HIV Prevention Programs: Perspectives from the Front Lines


Uploaded by CDCStreamingHealth on 03.08.2012

Transcript:
>> Barbara Harrison: Good evening.
>> Audience: Good evening.
>> Barbara Harrison: My name is Barbara Harrison and I'm Director of External Affairs here at the Martin Luther King
Center. And I just want to welcome you out, let you know that we are so pleased that you're here. We consider you and
you are one of our partners, so we have a long-standing relationship with you.
And I know when Mrs. King started the King Center in 1968, this is one of the things that she had in mind, that we would
have these types of relationships, that we'd have these type of gatherings where people would come together and be able
get information, give information and be able to help the community. So we're so pleased that you're here. You could
have been a lot of other places, considering the weather and everything that's going on and after a long day, but we're
glad that you're dedicating and that you're hearing part of this. And I was just looking at a lot of the materials and
you just have extensive materials and just a wealth of information, and so I know this part of your series is going to
be very excited and something that's going to be very informative.
I'll just be here at the front part. I thought it was going to be on a different day. I was really looking forward to
being a part, I won't be able to stay but a couple of minutes, because I have another engagement, but I'm looking
forward to getting some of the information follow-up, so I can definitely find out more about what's going on and what
you are doing and the changes that I know that you're going to make.
So as part of what we call Dr. King's memorial here, a living memorial and to his legacy to educate, to train people, we
know that you're part of that and on behalf of Martin King III and our new Chief Operating Officer, Mr. Robert -- Dr.
Robert Adams, I just want to say welcome to the King Center and we hope that you enjoy your evening here and come back.
I'm sure many of you have been here many times or at different times and some of you it may have been a little while, so
we want you to come back when you have a little more time and when our book store and resource center is open and you
have an opportunity to do that.
Also, I have a few flyers out about the upcoming event in Washington, where we have the dedication, the unveiling of the
memorial of Dr. Martin Luther King on August the 28th and we would like for you to reach out to us and get more
information, because we would love for you to participate in that. So thank you and welcome. (applause)
>> John Douglas: Good evening, everyone. I'm very pleased to be here. I'm John Douglas, from the Centers for Disease
Control and Prevention, and I want to welcome you on behalf of our organizational units involved in producing this
lecture series, the Division of HIV and AIDS Prevention and the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.
I want to echo Barbara's remarks. There's lots of things you could have been doing tonight, although this is a pretty
cool auditorium on a night that's as hot as it is out there. It's terrific that so many people have showed up this
evening for what we hope is going to be a really engaging evening of discussion.
This is part of a lecture series that CDC has organized with partners this summer to commemorate a fairly important
landmark in the epidemic of HIV/AIDS in this country, the 30th anniversary. And I wanted to just begin with a couple of
reflections about HIV/AIDS. I was talking to Donato, who's going to be our moderator, who is only 34 and I'm almost 59
in two days. And so I was around at the dawn of time of the HIV/AIDS epidemic and this 30-year business and pretty sobering.
You know, it's both a somber time. We have an epidemic that is very much still with us. We have over 600,000 people
that have died in this country in the last 30 years. We have over a million, 1.2 million that are infected and living
with HIV/AIDS. We have over 50,000 people a year are getting infected. So new parts of the epidemic are still very
much with us and of course this is a global situation. When you look at those global figures, it's staggers. Over 60
million people having been infected at some point during the last 30 years, half of them are now dead. Around 33
million people living with HIV and many thousands more many becoming infected each year.
But on the other hand, this 30-year business is really a time for in some ways taking stock and I think being positively
reflective. Within the last year we've done in this country what many other countries have done, but it took us a while
to get it together, which is produce a national strategy, the National HIV/AIDS Strategy, which is coordinating not only
work that health departments like CDC are doing, but what the entire government is doing.
We've got new prevention technologies. You're going to hear from a number of stellar community-based organizations
tonight about how they work with communities, but we've never had the repertoire of possibilities that we have now. We
don't have a vaccine yet, but the new antiretroviral drugs, not so new anymore, but new ones are better than the ones
before, have made what was a uniformly fatal illness 15 years ago into one that is not curable, but chronically manageable.
We've got these same drugs now offering tremendous possibilities for prevention. Just two weeks ago an announcement
that in relationships where one person is HIV infected and the other person's not, that taking medication, suppressing
your infection can reduce transmission by 95%. It's actually just strikingly extraordinary.
So I'm the CDC Scientist, in the parliaments of some, a government bureaucrat. I was the previous Director of our
Division of STD Prevention, where we worked very hard to try to enhance HIV Prevention. And I'm now, as I was sharing
with one of our speakers a few minutes ago, having the opportunity to try to bring the programs that we're doing at CDC
together in a framework that's trying to look at what we do with prevention through more of a lens of wellness. Sexual
health is a concept we're trying to promote as opposed to the more stigmatizing ways that we've dealt
with various diseases in the past.
But I want to close by noting that where I really get my grounding in terms of public health and HIV/AIDS is about a
mile from here. About every three weeks I volunteer at the Brady HIV/AIDS Clinic and although I think I do great public
health work and I think CDC does that, as well, when I have the opportunity every three weeks to sit down with people
that are living with the infection that somber and that positive stuff all comes together. The somberness of having the
infection, you've got to be attentive to your whole life, but that incredible hope that folks that have been able to
live with HIV and bring it under control really weekly or at least every three weeks, teach me an extraordinary amount.
I'd like to introduce our moderator for the evening, Donato Clarke. You already know that Donato is young and spry and
you'll enjoy meeting him. Donato has been involved in HIV/AIDS community work for more than 13 years as a community
advocate. He currently serving as the Special Projects Coordinator at the Georgia Department of Public Health, where
he's responsible for coordinating activities related to Atlanta's enhanced comprehensive HIV prevention plan and
Georgia's response to the national HIV/AIDS strategy that I just mentioned.
Donato is a native of Atlanta, he knows our city well. He obtained his Bachelor's in Business Administration from
Georgia State. Donato has been recognized for his academic achievement and involvement in public administration and
community service. And it's an extraordinary pleasure to have him moderate tonight's session. Please join me in
welcoming Donato Clark as our moderator. (applause)
>> Donato Clarke: Good evening, everyone. How is everyone doing?
>> Okay.
>> Donato Clarke: This is going to be a great session tonight and I'm very looking forward to it. We have some great
speakers tonight. And without further adieu, I will introduce our first speaker, Ms. Neena Smith-Bankhead.
Neena Smith-Bankhead is currently the Director Department of Education and Volunteer Services at AID Atlanta and is
responsible for oversight of all HIV staff and program focusing on prevention education for HIV. The program
incorporates behavioral interventions, community activities and HIV/STD screening services for the metro Atlanta area.
A native of Philadelphia, Pennsylvania, Neena received her Bachelor's Degree in Human Development and Family Studies and
a Master's Degree in Health Education from the Philadelphia -- I'm sorry, from the Pennsylvania State University. Neena
is also a consultant at The Messages of Empowerment, LLC, a Member of the Community Advocacy Board of the Hope Clinic at
Emory University, Abbott Pharmaceuticals Company, National Diversity Council for HIV Issues, a Volunteer of Education,
Department of the Georgia Lupus Foundation and a co-chair of the Higher Living Christian Church's Wellness Ministry.
She is also a new Board member of the Cos -- I can't say this, Comisa Care Inc., an agency that works with single moms
and their children. Neena's greatest accomplishment, however, is serving as a wife, a proud wife, and a mother of one son.
Ms. Bankhead will discuss a brief history of AID Atlanta and changes seen in the agency's organizational structure since
the early 1980s, including a discussion about the implementation of various behavioral interventions, a shift in target
population served by the agency and the change in needs of those members served. Neena will also highlight some of the
interventions and programs utilized by the agency to reach high risk members of our community focusing on innovative HIV
prevention messages, such as -- approaches approaching such as biomedical, that have evolved over the years and how AID
Atlanta continues evolving, specifically in relations with the integration of care and prevention services.
Ms. Neena Bankhead-Smith. (applause) --
>> Neena Smith-Bankhead: Good evening, everyone, and thank you all for coming out. And I just want to thank you all
for inviting AID Atlanta to be a part of this presentation this evening and I also want to just acknowledge, before I
get started, a few people who have had a very important impact or made a very important impact in my life.
So first I would like to acknowledge Ms. Jean Greer, who was the former Director of the Department of Client Services at
AID Atlanta a number of years ago and Jean was the person who actually gave me my first job in Atlanta in HIV Service
Provision, so I would like to acknowledge her, and at that time I wasn't even sure what to expect,
so I acknowledge her for the opportunity.
