# Presentation: 774397

## Presidential Advisory Council 

**Director**
**Center for Substance Abuse Treatment**
**Substance Abuse Mental Health Services Administration**
**U.S. Department of Health & Human Services**

**Presidential Advisory Council **
**on **
**HIV/AIDS**
**SAMHSA Update**

- March 25, 2008
- Washington, D.C.

## 	
	President George W. Bush

- 	***President George W. Bush***

**January 31, 2006**

*“**A hopeful society acts boldly to fight disease like HIV/AIDS, which can be prevented, and treated, and defeated.... We will also lead a nationwide effort...and come closer to the day when there are no*
*new infections in America.”*

## SAMHSA’s Organization

**Administrator (OA)**

**Terry L. Cline, PhD**

**Office of Policy, Planning, & Budget (OPPB)**

**Office of Program Services (OPS)**

**Office of Communications (OC)**

**Office of Applied Studies (OAS)**

**Center for Mental Health Services (CMHS)**

**Center for Substance Abuse Prevention (CSAP)**

**Center for Substance Abuse Treatment (CSAT)**

**SAMHSA’s Organization**

## Slide 4

## SAMHSA’s Goals

_**Measure and report program performance**_
-   Track national trends
-   Establish measurements & 	reporting systems
-   Develop and promote 	standards to monitor service 	systems
-   Achieve excellence in 	management practices

_**Increase service availability**_
- Support service expansion
- Improve services organization and financing
- Recruit, educate, and retain  workforce
- Create interlocking systems of care
- Promote appropriate assessment
- Assess resources and needs referral

-  _**Improve service quality**_
- Assess service delivery  practices
-  Identify and promote evidence-based approaches
-  Implement & evaluate innovative services
-  Provide workforce training & education

**Notes:**
SAMHSA’s vision is “a life in the community for everyone.”  

We’re achieving that vision through a mission that fulfills our mandate from Congress and focuses our attention on building resilience and facilitating recovery for people with or at risk for substance abuse and/or a mental illness, so they too can have an opportunity for a fulfilling life, a life that is rich and rewarding, that includes a job, a healthy home, and meaningful relationships with parents, family and friends.

Fulfilling this mission becomes more complex when you factor in other presenting problems such as HIV/AIDS as we know from many studies persons with a psychiatric disorder or involved in substance abuse or experiencing both have an elevated risk for contracting and/or transmitting HIV.  

## Past Year Perceived Need for and Effort Made to Receive Treatment among Persons Aged 12+ Needing But Not Receiving Specialty Treatment for Illicit Drug or Alcohol Use: 2006

**Past Year **_**Perceived Need**_** for and **_**Effort Made**_** to Receive Treatment among Persons Aged 12+ Needing But Not Receiving Specialty Treatment for Illicit Drug or Alcohol Use: 2006**

**The Challenge**

## Past Month Use of Specific Illicit Drugs among Persons Aged 12 or Older: 2006

## Past Month Nonmedical Use of Prescription Drugs (Psychotherapeutics) among Persons 12+:2002-2006

**Percent Using in Past Month**

**+**** Difference between this estimate and the 2006 estimate is statistically significant at the .05 level.**

## Past Year Methamphetamine Use among Persons Aged 12+, by Age: 2002-2006 

**Percent Using in Past Year**

**+**** Difference between this estimate and the 2006 estimate is statistically significant at the .05 level.**

## Injection Drug Use & HIV/AIDS

- According to CDC data on U.S. adolescents and adults
- – in 2005:
- Approximately 20% of the reported new AIDS cases were related to injection drug use.
- 20% of males and 33% of females living with AIDS were exposed through injection drug use.
- Almost one-third (28.2%) of AIDS deaths were adolescents and adults infected through injection drugs.

- Source: Centers for Disease control and Prevention, *HIV/AIDS Surveillance Report*, Vol. 17, Revised Edition, June 2007, retrieved 2/15/08.

## HIV Diagnoses by Race/Ethnicity

- In 2005, about half (49%) of the people diagnosed with HIV/AIDS were black (according to information from 33 states). Children are included in these data.

- Source: CDC *HIV/AIDS Surveillance Report: HIV Infection and AIDS in the United States and Dependent Areas*, 2005.

