Participants had sexual intercourse on fewer occasions and with fewer women. Those who had sexual intercourse used condoms more consistently and a smaller percentage reported engaging in anal intercourse.
Based on cognitive theory, the theory of reasoned action, and the theory of planned behavior, this intervention is interactive and uses videos, role plays, and condom demonstrations.
One the basis of findings published in The American Journal of Public Health, CDC has identified the program as effective.
Representatives from 20 states attended a training session so they can train others to deliver the curriculum. Original trainers are available to those interested in receiving training.
To order copies of the curriculum and a kit of materials, including videos, call 1-800-225-4276. For training information, call the Rocky Mountain Center for Health Promotion and Education at 303- 239-6494. For information on the study, call Dr. John Jemmott at 609-258-1110.
Project CARES (Comprehensive AIDS and Reproductive Health Education Study) is a five-year, multi-site study to prevent primary infection of HIV in women and infants.
With sites in Baltimore, Philadelphia, and San Francisco, this project currently evaluates clinic-based interventions for the prevention of HIV infection and unintended pregnancy.
Trained peer health advocates provide reproductive health counseling based on an established theoretical model of behavior change.
Drawing on social psychological theory, interventions are designed to facilitate reproductive decision-making; promote consistent and correct condom use for disease prevention; and assist women who choose to prevent pregnancy.
Project CARES offers services and individual counseling to women in drug treatment facilities, homeless shelters, and clinics. Since the intervention began in March 1993, approximately 1500 women have been enrolled in the study.
Preliminary indications show that participants are receptive to receiving counseling services from peer advocates.
A study, funded by the Behavioral Research and Evaluation Program Targeting Communities of Color, is being conducted to evaluate the male role in HIV/STD prevention and reproductive decision-making. Community-based organizations are helping to recruit minority couples to participate. Qualitative research methods will assess communications patterns and expectations in relationships. This study is being conducted in Los Angeles, California, and Baltimore, Maryland, in collaboration with the Pacific Institute for Women's Health (California) and the Cultural Systems Analysis Group from the University of Maryland at College Park (Maryland).
Through a collaborative effort with the National Institutes of Health and the University of Alabama, CDC is conducting research on the female condom. The study will investigate the behavioral determinants of consistent and correct use of the female condom among women who are at increased risk for sexually transmitted disease and HIV. Findings from the research will help develop recommendations for counseling strategies to facilitate consistent use of the female condom.
Fore more information on any of these research and outreach activities, contact CDC's HIV/AIDS Office, 1600 Clifton Road, NE, Atlanta, GA 30333, 404-639-0906.
These days, who doesn't feel the squeeze of tight budgets and shrinking staffs? Fortunately, the Technical Assistance Services to Communities Project is providing some relief.
The Center for Substance Abuse Prevention (CSAP), an agency of SAMHSA, operates the project. It offers free technical assistance to organizations that provide or would like to provide alcohol, tobacco, and other drug prevention services.
According to David Banks, PhD, deputy director of the project, the term "organization" is considered loosely. "Recipients or our services have ranged from health program coordinators at universities to a group of concerned mothers who wanted help organizing a drug prevention program for youth members at their church."
In the face of rising death rates due to health conditions related to substance abuse, communities are increasingly looking for convenient and cost-effective ways to implement education and prevention programs, said Dr. Banks.
CSAP's technical assistance project lends support on-site or off- site by supplying people with experienced consultants at no charge. Consultants are available to help programs address management and evaluation needs. They can also help with grantsmanship, fundraising plans, coalition building, financial and strategic planning, and multicultural communication. And expert speakers can serve as panelists and facilitators for conferences and workshops.
"We support substance abuse prevention efforts in communities all across the country," said Robert Harrison, the project director. "This includes strengthening programs already in existence and helping people just starting out." Harrison, who has worked for more than 28 years in the area of substance abuse prevention, has experience providing technical assistance to grantees of CSAP's High Risk Youth Demonstration Grant Program, with a special focus on minority communities.
This CSAP technical assistance project also strives to reach minorities, including faith communities and historically black colleges and universities (HBCUs). The project specifically targets organizations that are not currently funded by CSAP's demonstration grant programs, Harrison said.
For example, the National Association for Equal Opportunity in Higher Education (NAFEO), an umbrella organization made up of 117 HBCUs, has called on CSAP for assistance.