I would also like to acknowledge Miss Kim Anderson, current CEO of Families First and a former Executive Director of
AID Atlanta and I wanted to acknowledge Kim for trusting me when I said, "I think I can do this, give me a chance."
And I want to acknowledge her faith in me for doing so.
And then finally, I would like to acknowledge one of the co-presenters with me this evening, Ms. Dazon Dixon Diallo,
who was actually one of my earliest influences as an HIV Prevention. I met Dazon a few years ago when I was a student
at Penn State and her passion and her honestly about the HIV epidemic was definitely that thing that encouraged me to
stay in this field and to be as genuine and as open to this community as I could be. So thank you Dazon, for that. (Applause) --
It's because these ladies were here, that I am here. And so I just want to lift them up.
Now we're going to try to use the clicker. Ha.
I also want to acknowledge all of the people who came before me, who played a critical role in the development of AIDS
Atlanta. So as we all know, when AID Atlanta was founded in 1982, there was very little information about services and
HIV. There were a number of -- there was very little information about this mysterious illness. There were very few
supporter services. There was no treatment for HIV. There was a lot of fear. And the gay community was very
marginalized and stigmatized at that time, so there was a lot of bigotry,
a lot of discrimination and it was very troubling political times.
And so a number of very courageous and dedicated people in the community at that time decided that Atlanta needed a
place for people to be safe and to get the care, there needed to be a place for everyone because at that time there was
nowhere for people to go. I also learned during my research that there were really very few doctors that would even
treat people with HIV in the Atlanta area at that time and so that was a very troubling time for the epidemic.
So in 1982, due to the efforts primarily of a number of grass root organizations, community activists and volunteers,
people started to come together to form the early AID Atlanta.
And there is a number of stories about some of the founders and early executive directors of the agency, but I think one
of the most important stories that I want to share is about one of our founders, Mr. Graham Burton, who actually wanted
to help gay men's health crisis at that time. His focus was on raising money and providing services and supporting
their efforts. And he actually called the Executive Director of GMHC and said, "hey, I'm coming up to help you all,
what can I do?" And that person told him, "you go ahead and keep your money, keep your resources, you all are going to
need that in Atlanta very soon." And those were the early days of AID Atlanta's founding.
And so how it all got started and the call to action was where a number of very committed and dedicated and unsung
heroes came together to do this work. And so I wanted to lift up these two organizations because I believe that in our
community a lot of times there's a lot of concern about whether AID Atlanta's early history involved a number of very
relevant and powerful African American-based organizations and these were two that I learned about during my research,
as well as some other very prominent Atlantans, like Sandra McDonald, who was a member of AID Atlanta's Board of
Directors in some of the early days. Organizations like Black and White Men Together, African American Lesbian and Gay
Alliance, really helped to form the early days of AID Atlanta.
AID Atlanta's focus at that time, because there was such a lack of information and there were so few resources really
focused on providing awareness, providing education and healthcare providers and a lot of education and information to
people who worked with people who may be living with HIV. There were also a number of social services that were being
provided. The Buddy Program and Referral Services and again, all of these services were primarily provided by volunteers.
In the early '80s, two other organizations -- I'm sorry, I skipped a -- two other programs of AID Atlanta that were
some of the early services provided by the agency were our pastoral care program, which primarily provided support to
those people who at that time were dying of AIDS. Our AIDS 101 program, which is still in existence at this time, but
at the time it really focused primarily on prevention and some of those awareness campaigns, death and dying and
bereavement related services, which is very different than our focus today. And then our AID Atlanta hotline, which
was established also in the early '80s, was primarily volunteer driven and in the early days of the epidemic was really
a local based hotline service.
I'm actually jumping around a little bit. And also in the early '80s, just a couple other points that I want to share.
DHR started funding -- DHR is the Department of Human Resources, it's the State Health Department, they actually started
funding that local hotline and helped it to become a national hotline in some of those earlier days. And so the Georgia
AIDS Infoline was formed in the early '80s.
AID Atlanta started providing case management services due to a grant from the Robert Wood Johnson Foundation and the
first $400,000 grant was provided through that organization. AID Atlanta was also instrumental in bringing the AIDS
quilt to the Atlanta area.
We all know that in the '90s, many of us know and many of us actually were doing work at the time when Magic Johnson
disclosed that he was living with HIV. This is a pivotal time in the epidemic's history because as a result of Magic
Johnson talking about his status, we started to recognize that some of the early misconceptions of who gets infected
with the virus and who is the most challenged with the virus, Magic Johnson's disclosure actually helped us to recognize
that HIV wasn't just for one group, but anybody could become impacted.
And what's really interesting, just a little point to note that in December 1991, the month after he talked about his
status, our little small hotline had 11,000 calls in one month. Now can you imagine how many calls that is? We
currently have a very busy hotline, three full-time staff and we probably get about a thousand calls each month, so we
had about a thousand times more calls at that time.
Also, just wanted to point out in the early 1990s, AID Atlanta had its first AIDS walk and protease inhibitors, another
very prominent point in the history of the HIV and AIDS epidemic, started to become available in 1995, 1996. And also
just wanted to lift up one of our former Executive Directors, Ms. Sandy Thurman, who was also appointed by President
Bill Clinton as the Director of the national AIDS Policy. These are all really important things that happened in the
early '90s because it really had an influence on shaping how AID Atlanta would provide services in the next timeframe.
And I just wanted to list a few of the programs that AID Atlanta provided again in those early days in the early '90s.
Also just wanted to mention reconstruction because as a result of protease inhibitors, some of the focus of our
education programs also shifted. So instead of only focusing on death and dying and bereavement services, in the '90s,
AID Atlanta created a program called reconstruction, where the purpose was to help people get back to work, because as
you can imagine, so many people were dying and dying so quickly in the '80s, that the focus really was on making them
comfortable. So in the '90s, once treatment was available, people weren't dying as quickly, people weren't dealing with
the same kind of issues and a number of people actually sold their resources and everything and decided that since they
were going to die anyway, that they didn't need it. And so we needed to help people learn to live again and that is
what we did in the '90s.
And so in the year 2000, or in the 21st century, AID Atlanta made another pivotal shift and one of those pivotal shifts
was when the agency recognized that we needed to be more active in getting the African American community involved in
the epidemic, not just being the people most impacted, but actually having an impact on changing how services were
provided to the community and changing how people view the agency. And so AID Atlanta hired our first African American
Executive Director, Ms. Kim Anderson. And a number of firsts happened as a result of Ms. Anderson's tenure with AIDS
Atlanta. One was that we initiated our STD program, which was very important. We also started to partner with some
international organizations and we also had a very strong focus and started to really think about the needs of young
African American gay and bisexual men.
Also under Ms. Anderson's direction and at that time AID Atlanta determined what our most important services were as an
agency. At that time in the early 2000s, the CDC was talking a lot about their initiative called Advancing HIV
Prevention, which had a very strong focus on making HIV testing a routine part of care, having some innovative ways of
testing people for HIV and focusing on prevention for positives. This had an impact on AID Atlanta's work and at the
same time, we were also looking at how we could make HIV testing and counseling more accessible and accessible to our communities.
So with a generous grant from the Healthcare Georgia Foundation, we were able to increase our capacity and do a lot of
adjustments to our testing and counseling program so that we could provide additional services. And I'll just share
with you that in 2001, we tested roughly 1200 people a year for HIV. And currently, according to our most recent
statistics from 2010, we test 6000 people per year for HIV. So we've increased our testing capacity by 400%.
And also, just want to acknowledge our CFO David Begley, for helping me figure out that that was 400%. Thank you, David.
And the next few slides, just highlight some of the different programs that AID Atlanta currently provides. So our
African American Women's Outreach Program, Sister Soul, provides services to over 5000 African American women each year.
Our CTRS, our Counseling, Testing and Referral and Comprehensive Risk Counseling program serves over 5000 people -- I'm
sorry, over 6000 people each year with testing and counseling and Congressman John Lewis this year actually volunteered
to do an HIV nest public to demonstrate how easy the testing process is, so we thank him for that.
Our Deeper Love program, which is our African American gay outreach program, has been in existence since the early 1990s
and provides a number of different types of prevention services to African American gay men. Our Goal Atlanta gay
outreach program, which focuses primarily on Caucasian gay and bisexual men, and I'll talk about that a little bit more
in a second, but they serve over 5000 people per year and we're currently developing an internet-based intervention.
Okay. I have two other -- okay, they told me my time is up. I want to show you two quick clips, if I can.
One is to focus on our evolution program. And this will give you an idea of how we provide --
what our evolution program is all about.
(music playing) --
>> Neena Smith-Bankhead: Did I do that? Did I advance those? I'm sorry. Yeah, I want it to go back. There we go.