## Blacks & HIV/AIDS

- Of the 956,019 AIDS cases reported to CDC through 2005, blacks accounted for:
-   40% of total
-   60% of women
-   59% of heterosexual persons at high risk*
-   59% of children aged <13 years
- Of AIDS cases reported during 2005, 48% were black adults and adolescents.

- *High-risk heterosexual contact with a person  known to have, or to be at high risk for, HIV infection.
- Source: CDC *HIV/AIDS Surveillance Report: HIV Infection and AIDS in the United States and Dependent Areas*, 2005.

## Hispanics & HIV/AIDS

- Hispanics account for a disproportionate share of AIDS cases.
- Hispanics make up 14% of the population -- yet, from 1981 through 2005, they accounted for:
- 19% of total number of AIDS cases reported to CDC
- 19% of women reported having AIDS
- 22% of heterosexual persons at high risk*
- 23% of children aged <13 years

- *High-risk heterosexual contact with a person  known to have, or to be at high risk for, HIV infection.
- Source: CDC *HIV/AIDS Surveillance Report: HIV Infection and AIDS in the United States and Dependent Areas*, 2005.

## Women & HIV/AIDS

- Estimated Number of AIDS Cases and Rates for Female Adults & Adolescents, by Race/Ethnicity
- 2005 – 50 States & DC

- Source: CDC *HIV/AIDS Surveillance Report: HIV Infection and AIDS in the United States and Dependent Areas*, 2005.

| Race/Ethnicity | Cases | Rate (cases per 100,000 population) |
| --- | --- | --- |
| White, Not Hispanic | 1,747 | 2.0 |
| Black, Not Hispanic | 7,093 | 45.5 |
| Hispanic | 1,714 | 11.2 |
| Asian/Pacific Islander | 92 | 1.6 |
| American Indian/Alaska Native | 45 | 4.4 |
| Total* | 10,774 | 8.6 |

- *Includes 83 female adults & adolescents of unknown race or multiple races.

## American Indians/Alaska Natives (AI/AN) & HIV/AIDS

- American Indians and Alaska Natives (AI/AN) have the third highest rate of AIDS diagnosis in the United States, despite having the smallest population.
- AI/AN people with AIDS are likely to be younger than non-AI/AN people with AIDS.
- AI/ANs also have the shortest time between AIDS diagnosis and death.

- Source: CDC *HIV/AIDS Surveillance Report: HIV Infection and AIDS in the United States and Dependent Areas*, 2005.

## SAMHSA’S HIV/AIDS &

**SAMHSA’S HIV/AIDS &**
** ****HEPATITIS ACTIVITIES**

## SAMHSA GoalsMinority AIDS Initiative (MAI)

- Increase access of racial and ethnic minority communities to HIV prevention, care & treatment services;
- Implement strategies and activities specifically targeted to the highest risk and hardest-to-serve populations; and
- Establish collaboration, partnership or opportunities for programs and/or activities to be integrated, including
- Faith & Community-based organizations
- Research institutions
- Minority-serving colleges & universities
- Healthcare organizations
- State & local health departments
- Criminal & Juvenile Justice Systems

## SAMHSA MAI Funding

|  | FY 2007 Actual | FY 2008 Enacted | FY 2009 Estimate |
| --- | --- | --- | --- |
| Center for Mental Health Services | $9,283 | $9,283 | $9,283 |
| Center for Substance Abuse Prevention | $39,358 | $39,385 | $39,385 |
| Center for Substance Abuse Treatment | $62,488 | $63,129 | $63,129 |
| TOTAL SAMHSA | $111,129 | $111,797 | $111,797 |

- Dollars in Thousands

## SAMHSA HIV/AIDS & Hepatitis Targeted Capacity Expansion Grants

- The SAMHSA HIV/AIDS and Hepatitis Targeted Expansion (TCE) grants are administered by each of the 3 Centers:
_**CSAT:**_
-   The purpose of the CSAT TCE/HIV grant program 	(63.1M) is to enhance and expand substance abuse 	treatment and/or outreach and pretreatment services 	in conjunction with HIV/AIDS services.
-   These grants require that at a minimum, 80% of all 	clients will be tested for HIV/AIDS.

