HIV infection rates are down everywhere but the South
Two partially used syringes and needles are seen as Rocky Meadows, left, former addict and founder of Lifehouse treatment and recovery center, walks with two former addicts along rail tracks where addicts use drugs on Oct. 2, 2019, in Huntington, West Virginia. Ricky Carioti/The Washington Post via Getty Images
A new federal grant program looks to improve health equity in Southern states for vulnerable populations like individuals of color and members of the LGBTQ+ community.
New HIV infection rates have been declining in the U.S. for nearly a decade, thanks in large part to more widespread testing, increased access to treatments and safe sex education. But the progress health officials have made has not been equal: Marginalized communities in the South are lagging.
Indeed, of an estimated 31,800 new HIV infections in 2022, 49% were located in the South, according to the Centers for Disease Control and Prevention. Black and Hispanic/Latino individuals were most impacted, accounting for 37% and 33% of those new cases, respectively.
In an effort to tackle the disparity among marginalized communities, the federal government has announced a $1.6 million grant. The U.S. Substance Abuse and Mental Health Services Administration, or SAMHSA, plans to distribute funds to four awardees that will receive up to $400,000 annually for three years, according to a notice of funding opportunity released late last month.
But the federal government is going a step further by encouraging applicants to implement a syndemic approach to improve preventative health systems and services for HIV infections and substance use disorders. That’s because an individual using a syringe to ingest drugs has a higher risk of contracting or transmitting HIV and other infections if they share a dirty needle with others. In fact, individuals who share needles constitute about 1 in 10 HIV diagnoses. Plus, individuals experiencing those challenges are more likely to face adverse social determinants of health—or nonmedical factors impacting an individual’s well-being—such as being low income and unable to afford health and treatment services.
A syndemic approach “looks at the fact that folks can experience multiple health conditions that connect to each other at the same time,” said Rob Morrison, executive director of the National Association of State Alcohol and Drug Abuse Directors. “On top of that, they can be experiencing challenges outside of their health conditions that make it difficult to either prevent those conditions or get help early on.”
Using a syndemic approach, Morrison said public health officials can more effectively “treat people holistically, not just addressing health and substance use disorders, but also … social determinants of health.”
To do that, the funding program calls for applicants “to implement innovative and multipronged approaches to prevention activities that embrace culture and deliver trauma-informed practices,” according to the funding notice.
Applicants are encouraged to, for instance, collaborate with “nontraditional and unconventional prevention spaces” to initiate and implement mental and behavioral health services among vulnerable residents. Those spaces could include barbershops, child care and child development centers, nail or hair salons, vape shops, and others that inform and connect individuals with available resources and services to address their physical and mental health conditions.
With the funding, recipients can also develop peer support groups to assist individuals on their recovery journeys, implement telehealth services to connect geographically isolated communities to health supports, provide communities with harm reduction supplies like naloxone or HIV testing supplies, and finance outreach and education campaigns, among other approaches.
By prioritizing preventative care, Morrison said governments could see cost savings across the health care landscape, such as a decrease in emergency department expenses. The criminal justice system stands to see reduced costs in housing and health care as well, if fewer individuals with a substance use disorder or mental health condition are referred to prisons and jails.
Grant recipients must report to SAMHSA data on the number of individuals screened for infections like HIV, linked to social services like food or housing assistance, referred to substance use or mental health treatment services, and other metrics, to measure their project performance.
When applying, applicants must provide a demographic profile of their population of focus, including gender identity, sexual orientation, socioeconomic status, race and ethnicity and other descriptors, according to the funding notice. They are also required to identify where health and well-being services will be delivered based on local needs, such as service gaps and disparate health outcomes among historically underserved populations.
State governments, U.S. territories, tribal governments and organizations, health facilities, and public or private nonprofits are eligible to apply.
Applications are due Aug. 28.
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