There is a little -- I apologize. Here we go. Here we go.
(video and music playing)
>> Neena Smith-Bankhead: Thank you. I have a few other things that I wanted to thank some of our actors from the video
are actually in the audience this evening, so I won't call them out, but I just want to thank them for participating.
I'm actually going to skip through and close. Just talking a little bit about AID Atlanta moving forward, we've
revised our Mission Statement to focus on reducing new infections and improving the quality of life of our members,
focusing on compassion, equality, leadership and empowerment, our core values.
Our strategic plan is called the Single Garment, recognizing that people, whether they're HIV positive or very high risk
HIV negative should all have access to the following kinds of service, access to care, wrap-around services, where
providing services from a harm reduction perspective and we want to focus on structural interventions and I'll talk
about that more in the question-and-answer period.
I'll skip our aspirational values. But just to talk about our future priorities. AID Atlanta will be focusing on,
just given the current political environment, one of our major areas of focus at this time are on ensuring that the
services that we have or the services that are most needed by our community. So we want to make sure that we're
focusing on medical care coordination, embedding ourselves in the community and providing advocacy and other structural
type interventions.
On a programmatic level, we want to look at prevention for positives and enhance our ability to provide linkage
services, look at various biomedical interventions and how AID Atlanta can be a part of those processes and then
continue to evaluate the effectiveness of the services that we provide with some of our community partners and
university institutions. And then in closing, I do have one quick, quick -- I promise, it's the last one, I promise, I promise.
This one is cool, but I'm not going to show it. But I really want to it leave you all with a message again from some of
our young African American members of the community, who did a video, and this is going to be a part of one of our
innovative new services, a part of our social marketing campaign for our evolution center.
>> Male Voice in Video: From where I stand black gay love is everlasting.
>> Male Voice in Video: From where I stand, I want the time and effort.
>> Male Voice in Video: From where I stand, coming out was not a barrier, but a beginning.
>> Male Voice in Video: From where I stand, I'm proud to be a black gay man.
>> Male Voice in Video: From where I stand, friendships are just as important as relationships.
>> Male Voice in Video: From where we stand, everything is up for discussion.
>> Male Voice in Video: From where we stand, we are family and friends.
>> Male Voice in Video: From where we stand, there's safety in numbers.
>> Male Voice in Video: From where we stand, we talk about condoms; do you?
>> Male Voice in Video: From where I stand, black gay love crosses boundaries.
>> Male Voice in Video: From where I stand, our safe word is communication.
>> Male Voice in Video: From where I stand, the community starts here.
>> Male Voice in Video: From where we stand, my partner's health is my own.
>> Male Voice in Video: From where I stand, black gay men are beautiful. (applause) --
>> Neena Smith-Bankhead: So on behalf of the staff, volunteers and members of AID Atlanta, thank you for coming out and
listening to our presentation this evening. Thank you. (applause) --
>> Donato Clarke: Let's give Neena another round of applause, please. (applause) --
>> Donato Clarke: It's tough to cram a lot of information in 10 minutes or less, so she did a fantastic job. Thank
you for all that you provided for us.
Our next awesome presenter is Ms. Dazon Diallo -- Ms. Dazon Dixon Diallo, of SisterLove. She's the Founder and
President of Sister Love. SisterLove was established in 1989 as the first women's HIV/AIDS organization in southeastern
United States. She's also an adjunct faculty member at Women's Health at Morehouse College -- at Morehouse School of
Medicine Master of Public Health Program in Atlanta, Georgia.
Ms. Dixon is also the founding member of SisterSong, member of color reproductive justice collective. She currently
chairs the Fulton County HIV AIDS planning council or the Ryan White Council and the steering committee of the Global
Campaign for Microbicides. Ms. Diallo is the co-chair of the Community Advisory Board of the Hope Clinic of Emory
University's HIV Vaccine and Microbicides Research Center.
Ms. Diallo hosts a weekly radio program focused on black women's called SistersTime on WRFG 89.3 FM and the website
wrfg.org in Atlanta. She has pioneered in the women's HIV AIDS arena and reproductive justice arena, developing a
center program intervention that is part of the CDC national compendium of effective base HIV prevention intervention
establishing the first transitioning housing program for HIV positive women and children.
Her long-term vision is for HIV positive women to be leaders in promoting services for HIV and AIDS and equity in
women's health rights. In 2001, Dazon opened a SisterLove Program in Mpumalanga, a rural South African province near
Johannesburg, where the project focuses on capacity building and sustainable development for local women-led HIV
organizations. She has received numerous awards and recognitions over the 27 years she has worked in HIV and AIDS and
in women's human rights. Ms. Dazon Dixon holds a Master's Degree in Public Health from the University of Alabama at
Birmingham and a Bachelor's from Spelman College in Atlanta, Georgia. Uh-huh.
Dazon will discuss her perspective on how HIV AIDS prevention services have increased for women on the community and
local level, as well as globally. For an example, SisterLove in South Africa, and she will provide a brief overview of
the progression of SisterLove since its inception in 1989. Please let me welcome, Ms. Dazon. (applause) --
>> Dazon Dixon Diallo: Wow. Neena, you're a good storyteller. Thank you. So good evening.
>> Audience: Good evening.
>> Dazon Dixon Diallo: Y'all want to be asked again? Good evening.
>> Audience: Good evening.
>> Dazon Dixon Diallo: All right. I am so glad that you all are here. I really am glad that you are here and I say
that because even 30 years later in the epidemic, those of us working in HIV and AIDS are no longer shocked, are no
longer surprised and are no longer even dismayed when every seat in the house isn't full. We actually are thankful that
some seats are full because when you're working and fighting and struggling this long against one disease that most
people wish they didn't even have to think about, you're thankful that somebody is still think burglar it with you. So
I'm really, really glad that y'all are here and I mean that from the bottom of my heart. (applause) --
>> Dazon Dixon Diallo: Alverna Denise Conn, Debbie Thomas, Rhonda DeVour, Cynthia Morris, Pandora Singleton, Anette
Siveradefo, Novella Dudley, Janice Jero, Guju Lamini. How about Arthur Ash, and EZ-E and Richard Anderson, and just a
small handful, just a tiny fraction, as you heard John mention earlier, of what I call my heroes, my newest ancestors.
They are those who came before us and left before us in the struggle and in the fight against HIV and AIDS, whether it
was in their bodies or whether it was just in their lives. And I call on them, especially every time we get an
opportunity to share like this, but I call on them because they remind me and they guide me and they bind me to this
struggle to its end, to its just end and I'll talk about that in a little before.
Before I go, I wanted to make sure I call those folks, but before I go any further, I also want to make sure you hear
the voice of folks living with HIV on a regular basis because they have what I consider the indigenous expertise, the
indigenous knowledge and yes, in some and most cases, the indigenous solutions to how we're going to end this epidemic.
Just a little bitty video, because I ain't gonna let Neena upstage me all the way. Can we go with the video, please?
(video and music playing)
>> Female Voice on Video: I think it will probably always be uncomfortable telling your partner, even if you speak in
a public forum, because once you get intimate with somebody, it matters to you, you know. And I don't mean sexually, I
mean intimate, it matters how they see you, so it becomes difficult to tell them that you are, especially if they are
not. There is another level and I call it "living with" and I call it "living through," because what we're going
through, that is when you go to the doctors, you speak out, you accept, you know what your responsibility, you're not
afraid anymore. You're not bold with it, because I still struggle with I get involved in relationships with making sure
that I tell that partner. Would I tell that partner? One, I don't want to be with anyone that doesn't want to be with
me, I'm better than that today.
>> Female Voice on Video: And I got them all together for Christmas, my family, my aunt's children, there were other
aunt's children and I said, "I'd like to tell you all that your cuz has HIV and AIDS." And after I said that and
explained to them where I got it from, I could feel each one of them as I looked around, I saw the sadness, I saw the
content, I saw the tears. They still having family issues and I just think it's such a shame that we are still having
first thing is stigma is family still.
>> Female Voice on Video: I moved in with SisterLove in 2000. I signed a contract to stay with them 18 months. In the
contract it states that you have to tell your kids about your status within 30 days. I really didn't know how to tell
them. How do you tell little people this? They're children, put they're little people. How do you make them understand?
One day we was all walking to the store. I asked them, what do you know about HIV and they both said, you die, you just
die. No, I told them, no, you don't die, you know. They looked at me and I said, this is what I got. I still wasn't
sure about, you know, was I saying it right or did I say something wrong or what else I need to say, so I ended it. I
ended the conversation. I explained what I told them and SisterLove took it from there.