**Notes:**
CSAP’s Programs of Regional & National Significance (PRNS) for Minority AIDS Initiative Discretionary Grants from FY 2004 to 2006 appropriations has remained consistent.
SAMHSA anticipates receiving a continuing resolution from Congress for FY 2007 budget

## SAMHSA HIV/AIDS & Hepatitis Targeted Capacity Expansion Grants

_**CSAP:**_
- The purpose of the CSAP TCE/HIV grant program (39.3M) is to** **assist communities in expanding existing HIV/AIDS and substance abuse prevention services.
_**CMHS**_
- The purpose of the CMHS HIV/AIDS Minority Mental Health Services grant program (9.2M) is to increased capacity to provide culturally competent mental health treatment services to individuals living with HIV/AIDS.

**Notes:**
CSAP’s Programs of Regional & National Significance (PRNS) for Minority AIDS Initiative Discretionary Grants from FY 2004 to 2006 appropriations has remained consistent.
SAMHSA anticipates receiving a continuing resolution from Congress for FY 2007 budget

## SAMHSA Projects to meet MAI Objectives

- _Increase testing of affected populations _
- Rapid Testing Initiative
- Enhancing Substance Abuse Treatment Services to Address Hepatitis Infection Among IDU’s
- _Capacity-building and testing_
- Targeted Capacity Grants
- Minority Education Institution (MEI) Initiative
- SAMHSA/ONDCP Drug-Free Communities Support Program (DFCSP) Faith-based Substance Abuse and HIV Prevention Initiative
- _Sustainability _
- One-SAMHSA Minority HIV/AIDS Initiative (MAI) Conference

## SAMHSA’s Rapid HIV Testing Initiative (RHTI)

_**From FY 2005 through FY 2007, 416,895 rapid testing kits were distributed to CSAT and CSAP grantees**_.
- The RHTI was designed to reduce HIV incidence rates among minority populations who may be at an even greater risk for acquiring or transmitting HIV associated with substance abuse and/or a mental health disorder than other populations.
- SAMHSA secured a federal contract with OraSure Technologies to supply rapid HIV test kits at no cost to eligible service providers.
- These rapid HIV test kits were approved by the Food and Drug Administration and waived under the Clinical Laboratory Improvement Amendment of 1988 (CLIA) for use in non-clinical settings.

## SAMHSA’s Rapid HIV Testing Initiative Goals

- Incorporate the new rapid HIV testing methodology into SAMHSA's qualified program sites as a strategic intervention:
- To facilitate early diagnosis of HIV among at-risk minority populations involved in substance abuse (SA) and/or living with a mental health (MH) disorder, and
- To increase referrals to sustained quality counseling, treatment, and other supportive care services for such persons diagnosed with HIV;
- Provide effective counseling to persons who previously tested negative to decrease their risk of acquiring HIV;
- Identify an increased number of evidence-based prevention and treatment programs and practices in the area of HIV/AIDS associated with SA and/or MH.

## SAMHSA’s Rapid HIV Testing Initiative

- SAMHSA provided access to training, including travel, to eligible service providers.
- The fundamentals of rapid HIV testing, prevention counseling, and related data collection activities was covered during the training.
- Targeted populations included persons with a substance use (e.g., injection drug users) and/or mental health disorder, men who have sex with men, at-risk college students, sex workers, at-risk pregnant women, reentry populations, and transgender populations.

## Hepatitis A&B Vaccination & Hepatitis C Testing 

- _Prevention Strategies:_
- Provide an early diagnosis of Hepatitis infection in drug users involved in treatment programs and refer HIV+ clients to care and recovery support services.
- Provide testing for Hepatitis C infection in HIV+ clients of substance abuse treatment programs
- Vaccinate for Hepatitis A and B infections with the Twinrix vaccine, followed by referral to Hepatitis care for those individuals who test positive for Hepatitis C infection to reduce the risk of progressive liver disease.

## Hepatitis A&B Vaccination & Hepatitis C Testing Outcomes

- CDC-recommended immunizations are occurring as a ‘one-stop’ patient care service so that patients are effectively immunized against Hepatitis A and B virus that could otherwise result in significant disability or death.
- 40,000 Hepatitis C test kits have been procured and distributed allowing for testing of 800 individuals at each of the 50 testing sites.