Millie Freeman, director of health education at NAFEO, said the CSAP consultants designed an evaluation and provided conference support for the substance abuse component of an HIV/AIDS peer education program, held at Hampton University in Virginia. "It's extremely beneficial, especially if you have limited funds to pay speakers and trainers," she added.
So how do you get the ball rolling to access these services? Organizations are invited to call the CSAP Training Project and request an application. For callers who need help structuring goals and finding a consultant, project staff members are available to give guidance. On the other hand, some requestors already have an expert in mind. In such instances, they should identify the consultant of their choice and submit that person's resume along with the application.
In locating consultants, the project considers an organization's unique situation. You might want the services of someone who is bilingual or someone from a particular minority group. In cases where a consultant must make an out-of-state visit, the project picks up travel costs.
Applications must be submitted 30 to 45 days before the proposed technical assistance event. They are evaluated on the basis of whether the proposed activity/event is clear, concise, and complete; whether the application reflects a specific, concrete, and realistic plan for using consultants; and whether the planning time is limited and achievable, and presents an objective and measurable prevention outcome.
To discuss your technical assistance needs and request an application, call the CSAP Training Project at 301-495-1591, ext. 244.
CDC National AIDS Clearinghouse, PO Box 6003, Rockville, Maryland 20849-6003, Publications: 1-800-458-5231. CDC National AIDS Hotline, Information: 1-800-342-2437. Spanish Hotline: 1-800- 344-7432.
National Council of La Raza AIDS Center. 1111 19th Street, NW, Suite 1000, Washington, DC 20036, 202-785-1670.
National Native American AIDS Prevention Center. 2100 Lake Shore Avenue, Suite A, Oakland, California 94606, 1-800-283- AIDS.
American Indian Health Care Association. 1550 Larimer Street, Suite 225, Denver, Colorado, 303-607-1048.
Gay and Lesbian Medical Association. 273 Church Street, San Francisco, California 94114, 415-255-4547.
Minority AIDS Project. 5149 West Jefferson Boulevard, Los Angeles, California 90016, 213-936-4949.
People of Color Against AIDS Network. 4900 Rainier Avenue South, Seattle, Washington 98118, 206-721-0852.
National Black Women's Health Project. 1237 Abernathy Boulevard, SW, Atlanta, Georgia 30310, 404-758-9590.
National Minority Aids Council. 1931 13th Street, NW, Washington, DC 20009, 202-483-6622.
National Association of People with AIDS. 1413 K Street, Seventh Floor, SW, Washington, DC 20005, 202-898-0414.
AIDS Action Council. 1875 Connecticut Avenue, NW, Suite 700, Washington, DC 20009, 202-986-1300.
The Cleveland Foundation supports community programs that address AIDS prevention. Funding is limited to Cleveland area. Initial approach letter and two copies of the proposal are required. Deadline: Next deadlines are September 15 and December 31. Contact: Cleveland Foundation, 1422 Euclid Avenue, Suite 1400, Cleveland, Ohio 44115, 216-861-3810.
The National Institute on Drug Abuse, part of the National Institutes of Health, supports programs of research and services to drug abusers at high risk for HIV/AIDS. Applications may be submitted by for-profit, non-profit, public, and private organizations. Deadline: September 1. Contact: The Office of Grants Information, Division of Research Grants, National Institutes of Health, 6701 Rockledge Drive, MSC 7762, Bethesda, MD 20892, 301-435-0714.
The Chicago Resource Center provides funding for battered women and gay, lesbian, and AIDS organizations and programs. Funding is for small community-based AIDS prevention projects and open to non-profit organizations that have budgets less than $100,000. Deadline: September 29. Contact: Chicago Resource Center, 104 South Michigan Avenue, Suite 1220, Chicago, IL 60603, 312-759-8700.
The Milwaukee Foundation funds programs covering several topics, including AIDS and drug abuse. Giving is limited to Wisconsin. Initial approach letter and application form are required. Deadline: Next deadline is in October. Exact date to be determined. Contact: The Milwaukee Foundation, 1020 North Broadway, Milwaukee, WI 53202, 414-272-5805.
Closing the Gap is published by the Office of Minority Health Resource Center, a service of OMH. If you have comments please call 1-800-444-6472 with comments, write to OMH-RC, P.O. Box 37337, Washington, DC 20013-7337, or e-mail us at info@omhrc.gov.
Editor Blake Crawford Copy Editor Symra Spottswood Writer Michelle Meadows
Last Modified: July 8, 1996
The Office of Minority Health Resource Center
E-Mail: info@omhrc.gov
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