I didn't know, had I done any damage telling them the way I did or was there any damage that I should have been the one
who took the ball and ran with it, but in my heart, I kept saying, I did the right thing because SisterLove has all the
answers I didn't have.
>> Female Voice on Video: You know, regardless to the virus, regardless to the stigmas. I refuse to allow somebody else
to devalue me about something they know nothing about. And I had made the decision that I'm going to speak about being
HIV positive, so I disclosed it in a room full of people. And honestly, I can say, I remember my eyes foggy and full of
tears, but my shoulders and my heart was so relieved because I got it out.
I finally said it. That's when I began to deal with the shame, the criticism, the blame, all those stages of which you
have to go through when you find out. You've not walked through it, you don't know what it took to get me to this other
side. You have no idea the course that I've been. I think as people (indiscernible) it's our responsibility to let
people know because if we don't do it, then who's going to do it.
>> Dazon Dixon Diallo: That's part of a six -- five-video series called Everyone Has a story, which is truer than true
and can be accessed at www.sisterlove.org. You, too, can have it and see it and use it. We also have facilitators,
guides, brochures, slide decks, whatever you need to get the word out and to get the word across from the stories of
southern Atlanta black women living with HIV and leading in the fight. Thank you.
Thank you for sharing that and witnessing that with me.
So I just wanted in the last six to seven minutes that I've got, trying to keep up my -- try and tell you like a 22-plus
year story in the 30 years of the epidemic and I'll start out with this. There is a campaign, if you didn't know and, I
also recommend folks go online, part of the Greater than AIDS campaign there, is a message called Defining Moments,
where you can hear stories and see pictures of people all over this country who all have defining moments
for when they got involved in HIV.
Well, the SisterLove story starts with my defining moment because I am the founder and as a very young person, I was
work nothing reproductive health at a local clinic and I tell people my defining moment was in the summer of 1985, when
Rock Hudson disclosed. And people, they get that Scooby-Doo look when you talk about it. I'm a young black woman who
talks about Rock Hudson and they go, "what"?
And the truth of the matter is that I was working at the health center are on the day that someone from AID Atlanta
called us because for some reason post-Rock Hudson disclosure, women all over Atlanta finally started think burglar AIDS
in their lives. I don't know, at first I thought, maybe we all just think we are leading ladies like Elizabeth Taylor
or Grace Kelly, she was my favorite, or it could be the real simple fact that never expecting Rock Hudson, the leading
man, to ever be gay, everybody automatically -- or these women might have automatically thought, well, if Rock Hudson
can have it, maybe my man can have it and that prompted the call.
And I don't know if we ever made the connection between that kind of risk assessment, which is very challenge of what we
have today in helping, especially African American and black women in this country, conduct their own risk assessments
and then act accordingly to that. What happened then is not happening so much now and therein lies our challenge.
So what happens was I started volunteering when AID Atlanta was on cypress Street, right then and there and we created
a women's model, it was a safer sex party. We still learn a whole lot of things about our own sexuality from gay men
because we all sleep with the same people, men.
So we learned a lot and started to transform that conversation and the way we could talk to women about AIDS and sex and
death and hope they didn't run out on us before we finished the message. And we created the Healthy Love Party over time.
That Healthy Love Party, as we come through overtime, is now as you heard Donato mention, created by black women, for black women
in our communities, a home-grown intervention, with a little bit of help, a lot of resources and a lot of time, five
years it took, we conducted our own evaluation, research, our own study, rigorous, the whole randomized control trial
thing and have come out on the other side determining that the Healthy Love Party actually is an evidence-based
intervention, that it's included in the compendium, that we're going through the replication phase now and within the
next 18 months we hope to be a DEBI, Diffused Evidence-Based Intervention. (applause)
>> Dazon Dixon Diallo: That's just a small part of who we've been for the last 22-plus years, SisterLove. We're on a
mission to eradicate the impact of HIV and other reproductive health challenges of women and their families and we do
this through education, prevention, support services and human rights advocacy in this country and around the world.
We're very intentional about identifying the work that we do around HIV in the human rights framework because if you
looked at civil rights, political rights, economic rights, social rights, cultural rights, sexual rights, environmental
rights and developmental rights, which all make up the framework of the human rights paradigm, you could pick any one of
those categories of rights and identify someone whose affected by HIV and has had their rights violated on some front.
And the browner you are, the poorer you are, or the more female you are, or the younger you are, the more likely -- or
even the gayer you are, the more likely you are to have those rights violated before HIV even comes along and so HIV
only helps exacerbate those things.
And so we do a lot of things in addition to prevention education and outreach. We do integration of HIV and violence
against women. We've been partnering on an intervention called RISE, which integrates HIV prevention education and
domestic violence education and service delivery to make sure that providers on both ends of those spectrums are
educated and skilled enough to identify, refer for services and help folks in need.
In addition to integrating the human rights framework, we also want to locate HIV in the whole realm of sexual and
reproductive health and rights because for women this is the forefront of everything about protecting themselves, as
well as being able to manage their own lives if HIV should happen in their lives. For example, while we were out busy
doing Healthy Love Parties and doing education campaigns, it was important to us, 1989, when we recognized that while
women might have only been 7 or 8% of the overall epidemic at that point, before that, we were 0 and so we were climbing
on a regular steady basis. Well, now we know we're anywhere from 25 to 30% nowadays in the epidemic. But back then
women were also dying a lot faster, oftentimes never having received an AIDS diagnosis.
And so we were a part of a national campaign that launched to say "women get aids, too." As a matter of fact, the name
of that campaign in 1990 to 1993 was Women Don't Get AIDS, We Just Die From It. That campaign led to one of the largest
watershed moments of public health in this country with regard to HIV.
In 1993, it's the year that the Centers for Disease Control actually augmented the AIDS definition to make sure it
included those opportunistic infections that were uniquely being experienced by women, things like cervical cancer,
pulmonary tuberculosis, which were not originally included in the longer lists of AIDS defining illnesses. So that was
a win for us then, but since then I think we've slidden backwards just a little bit, given the fact we've increased in
the epidemic, but we haven't necessarily increased in resources, we haven't necessarily increased in the proper
representation or in the leadership, or in the voices of people living with HIV in the national and in the international
spectrum. So we still have a lot of work to go.
So to close out on some of the things that we're working on, specifically around organizing HIV positive women and
women's voices, is we have this particular video campaign, we have the 2020 leading women's society, which is an annual
event or activity where we honor leading women, women who are actively involved in the community across the spectrum who
have been living with HIV 20 years or more and until you've met this group of women, you ain't seen leadership, it is
amazing who these people are across the country. We've been directly involved in the National HIV/AIDS Strategy, both
in its formation, as well as getting it done and now getting it implemented and monitoring its progress and as a result
we already see that women are about to be left behind if we don't get out in front. And so we've launched the "30 for
30" campaign, which is meant to recognize that if we are anywhere near 30% of the epidemic, so shall we receive 30% of
the resources, 30% of the consideration. And that's a minimum, but 30% of whatever is made available to people who are
trying to live without HIV and those who are struggling to live with HIV and happen to be female.
We also want to make sure that we're getting the word out because we've been integrating prevention interventions with
biomedical intervention since the beginning. I've been a part of Emory's Vaccine Clinic since they -- HIV Research
Center since they started. We've also been a part of recent, the global campaign for microbicides. If you didn't know,
there was good news for us with women out of that, with the CAPRISA trial, which was a South African led, South African
run trial that shows us that we can have a topical compound that will help women be self determining and not have to
negotiate with anybody else about whether they're going to protect themselves or not and that's a part of our challenge
in making sure that women have that power. So to have that compound, to have that option available for women means a
whole lot for helping us in this epidemic.
We've also learned that what helps benefit women is the fact that if their partners, particularly male partners, who
happen to be HIV positive actually get treatment and get on treatment early that somewhere between 70 and 95% they're
less likely to be infected by their partners with condoms and without. (applause)
>> Dazon Dixon Diallo: That also speeds in -- leads us into treatment as prevention, which we've always said if we get
people into treatment, if we get people into care, we will help end transmissions and end the epidemic and we now have
the science to prove it. Now -- now we need community to make it happen.
My final word on this is that for the first maybe 2-1/2 decades of the epidemic, without question, community was always
out front. Community drove Ronald Reagan. It took him six years, put community drove President Ronald Reagan to
finally say the word. Community galvanized how the Federal Drug Administration challenges and moves research and
approves drugs. Community challenged and won on how money from the Federal government gets to the streets and into the
communities so that people living with AIDS can survive and thrive. Community changed how people talk about sex and
sexuality and HIV and sex education and policy.