## SAMHSA/CSAT & CDC Collaboration

- SAMHSA is actively engaged in collaborating with CDC regarding HIV initiatives and data. Outcomes from a February meeting between SAMHSA and CDC include:
-   SAMHSA will identify points of contact for 	collaboration in data collection and implementation 	guidance for testing.
-   SAMHSA is actively engaged with CDC in 	implementing the HIV testing guidelines.

## CSAT 

_**CSAT**_** **
**HIV/AIDS &**
** ****HEPATITIS ACTIVITIES**

## HHS/SAMHSA CSAT Minority AIDS Initiative 

**HHS/SAMHSA CSAT Minority AIDS Initiative**

## CSAT - Minority  AIDS Initiative

- Minority AIDS grants are awarded to community-based organizations with two or more years of experience in the delivery of substance abuse treatment and related HIV/AIDS services.
- Programs target African American, Latino/Hispanic and other racial or ethnic communities highly affected by substance abuse and HIV/AIDS.
- HIV Outreach grants served 22,760 clients
- TCE/HIV grants served 18,158 clients
- As a whole, the HIV Portfolio served a combined 40,918 clients

## HIV/AIDS Outreach – TCE/HIVEvidences of  Success

| National Outcome Measures (NOMs) | % at Intake | 6-Month Follow-up (%) | Difference |
| --- | --- | --- | --- |
| Clients reporting no substance use  | 31.9% | 56.1% | Increased 75.9% |
| Clients reporting being employed | 25.0% | 37.6% | Increased 50.7% |
| Clients reporting being housed | 33.5% | 39.8% | Increased 18.8% |
| Clients reporting no arrests | 84.9% | 87.3% | Increased 2.9% |
| Clients reporting being socially connected | 68.9% | 73.0% | Increased 6.0% |

## TCE/HIV and HIV OutreachChanges in Risk Behaviors

- Clients reporting injection drug use decreased 62.3% between intake and 6 month follow-up

- Source: SAIS data FY 2004 through 3/21/08

## TCE/HIV and HIV OutreachChanges in Risk Behaviors

- Clients reporting having unprotected sex decreased 10.4% between intake and 6-month follow-up.

- Source: SAIS data FY 2004 through 3/21/08

## TCE/HIV and HIV Outreach Changes in Risk Behaviors

- Clients reporting having unprotected sex with an HIV+ individual decreased 10.1% between intake and 6-month follow-up.

- Source: SAIS data FY 2004 through 3/21/08

## TCE/HIV and HIV OutreachChanges in Risk Behaviors

- Clients reporting having unprotected sex with an injection drug user decreased 34.2% between intake and 6 month follow-up

- Source: SAIS data FY 2004 through 3/21/08

## TCE/HIV and HIV Outreach Changes in Risk Behaviors

- Clients reporting having unprotected sex with an individual high on some substance decreased 38.1% between intake and 6 month follow-up.

- Source: SAIS data FY 2004 through 3/21/08

## HHS Minority HIV/AIDS Initiative

- April 2007, received $3 million to increase or enhance services to American Indians and Alaska Natives at risk for substance use and HIV/AIDS
- Some areas of activity :
- HIV/AIDS Rapid Testing and training
- Education
- Prevention
- Outreach
- Capacity building

**HHS Minority HIV/AIDS Initiative**

## Implementing through partnership with—
National Council of Urban Indian Health
National Native American AIDS Prevention Center
Urban Indian Health Institute
National Indian Health Board
Northwest Portland Area Indian Health Board
Navajo AIDS Network, Inc
South Puget Intertribal Planning Agency
Ti-chee Native American HIV Prevention
Native Health
Alaska Native Tribal Health Consortium

- National Council of Urban Indian Health
- National Native American AIDS Prevention Center
- Urban Indian Health Institute
- National Indian Health Board
- Northwest Portland Area Indian Health Board
- Navajo AIDS Network, Inc
- South Puget Intertribal Planning Agency
- Ti-chee Native American HIV Prevention
- Native Health
- Alaska Native Tribal Health Consortium

**HHS Minority HIV/AIDS Initiative**

## Implementing through collaboration with—
Indian Health Service
Center for Disease Control

- Indian Health Service
- Center for Disease Control

**HHS Minority HIV/AIDS Initiative**

## HIV Rapid Testing

- Purchase and distribute 50,000 test kits to tribes, tribal organization, urban Indian health clinics that have the capacity to provide HIV Rapid Testing
- Host two CDC Rapid HIV Testing Training
- Host CDC Rapid HIV Testing Train the Trainer