Community was always out in front saying, why aren't you researching this, why aren't you researching that, why don't we
have more of this and when are we going to have more of that? Now you have to be careful what you ask for, because I
would say and I would argue that over the last five years or so, science and policy have moved out front. We have a
national AIDS strategy. We have legislation happening all across the country, oftentimes not in our favor, if you think
about HIV criminalization laws. We have science that is moving so fast I don't even know if we can catch that train
that's already left the station.
But now that we have more resources, now that we have more hope for biomedical, as well as behavioral interventions, we
now need that new community of advocates, activists, providers, civil service workers, civil society, to get back out
front so we won't be fighting the fight of who's going to get medicines, when they're going to get them, how they're
going to get them, who's going to pay for them and how long they're going to be able to sustain themselves on them.
These are questions that only community can drive the debate and drive the dialogue and the discourse.
And so in my closing, I would also honor Sandy Thurman who, gave SisterLove our first office space at AID Atlanta
because she was just convinced that she needed younger energy like me around her. But also because they recognize not
having women services at the time when she came in that we were the perfect partner. And I also want to honor Marquise
Walker, one of the founding members of Black and White Men Together, who is also the assistant financial aid director at
Spelman College, who, if he had not intervened for me in my senior year, y'all would be seeing like a Georgia State, or
Fort Valley State or Savannah State or somebody state college graduate -- no dis because I'm from Fort Valley. But
because of Marquise who died in AIDS of 1986, I promised him that I would do something different and to this day I'm
holding my promise. What's yours? (applause)
>> Donato Clarke: Thank you, Dazon. Our final speaker this evening is Mr. Jeffrey McDowell, of the Atlanta Harm
Reduction Coalition. Mr. McDowell has been the Executive Director and Chief Trainer of Atlanta Harm Reduction Coalition
for the past three years. Mr. McDowell has assisted in the development and implementation of guidelines and standard
operating procedures for State's only known syringe exchange program. Since its inception in 1994, the Atlanta Harm
Reduction Coalition has served over 4000 unduplicated intravenous drug users averaging about 350 to 500 clients per month.
Most recently Mr. McDowell was one of approximately 54 subject matter experts from across the nation invited by the
Centers for Disease Control and Prevention to help develop Federal operational guidelines for health department funded
syringe services programs. Since that time, Mr. McDowell has launched advocacy efforts to address the decriminalization
and expansion of sterile syringes in Georgia. He also serves as Project Manager of the National AIDS Foundation
Advocacy Direct Services Activities Team and is the current member of the Atlanta Harm Reduction Coalition and Drug Policy Alliance.
Mr. McDowell has worked extensively with substance abuse users in both inpatient and outpatient treatment programs for
14 years, providing clinical assessments and substance abuse counseling. He was instrumental in developing and
implementing the first overdose prevention program at Atlanta Harm Reduction Coalition and is currently compiling data
and conducting research to support -- I'm sorry --
to support Naloxone distribution programs at Fulton County and the Atlanta metro area.
Mr. McDowell will discuss the impact of substance abuse and the availability of syringe services within the HIV and AIDS
epidemic within the metro Atlantic area and he will also discuss how syringe services will ramp up over the next five
years. A brief overview of the Atlanta Harm Reduction Coalition Service will be provided to include the agency's
advocacy strategies to incorporate syringe services in the metro Atlanta service with the assistance of local, legal and
law enforcement advocates and agencies. Without further adieu, Mr. McDowell. (applause)
>> Jeffrey McDowell: All right, that intro was worth 10 bucks, so I owe you 5. First of all, I just want to say good
evening to everybody and this has been fantastic. I don't know who's responsible for this lineup that I come behind
Dazon, she's something else. Neena, thank you so much, this has been great and been very informative.
You know, I come to you tonight on behalf of drug users in this movement. I think a lot of times when we think about
the populations affected by this epidemic, rarely do we begin to think about the impact that this epidemic is having on
drug users and so tonight I want to make sure that I'm a voice for them and that tonight you clearly understand that
going forward we cannot and I repeat, we cannot afford to take the focus off of this population.
I forgot the little clicker thing, so always my biggest -- let's talk a little bit about what "harm reduction" is and I
think sometimes people can have their myths about harm reduction and so I hope to be able to clear that up tonight. You
know, harm reduction for us is a valuable public health model that's used to be able to reduce the harms associated with
drug use. But what we've found is that it's not only effective in reducing harms associated with drug use, but it's
also effective in reducing all kinds of harm, such as political and economic harms.
The intent is to be able to educate people more about harm reduction so that as you heard Neena speak earlier, I was
very happy to hear that AID Atlanta is now incorporating harm reduction strategies and methods into their daily
services. And one of the things we want to do is make sure that people clearly understand that harm reduction is not
just an intervention. It is a model. It is a concept from which we launch interventions and it is a very effective concept.
Just in case you still don't have it, I think that hopefully this may bring a little bit more into view.
This is my friend Risky. (laughter) --
>> Jeffrey McDowell: You know, our harm reduction services and programs at AHRC is based on five stages of change
model. Anybody want to guess what stage ole Risky is in here? One thing is for sure is he has his harm reduction on,
we can see that with the helmet. But I think it is a great analogy to show that people are going to be people.
And what we have to do is understand that human behavior is very complex and sometimes people and oftentimes people will
take risk even though they know the consequences. So I think this speaks volumes within what we are seeing within the
epidemic and how valuable of a resource the harm reduction model is.
Atlanta Harm Reduction Center was founded in 1994. It was born and derived out of the Act Up stage. How many people
remember Act Up? Ah, there the Act Up people. One of our co-founder is actually here tonight and I would be certainly
remiss if I didn't recognize Ms. Mona Bennett. (applause)
>> Jeffrey McDowell: She was one of about a dozen or 14 co-founders for AHRC. And what generally took place was that we
had a bunch of public health students and we had the Act Up activists who heard about this neighborhood in northwest
Atlanta that was devastated with heroin use. The grounds were littered with discarded syringes and HIV risk went
through the roof and they wanted to do something. They knew nothing about harm reduction. They knew nothing about
syringe service or syringe exchange service, but they knew they needed to get out and begin to do something.
And so these public health students, at this time, we're talking in the early '90s, most of them were white, young
females who was walking in this predominantly troubled neighborhood that was high in crime and full of drug use and so
you can imagine what the police thought when they saw them all walking down the street. They wanted to know, is
everybody okay, was everybody all right, and they said, "yeah, we're fine." Eventually what happened, they were able to
engage individuals within the neighborhood and begin to put forward some efforts that resulted in what we now know today
as the first needle exchange program in the City of Atlanta and in the State of Georgia.
In 1994, we went on to become a nonprofit organization and from there we have derived it to a full-fledged HIV
prevention organization serving 12 to 1800 people per year. We do that based on our stages of transition and change, we
call it Steps. It's a five-tier program. Of course our target population is injection drug users and people at high
risk for HIV/AIDS, STIs and viral Hepatitis, which is I think another focus that sometime consist get lost. We've got
to begin to take a look and make sure that we give these things equal effort.
When it comes to intravenous drug users, where you will find HIV, you more than likely will find Hep C. So that is one
of those areas that I think we need to focus more on, there is a need for more screening there, is a need for more
treatment. And I would be absolutely -- I will not be astounded, but some people would be astounded once we begin to
get the resources and do a Hep C screening, along with HIV, it is going to double the numbers, probably in some cases triple.
We do our work in marginalized communities and people have several pathways in which they can enter our services. Some
people come to us linkage to care, people who are already HIV positive, some people come to us from community partners
such as SisterLove, AID Atlanta. Some people come to us from the penal system. We have a lot of people, since we are
located in northwest Atlanta, we are a stone's throw from a detention center. We get a lot of people coming out of the
correction facilities into the neighborhood. Therefore, we are able to address a lot of these individuals and be able
to provide services for people who know they are positive coming out of prisons and correctional facilities. Other ways
is people just merely walk up and walk in. We're about as community-based as you can get. We sit right in the center
of the community. People can easily walk up to us, it's easily accessible. And so it make its very easy for us to track and
retain people and be able to build the type of relationships that eventually results in increasing the quality of their health.
The other place that we often run into folks is our syringe exchange, which right now we had one location and started
another outreach location on the far south end of Bankhead, another area we identify having a large concentration of
intravenous drug users. Through the syringe exchange program, we are able to provide a lot of the wrap-around services
I'll talk about in the next slide, but it also gives us an opportunity to meet people where they are in their
environment, rather than have them catch two trains and a bus and come to my office where it's nice and cool and
comfortable and cushy and safe for me and that's okay where it works. But we've found with drug users, we have to get
out and do outreach activities, go into their environment, where they feel safe and build those types of relationships.