## Challenges

- Stigma in facilities and communities
-  Concern for confidentiality
-  Jurisdiction in situations at the state level
-  Lack of consensus on what / how to educate
-  Lack of human resources with local expertise
-  Appropriate but competing priorities with funds
-  Complacency  (#) / perception that HIV is rare
-  Gathering data remains complex
-  Reactive paradigm

**Challenges**

## FY 2008  Targeted Capacity Expansion Program for Substance Abuse Treatment and HIV/AIDS Services (TCE/HIV)

- _Award Information_:
-   **Application Deadline: March 27**
-   Funding Mechanism:  Grant
-   Anticipated Total Available Funding:  $19.8 million
-   Anticipated Number of Awards:  Up to 50
-   Anticipated Award Amount:  Up to $450,000 for treatment 	services; up to $350,000 for outreach & pretreatment services
-   Length of Project Period:  Up to 5 years
-   For more information & application: _http://www.grants.gov_/
- Proposed budgets cannot exceed $450,000 ($350,000 for outreach & treatment) in total costs (direct and indirect) in any year of the proposed project.  Annual continuation awards will depend on the availability of funds, grantee progress in meeting project goals & objectives, timely submission of required data and reports, 7 compliance with all terms and conditions of award.

## SAMHSA/CSAT Rapid HIV Testing Requirements in FY 2008 TCE/HIV RFA

- CSAT has an HIV testing requirement in the FY 2008 TCE/HIV RFA:
- All grantees must provide on-site HIV testing in accordance with State and local requirements or provide referral to an HIV testing site certified by the local health department if the client requests off-site HIV testing.
_**CSAT expects that all FY 2008 TCE/HIV grantees test a minimum of 80% of all clients.**_
- Grantees must justify an HIV testing rate below 80%
- _CSAT will consider any failure to provide an adequate justification when making annual determinations to continue a grant and the amount of any continuation award._
- HIV testing may also be made available to the injection and/or sexual partners of the clients

## CSAT – SAPT Block Grant Set-Aside

- The Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) Reorganization Act of 1992 amended Title XIX, Part B, Subpart II of the Public Health Service Act
- Requires States with an AIDS case rate of 10 or more per 100,000 individuals (“Designated States”) to set-aside a certain percentage of the SAPT Block Grant to establish 1 or more projects for early intervention services for HIV.
- _Currently, all Designated States are required to set aside 5% of their SAPT Block Grant allocations for early intervention HIV services_.

## CSAT – FY 2008 SAPT Block Grant Set-Aside

- In FY 2008, 21 States, Puerto Rico, and U.S. Virgin Islands were HIV “Designated States.”
- Total SAPT HIV Set-Aside funding:  **$56.77 Million**
- HIV early intervention projects include counseling, HIV testing, and referral services.
- States are being encouraged to use part of their HIV set-aside to purchase Rapid HIV Test Kits

##  Block Grant HIV Set-aside States

-  **Block Grant HIV Set-aside States**

- = HIV Set-aside State (Reported 10 HIV cases per 100,000 to CDC

## Examples of MAI Grantee Activities

- St. Luke’s-Roosevelt Institute for Health Scis - NYC
- Offers HIV rapid testing, along with pre- and post-test counseling at the hospital’s emergency room. Target population: HIV positive and HIV high-risk minority adolescents with substance abuse problems in school-based and outpatient treatment settings
- Test Positive Aware Network – Chicago, IL
- Aims to decrease substance abuse and HIV transmission among African American men by providing education, brief interventions, individual and group level counseling, HIV testing, and substance abuse treatment.

## Examples of MAI Grantee Activities (cont’d)

- Latino Community Services Inc. – Connecticut
- Latino Faith Partnership for Prevention and Treatment, in partnership with a core group of Latino pastors, targets the Latino/Hispanic community in CT with evidence-based practices for community outreach, screening, HIV/STD testing, substance abuse treatment and HIV prevention intervention
- Prototypes – Los Angeles County, CA
- In collaboration with the Los Angeles County Public Defender’s office, provides HIV/AIDS services, including rapid confidential HIV testing and referrals for medical treatment, to mostly Latina and African American women sex workers in Los Angeles

## CMHS 

_**CMHS**_** **
**HIV/AIDS &**
** ****HEPATITIS ACTIVITIES**

## CMHS - HIV/AIDS Initiatives

- _The Mental Health HIV Services Collaborative (MHHSC) Program_
-  The MHHSC grant program is designed to support 	the provision of culturally competent HIV/AIDS-	related mental health treatment and case management 	services to persons in minority communities.
-   MHHSC serves to strengthen & expand the capacity of 	community-based entities to address the treatment 	needs of under-served individuals.

## CMHS - HIV/AIDS Initiatives

- _The Mental Health HIV Services Collaborative (MHHSC) Program – Cohort I (2001-2005)_
-   20 MHHSC grant sites provided approximately 8,000 	individuals with HIV-related mental health services
-   12 of the 20 sites developed or expanded services in 	traditional (clinical) settings; 8 provided services in 	both traditional and non-traditional (e.g. home-based or 	mobile treatment) settings
-   The grant sites engaged in collaboration with other HIV 	& behavioral health services providers in their 	locations, enhancing a network of care.

## CMHS - HIV/AIDS Initiatives

- _The Mental Health HIV Services Collaborative (MHHSC) Program – Cohort I (2001-2005) – cont’d_
-   All 20 grant sites received training on providing 	culturally-competent care
-   All 20 grant sites formed or expanded Consumer 	Advisory Boards that played a meaningful role in 	project activities.

## CMHS - HIV/AIDS Initiatives

- _The Mental Health HIV Services Collaborative (MHHSC) Program – (2006-2010)_
-   There are currently 16 MHHSC grant sites in Cohort II
-   Allocated for Grant Awards: $8.4 Million annually 	(approximately $525 K per grantee per year)
-   NOMs data from grant sites is being collected by 	CMHS’ new TRAC system, which went live in 2007.
-   Data is expected to be available later in FY 2008.

## CMHS Mental Health HIV Services Collaborative Program

- ● Sites funded FY 2001-2005
- ♦ Sites funded beginning in FY 2006

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## CMHS - HIV/AIDS Programs

- _The Mental Health Care Provider Education in HIV/AIDS Program (MHCPE) III_
-   Annual allocation of $450,000 is in the form of 3 	contracts for professional training on HIV & mental 	health:
- American Psychological Association ($150,000 annually)
- American Psychiatric Association ($150,000 annually)
- National Association of Social Workers ($150,000 annually)
-   Built on the goals and successes of the original MHCPE 	program administered by CMHS since 1992, this 	program has supported training for over 200,000 mental 	health care providers.

## CMHS - mental health AIDS

*mental health AIDS*** **is a free, online, quarterly biopsychosocial research update designed to summarize, organize, and facilitate the practical application of the immense and ever-increasing body of peer-reviewed literature on HIV & mental health for front line clinicians.
- The format reflects a systems-oriented approach to the understanding of health and disease.
- HIV mental health treatment planning considers not only the psychiatric & psychological aspects of infection, but the biological, social & spiritual aspects as well, so that treatment may be offered from a "biopsychosocial" perspective.
- A "systemic" model of this type reinforces the use of the provider-client relationship in delivering health and mental health care.
- Web site: _http://mentalhealthAIDS.samhsa.gov_

## Examples of MAI Grantee Activities

- Gay Men’s Health Crisis, Inc. – NYC
- Provides culturally competent HIV/AIDS-related mental health and substance use services for African American and Hispanic/Latino New Yorkers living with HIV/AIDS
- Haight-Ashbury Free Clinics, Inc. – San Francisco, CA
- Offers targeted mental health care integrated with substance abuse treatment and primary care for medically indigent, dually and triply diagnosed HIV positive African Americans in San Francisco.