Just a snapshot about healthy outcomes from last year and some of the wrap-around services that we provide. We talked
about the Hep A and B vaccinations, which we think is really important to at least begin to vaccinate individuals.
We provide TB skin tests. Again, there is another one of those variables, when it comes to drug users,
there are high rates of tuberculosis.
We also provide other STD testing, HIV testing, peer groups and also our risk reduction groups. And as you can look at
the data clockwise from last year, you can see that we have a great volume of people and we have to thank the county
health department who comes out and collaborates and provides those services.
One thing we realize in doing this work is that if I'm hungry I'm less likely to take an HIV test. If I need a shower,
I probably don't want to hear nothing about any education you want to offer me. If I need to use the phone or I need to
have access to the internet, we're talking basic needs. And Maslow's hierarchy of needs is one that we follow very
closely and we found out it's very, very effective. We supply probably a little over 500 meals per month out of our
building, but it's a great catch and it's a great draw to be able to bring people in, be able to address nutrition, but
also be able to get people's basic needs met, so that we can in fact do some of the interventions that we want to do.
Also, condoms is always a constant and we do about 1400 of those a month. One of the CDC DEBIs that's been very
effective for us is Safety Counts. Safety Counts is a specific drug user intervention specifically designed for drug
users. We've been doing the intervention now for over five years and we average 100 people per year. It is a very
popular intervention. It's based on self-assessment and as you can see, it has seven elements that go along with it.
It's about a four-month tracking period, so we're able to keep up with people and make sure that during that period of
time, we can address what their needs are, whether they are already positive, we make sure people get tested and also
it's a great way for us to be able to build relationships we need to be able to get people into care. So four months is
quite a while, but we've been at it 68% completion rate with this DEBI. We really like it and so does our clients.
The other element of what we do is with Drug Court, because we have high concentration of folks coming to us from the
penal system, we've been very fortunate to be able to get some resources to be able to in fact do some work within the
Fulton County Drug Court with former drug users. These are individuals who are for the most part in treatment and quite
different from our population that we serve on the street, which is out of treatment. But it allows us to do some basic
education, some testing and also it allows for us to do some harm reduction trains cultural competency with staff.
Again, we heard Neena talk about AID Atlanta. We were able to go over and train their entire staff in harm reduction.
And so it's great to see they are utilizing those strategies and models of meeting peep where he will they are and
looking at what stage of change they are in and be able to build upon that. So we're able to do this as well for Drug Court.
Now we are able to provide case management for people living with HIV/AIDS within the drug court. So now we're able to
get a couple of things done at one time while they are there and in treatment, receiving the services from Drug Court,
now they also have access to one of our case managers.
We do about 400 participants each year through Drug Court. Voices is another popular DEBI, that we do. We target
African American women and as you can see, you know, safe sex videos and group discussions and we have some discussions
around condom negotiation and proper usage and of course there's another opportunity for us to be able to get people
tested and to be able to link to care where needed.
So as going forward, we look at the challenges. How do we get over the wall? How do we get past the barriers of what
we've seen and what we are seeing right now? For us, in looking at the drug using population, there is a couple of
critical things. I think I went back. You know, in looking at the national HIV AIDS strategy I was real pleased that
the executive summary actually specifically spoke about people struggling with addiction and drug users. The program
services we're providing work very well with this strategy and we really, really looking forward to the resources to be
able to support this strategy.
But as you can see, you know, I think there's a great awareness that drug users is definitely one of those populations
we can't afford to continue to overlook. When we take a look at what is happening over the last 20 years, talking about
the drug user population and infection and transmission rates, as you can see, IDUs seem to be the only ones going down.
So what's going on? What's happening here?
As I said earlier, we began our harm reduction services in many of the harm reduction and syringe service programs
across the nation began to pop up guess about when? Around 1992. If you take a look at this timeline and what we're
seeing in terms of decreasing infections, you can see that drop begin what? Right around 1992.
So in terms of correlation and direct cause, I truly believe that it has been the work that's been done through harm
reduction and syringe service programs that makes a real difference with this population. It is the only population
that is still on steady decline, however, if we look at the south, these numbers may be a little bit different and I'll tell you why.
When you look at syringe service programs across the United States, this is what it looks like. And I have some recent
information to suggest that Louisiana is no more and North Florida is no more. So when you look at the south, we're
going to see a pretty big gap here in just a minute, but we can see that our friends and neighbors to the north, the
midwest and west coast got it and they're making sure that they have syringe service programs and harm reduction
programs within their states. Some have as many as eight agencies providing syringe service programs
and providing harm reduction services.
Let's take a look at the south. We don't have a lot of support. And so when we look at the numbers in terms of what we
want to change in the south, I truly believe that this is one area that we got to put more support around. It's one
area that we have to work on the double stigma, because I always say drug users have a double stigma. It's one thing to
be an addict, but it's another thing to be an addict and HIV positive. How about that one?
So I think we need to work on trying to get this map more in agreeance in what we see across the nation, because as you
see we really like syringe service programs in the south. We are probably one of the bottom six states that actually
have syringe service and of course we're not able to reach the masses of people. It's important to mention that Georgia
has about 80,000 intravenous drug users.
Syringe service programs do not only seek to serve intravenous drug users or those who may be injected substances, but
they also serve diabetics. We have a lot of diabetics who don't have access to sterile syringes for their medication
and a lot of times they'll use the syringe service program. It is free, it's accessible. The other population that's
vastly growing and the transgender population, because we know there's a hormone injection. There is a lot of sharing
there, as well. We've gotten a lot of calls to be able to come and implement the harm reduction service within those populations.
While we look at some other data, we can see that we can still kind of ill afford to put drug user interventions and new
innovations on the back burner. 70% of all the positive intravenous drug users, I'm talking HIV positive individuals
live in the metro area. So 7 out of 10 live in this area.
When you look at what AHRC has been able to do on average we've been doing 120,000 exchanges from street corner in
northwest Atlanta. We dispose of 60,000 tainted syringes each year. Serving 1600 individuals, we have individuals that
come from as far as Chattanooga, Tennessee, to be able to access the syringe service program. Again, it's a great tool
to be able to provide some wrap-around services such as drug treatment, linkage to other mental health services and a
lot of the other services that folks won't come into the Office for.
Proper disposal, you know, which is a big issue when it comes to this particular intervention. People worry, okay,
well, what are we going to do with all those syringe? Well, we've been able to devise a policy and a process that
allows us to be able to dispose of these. So we have a contract where people come in and actually haul these out of the
community. Again, we're talking about over 60,000 a year.
I think in the beginning Mona mentioned there were more than 500 per lot in 1994, when they first came. This is an area
in Cabbagetown that don't have any disposal. This is where our police officers and other people who have to work in
neighborhoods can come across this type of discarded paraphernalia and because right now the resources are not there for
us to be able to expand our services, this is one area that we're not in, but as you can see, there's a lot more areas
that we do need to be in, if it's nothing else than to get disposal services started and get them started quickly. This
is definitely one of those area where is children, people's pets, a lot of bad things can happen from this one. One
thing we've been able to do is work with police department around officer safety, needlestick prevention. This is the
type of thing if you're chasing someone, if you're a police officer, you don't want to fall in this.
Moving forward, what do we do? Obviously we need to do some policy reform. We need to take a look at drug user
intervention. We need to take a look at some of the decriminalization that we need to get moved and so that we can
begin to move the bias and the discrimination that we see toward drug users and drug users' interventions. Again, we
want to see SSP expanded. We want to see more of it in our state and we certainly want to see more of it in the south.
We like to have increased access to surveillance staff. We don't have a lot of tons of resources to be able to find out
exactly where that next hot spot of using populations are, but certainly a local government and Federal government have
that data. So we'd like to work more intricately with them to be able to identify where these new hot spots are, so it
will help us with vision and planning. And always, always, always, we need more resources, right, Dazon?
>> Dazon Dixon Diallo: Yep.
>> Jeffrey McDowell: We need to get busy. We need advocates, you know. Dazon said it best. This is the time for folks
to come back out and be able to support what we're doing. We have a lot of national support and these are just a few of
the people who we work with intricately to make sure that we can get out, get the word out.
You can go to our website there, is a lot of other information, including overdose information. I just want to say
really, really quickly, that, you know, the data suggests that we have more people dying from drug overdoses than we do
gunshots and motor vehicle accidents. So that says a lot. We need more and more information out to the public. So
please go to that website and you can get more information about that.
I want to thank you so much for your time and I especially want to thank some of our front-line workers who are here,
some of our staff and volunteers, if y'all could just kind of wave. I don't do this by ourself, we do it with you guys
so thank you so much for all your hard work. (applause)
>> Donato Clarke: Please let's give another round of applause for our panelists. (applause)
>> Donato Clarke: Thank you so much. They have nourished us with a lot of food for thought and with every great meal
you should leave room for desert. So with that being said, we're going to open the floor for questions and answers to
our panelists if you all have any questions. We have some microphones that are available for you to ask your questions,
if you have any. If not, I can start them off.
While we're waiting for the microphones to pass around, let me start off with this question for our panelists. What challenges
would you say you have seen in the last 10 years that's related to the primary target population that you've been serving and
what do you think are some continuous needs that we need to address as it relates to HIV prevention for those populations?
>> Neena Smith-Bankhead: One of AID Atlanta -- AID Atlanta actually focuses on a number of different target
populations, but one of our largest and our primary target population is -- includes African American and Caucasian men
who have sex with men and what we've noticed in the last 10 years there seems to be a decline in people's interest in
talking about HIV, especially among Caucasian men who have sex with men, gay and bisexual men. And so in terms of
services that AID Atlanta is looking to provide, one of the things that we're doing is trying to provide more
innovative type of services and trying to embed our services in the types of activities that that community is
interested in participating in.
So for example, we didn't have a chance to see the clip, hopefully we'll be able to sneak it in before we leave. But we
actually are launching a home-grown intervention that's an internet-based intervention, it's kind of an internet-based
soap opera, and there will be some activities and things that go along with that, so that people can access the services
in their time and in a different kind of way, a way that may be more appropriate for their interest and needs, so -- and
also just taking services into the community. Again, making sure that as Jeff mentioned that we're not requiring people
to come to us, but that we're actually getting out in the community and embedding our services, partnering with
organizations to provide services, wrap-around services with people.
>> Dazon Dixon Diallo: So there are many, but I think probably -- and I don't want to get too philosophical here, but I
think really one of the core challenges for us has been our lack and I'm talking about as a country and as a society,
but our inability to really acknowledge and recognize the sex, the stigma of HIV, which is really sex, it's not
sexuality, it's not homophobia, that's equality, that's human rights. It's about being able to talk about, think about
and engage in real conversations around sex and sexuality and sexual health, that is the biggest challenge to get into
any conversation around HIV, STIs, relationships, risk assessment, engage nothing condom use, getting tested, all of
that means at some point I got to acknowledge to myself and to somebody else, not only that I'm having sex, but how I'm
having sex, who I'm having sex with, how often I'm having sex and be afraid of being judged by that or about that.
And so the Healthy Love Party was really one of our first entrees of creating that safe space to have that, to celebrate
your sexuality and then take responsibility for making it safe and preventive, but we also want to talk about sex and
sexuality across what I call the horizontal diversity of us in the sense especially among HIV and among the African
American community is we're still not yet, whatever the setting is, we're still not yet able to have these
cross-cultural conversations even within our own culture, the straight, the bi, the gay, the trans, lesbian, men and
other identified folks, we couldn't sit still in a place and have a respectful, honest conversation about relationships,
much less about what HIV brings to that conversation.
And so I want to see us do a lot more of that, we're working on that, we're adapting our Healthy Love Party for Trans
women and trans men. We're also adapting -- it's always been adapted for different environments, including young
people, but bigger than that, we are starting to create those safer spaces to have those horizontal diverse
conversations across the sexualities within our population. And I just think until we get past that, that we're -- you
know, I said recently, I want to be able to talk about my, you know, sexual fluids the same way I can talk about mucus
and ear wax. It should be just normal conversation that you can hold and talk about so that people can get real about
what they need to do about that.
Nobody will have a problem handing you a tissue when you start talking about your nose is running. But really people
are not going to hand you a condom when you start talking about other stuff that's running, so I'm just sayin'.
>> Jeffrey McDowell: Thank you, Dazon.
>> Dazon Dixon Diallo: You're welcome, Jeff.
>> Jeffrey McDowell: Yeah. You know, that is so true. I think for us, we would like to see more activity and more
involvement from our clients who are HIV positive, people in poor black communities where drug use is prevalent, I'm
talking more impoverished neighborhoods. I mean, it's really not cool to be able to talk about your status and so we
have a lot of people within the community that, you know, I think like Dazon's "20 Women 20 Year" events and people like
that who can empower our community to be okay with their status. It is still so,
so taboo in a neighborhood that is already so devastated.
So we would love to see more involvement around people who are HIV positive and more peer-laid activities for us in
those communicates. Thank you.
>> Donato Clarke: Question? You can just speak --
>> Speak into it. Okay. There we go. I have a young teenage son that's interested in getting into public health and I
notice we have students in the audience, as well. So what would be your suggestions as to how they can make an entree
into the profession and specifically working with the different populations being young and not having been exposed
necessarily to the Bluff and different places that are --
>> Dazon Dixon Diallo: Well, I'm going to take the first stab at it and say bravo that he already recognize public health. Hallelujah.
>> But he doesn't know what in public health.
>> Dazon Dixon Diallo: But that's okay. You know, I used to teach an undergraduate at Spelman and one of the reasons I
introduced the public health there was because that was the last thing people were thinking about because there is no
money in it, it's always about, you have to work for the government, all those kind of issues. And what I find and this
is what I'm coming to for him and what are his other passions is my question, because the beauty of the discipline of
public health is that it is comprehensive enough, it is broad enough and it has so many avenues of engagement that
whatever your passion is, there's a place to bring it to public health. If it's arts, if it's music, if it's law, if
it's writing, if it's journalism, if it's teaching, if it's community organizing, if it's mobilizing, if it's medical
care, if it's primary carry, whatever it is, you can do that in public health. And so you don't always have to know
where you want to go in public health because that's going to find you. What you really need to know is what's your
true passion and how to locate it in public health and that's where you will find that peace that you want to do.
And I have found that that's exactly what most students who come into public health have done and it's helped us
tremendously. Tell me, ain't nothing wrong with JD in PH. Ain't nothing wrong with an MBA in PH. Ain't nothing wrong
with an MS and a Master of arts in PH. There's nothing wrong with any of those things because they all have something to do.
>> Neena Smith-Bankhead: I would also encourage anyone interested in the field to volunteer and I strongly encourage
volunteers. If we look at the history of a number of our organizations, most of the organizations really run with our
volunteers and volunteer consist provide so much input, insight and just give people who are interested in the field an
idea of what it would be like to work in these fields.
A lot of people who volunteer, didn't know some of the opportunities that Dazon mentioned even exist in public health
before they started working with an agency and I just think about all of our staff who started as volunteers and then
became full-time staff and some of them weren't in the field of public health initially, they were in a number of
different fields. So I definitely encourage anyone interested to volunteer, to get to know the staff, the issues, the
agencies, the communities and it can definitely be life changing.
I think most of us were volunteers at some point in our career, if not still.
>> Dazon Dixon Diallo: Yes, we love corporate and government refugees.
>> Jeffrey McDowell: I just want to ditto what I've heard thus far. I know for me and my experience is that, you know,
you don't find this field, it finds you. And you know, my love for drug users and the belief and hope where we start
off at is not where we have to end up at, is what kept me here and after doing so much work with drug users for 10
years, I actually didn't enter public health until four and a half years ago. So it was an interesting twist for me.
So again, I just think it's just one of those things, you find your niche as you go.
We have a series of summer, winter, fall and break students that drive from as far as Michigan here every year to
volunteer. And it's always amazing to see their after experiences from their time with us. And many of them always
say, because I came and did this work with the Atlanta Harm and Reduction Center, I now know what I want to do.
So ditto with the volunteerism.
>> Donato Clarke: Thank you. And also, take advantage of internships.
>> Dazon Dixon Diallo: Big time.
>> Donato Clark: Because you know, they are really big. At Troy University, we have a lot of intern opportunities and
I'm telling you, if you are really interested in entering into this field, take advantage of those internship
opportunities, whether they're paid or not because you can gain a lot of wealth of information and just experience in
interning. So that is another avenue I wanted to add, as facilitator, moderator, so to speak.
We have another question in the back.
>> Mona Bennett: Well, actually it's a comment. Good evening, y'all.
>> Dazon Dixon Diallo: Hey, Mona.
>> Mona Bennett: Hey, how y'all? I want to speak to the challenges. I just got to go back to stigma.
I got to go back to stigma.
The work that the Atlanta Harm Reduction Center -- excuse me, Coalition , does, it has been and always will be a hard
sell. You can't necessarily see the babies we're saving unless you see the back of our brochure, you don't always see
the puppies and the kitties that we're saving. It is a hard sell. That's one of the big things about the work we do.
It's a hard sell. And, you know, we're talking about sin and sinners, got to talk about that, too. You know, and you know.
>> Donato Clarke: Yeah.
>> Mona Bennett: And as career sinner, I'm out helping the sinners.
>> Donato Clarke: Thank you for that. We have another question from a gentleman here.
>> Yes. Like to say good evening to everyone. I have certainly been enriched, had the opportunity to drive down 20
from Birmingham to be here this evening. (applause
>> Donato Clarke: Thanks for being here.
>> So I love my teammate, Ms. Diallo here from UAB. But I'm part of that new blood that you're talking about, that find
your way, it's just I guess a gut connection, a divine appointment. But as a playwright, I'm using the arts to deal
with what I call urban social drama. We don't talk about our issues and tying that in with the faith community that
somehow doesn't know how to address this whole issue.
I mean, there are some people who are doing some great things, but I would say the majority of the churches come and go
everyday as if nothing is going on. And a whole lot is going on. It's difficult to tell the dear sisters to wait and
assume that nothing is happening while they're waiting, or the brothers. But I'm going to fast forward this and say, I
was led into something that just shocked me and that is 19% of all new HIV and AIDS cases are senior citizens.
>> Dazon Dixon Diallo: Yes. Yes.
>> We had enough problem on the front end when it was considered a youth piece and now we are backdooring it and its
meeting in the middle. HIV and AIDS is growing in the age group 50 and older faster than the 40 and under. And it's
directly attributed to the sexual enhancement drugs and nobody's talking about it. So as we've taken a play around the
country, it never fails that the senior women and the senior men, 50 and older, are left with their mouths wide open.
I mean, because they don't have the challenge of 50 and older of getting pregnant, so they're more apt to have
unprotected sex. The men have never liked the idea of condoms, so they go out and they've been out of the game for a
long time, you know. They've been talking the game, but now they can do something in the game. But they don't know how
to choose. So they're choosing young girls many times, who are dealing with all of the issues, the needles and having
two or three partners, those partners having two or three partners, they are all having unprotected sex.
So without going on and on, then this guy comes back home unsuspecting to his spouse many times and I'm hearing tragic
stories. She doesn't even know he has the Cialis, Levitra, Viagra, because he's hiding it under the car seat or in the
glove compartment. And can you imagine at 60, 70, you go to the doctors and the doctors don't treat seniors by asking
when the last time he had sex. So it plays itself off as aging symptoms, sweats, tired, and defined out at 60, 65,
you have HIV. Now the stigma.
>> Donato Clarke: Uh-huh.
>> Now the challenge of the medications. And so if we don't start talking about this problem, this challenge, we've got
a whole other thing happening. In 2006, it was 11% and here we are in 2011, and it's 19%. 25% and growing older. 25%
of all the cases are senior citizens.
>> Donato Clarke: Uh-huh.
>> And nobody's saying anything. So thank you for the time. Thank you for this.
>> Dazon Dixon Diallo: Name and play. Name and the place.
>> My name is George W. Stewart, the play is -- are you ready for this? Ain't No Fool Like an Old Fool. (applause)
>> Thank you very much for the time.
>> Donato Clarke: Thank you.
>> Dazon Dixon Diallo: George and this is -- there's a piece in here that's also really important and I just read this
article like maybe three or four days ago, which is a study of women partners of older men who are on the sexual
enhancement drugs. And the thing we come back to, especially around biomedical, prevention research. When you don't
include the whole population, when you don't include women, you know when they test Viagra, they weren't testing the
women partners, they were only testing how it was working out or if there is adverse physical reaction, right? There's
so many women that after 45, after 50, my body has changed, my hormones have changed and I am no longer biologically
compatible to somebody who is 65, but is having sex like he's 20. And that doesn't compute and so they do end up --
even in some cases giving -- what did I see that movie recently, the Hall Pass to their partners because they are not
having it like that and they are not giving it up like that.
And so I think this is another testament to the story. It's not just about the HIV risk itself, but again it comes back
to the stigma around sex and sexuality and that if we were looking at both partners maybe we would have rolled out this
sexual enhancement in a whole different way because spontaneity doesn't necessarily work after menopause,
you know what I'm say something yeah.
>> Donato Clarke: Uh-huh.
>> Dazon Dixon Diallo: Yeah.
>> Donato Clarke: All right. Before we close, we're going to have one more question. And this just in, please as a
reminder, complete your evaluation. We would love to receive your input as far as this event went tonight. And again,
I really appreciate everyone's attendance. We have one more question and then we'll thank our panelists again. Please
in the back. No question -- oh, I'm sorry, I thought you had a question. All right. We have a question in the front
and then we'll close. This will be our last question. Oh, okay. Okay. Right.
>> It's not really a question.
>> Donato Clarke: Okay.
>> But it's now that I'm inspired because I've -- I've gone through the exhibit at the CDC and I saw some of the things
that brought up memories for myself as a young young person seeing some of the signs and not understanding what was
happening with the impact of this epidemic. And also, I guess it is a question, too. I watched MTV's thing, the Live
Campaign, they have this movie series that's out of Kenya.
>> Dazon Dixon Diallo: Uh-huh.
>> Beautifully done, if you haven't seen it. It's fantastic. But I want to know the impact of this kind of media here.
You know, what do you think needs to be done? Are the productions that you're doing, I know you have done one also,
Dazon, and you are also doing one at AID Atlanta. What is the impact of that kind of thing? Me watching that from over
there, I was souped up. I was watching young people doing some serious things.
>> So perhaps the influence of media, conducive media.
>> Absolutely. Absolutely.
>> Dazon Dixon Diallo: I've got a pet peeve I'm going to start right now. I work in South Africa and in South Africa,
television is huge in terms of a communication tool, right? And it's used that way, very intelligently, both by the
government and by institutions and agencies. This past year PEPFOR. The President's Emergency Plan for AIDS Relief,
which is the largest international funding source that comes out of the U.S. and actually more than any other country,
funded Johns Hopkins University, which is an American institution, but has a huge program in South Africa. They produce
two nightly programs or weekly programs that would blow your mind.
One is called "Intersexion," spelled with S-E-X and it's a 25-week series that runs right after the most popular
night-time drama every week that actually ended up with ratings greater than the most popular prime-time night drama,
that focused on sexual networks. And it was suspenseful, it was a mystery, it was engaging, it represented the whole
spectrum of populations. It was creative, well written, beautifully produced.
And the second one is a series that just finished called "Foreplay: Sex for Women." And it was lifting up and
respecting women as sexual human beings, because you know violence and sexual assault and all of that against women is
really high in South Africa. So it really focused on the positive attributes and the power of women's sexuality and
women's relationships.
And I'm sitting there going, my tax dollars, one of our most prestigious universities producing amazing work that's
making huge effect and impact in South Africa and I can't get a minute of it on my TV, not even on cable. And that was
on regular, free, national television. And if I could see something like that on any of our national networks, I know
how far we would go. I know what that would mean for our water cooler conversations.
But we can't even get condom commercials on before 11:00.
>> Yeah.
>> Neena Smith-Bankhead: I think one of the reasons AID Atlanta has taken the approach that we've taken is in
recognition of the fact that people learn in a number of different ways, people are influenced in a number of ways and
we know that media, especially internet activity at this point has a huge impact. Many people don't utilize a lot of
the resources we've used in the past because we get all of our information through the internet. And so we definitely
believe that media has a huge impact and so we're doing a lot through internet usage and so we're trying to get a number
of social media types of clips developed that actually are another opportunity to represent the people who are most
impacted and have them have a voice.
Going back to what Jeff mentioned. We also struggle with having people who are comfortable telling their stories, due
to the stigma. But for whatever reason, we do have a number of people who would be willing to tell those stories on
video or at least to be a part of different video messaging that we can also disseminate into the community.
So again media does have a huge impact. It can impact how we dress. It impacts how we dance. It impacts how we think
about each other. I mean, we can call out some of those media influences that impact our language at this point. And
so we're trying to utilize all of those mechanisms as much as we can to get this message out and new innovative and
exciting ways for people.
>> Donato Clarke: Thank you, Neena.
>> Neena Smith-Bankhead: Thank you.
>> Donato Clarke: All right. Let's thank our panelists and thank our audience for coming, again, we really appreciate
it. And please do not forget to complete your evaluations.
And also, I want to make an announcement about the next lecture. Please mark your calendars as a plan to attend. The
lecture will be on politics and public health, "From Pennsylvania Avenue to Main Street: HIV and Public Health" will be
held on August 11th at Emory University, Rollins School of Public Health. For more information, can you visit
www.CDC.gov/HIV/30thanniversary. We really appreciate your participation and attendance. Thank you so much.
And also, lastly, we do have free HIV testing that is courtesy of Fulton County Department of Health and Wellness that's
being offered outside in the hallway. Thank you all.