## CSAP 

_**CSAP**_** **
**HIV/AIDS &**
** ****HEPATITIS ACTIVITIES**

## State Systems 
Prevention 
Infrastructure

**Prevention **
**Infrastructure**

**Community Coalitions Action Mechanism**

**General Public **
**Awareness and Outreach**

**Infusion of the Strategic Prevention Framework****MAI New Approach**

## CSAP MAI Active Grants

| Cohort # | Fiscal Year | Grants Funded | Number of Years | Average Award Amt. |
| --- | --- | --- | --- | --- |
| 4 | 2003           
Sept. 2003 to Sept. 2008  | 22 | 5 | $336,608 |
| 5 | 2004           
Sept. 2004 to Sept. 2008 | 45 | 4 | $141,666 |
| 6 | 2005           
Sept. 2005 to Sept. 2010 | 80 | 5 | $253,828 |
| 7 | 2008Will be awarded 9/30/08
Sept. 2008-Sept. 2013 | 46 | 5 | $400,000
(up to) |
| Total |  | 193 |  |  |

## CSAP Concentration of Minority HIV/AIDS Grants by States within Region

## HHS Secretariat MAI Emergency Fund

- The HHS Secretariat MAI Emergency Fund includes two programs:
-   Minority Education Institution Initiative
-   Drug Free and Faith-based Partners Initiative
-   Annual Funding:

| FY2005
Actual | FY2006
Actual  | FY2007
Actual | FY 2008
Actual |
| --- | --- | --- | --- |
| 
$3M | 
$4.5M | 
$6.0M  | 
$6.0M  |

## CSAP – Minority Education Institution Initiative (MEI)

- The MEI focuses on population areas where there are large underserved minority groups at risk for substance abuse and HIV. Project objectives are to:
-   Increase the access of racial and ethnic minority 	communities to HIV prevention and make referrals to 	care and treatment services.
-   Implement innovative strategies and activities specifically 	targeted to the highest risk and hardest-to-serve 	subpopulations.
-   Establish collaboration and new partnership opportunities 	for the MEI program or activities to be integrated with.

## MEI Approach

- The MEI Initiative focuses on several priority racial and ethnic groups and subpopulations, including:
-   African American/Black,
-   Hispanic/Latino, and
-   19 Native American/American Indian students on 	minority campuses.

## MEI Goals

- To increase substance abuse prevention education, awareness and HIV/AIDS/Hepatitis health promotion services to reduce health disparities for racial and ethnic minority college communities.
- To improve internal and external collaboration with partners to maximize the impact of MAI funding to minority education institutions.
- To increase HIV testing activities on campuses.

## FY 2008 MEI Initiative Update

- CSAP funds the Minority Education Initiative Program Coordinating Center (MEI-PCC) to administer a total of 18 subcontracts:
- 11 Historically Black Colleges and Universities (HBCUs)
- 4 Hispanic Serving Institutions (HSIs),
- 3 Tribal Colleges and Universities (TCUs).
- MEI project activities include:
- Training
- Community outreach
- Information and referral services
- HIV testing and referrals
- Material dissemination
- Workshops led by trained student peer educators (SPEs)

## 	MEI Initiative Demographics

- For FY 2006 and  FY 2007, students engaged in Substance Abuse Prevention and HIV/AIDS prevention activities ranged in age, and differed by race & gender:
- 77% of students engaged were between the ages of 18 and 21 years of age
- 75% of students engaged were African-American
- 61% of students engaged were female
- 9% of students engaged were Hispanic/Latino
- 6% of students engaged were Native American

## MEI Initiative FY 2007 Outcomes

- MEI institutions provide a variety of activities:
- 474 Peer Educator Training sessions conducted
- 866 HIV Awareness Educational Workshops held on campus and at satellite locations
_**7,685**_ HIV Rapid Testing and Standard Testing were conducted
- Across fiscal years 2006 and 2007 the MEI initiative engaged more than 25,000 students in prevention efforts

## Total Served Through All Activities

| Student Peer Educators  | 264 |
| --- | --- |
| Student Peer Educators Led Participants | 8,716 |
| Community Member Participants | 74 |
| High School Student Participants | 316 |
| Faculty Participants | 263 |
| Other Participants | 327 |
| Students Reached Through Awareness/Outreach | 36,643 |
| Total Reached Through Programming | 46,603 |

## Examples of MAI Grantee Activities

- Asian American Recovery Services, Inc. San Francisco, CA
- Provides substance abuse prevention and HIV and Hepatitis prevention services to minority populations and minority reentry populations. Targeting Asian Americans and Pacific Islander Americans, the needs of the reentry population, limited English-speaking immigrants and other high risk individuals
- AIDS Service Center of Lower Manhattan
- AIDS Service Center NYC proposes an integrated HIV, Substance Abuse, and Hepatitis Prevention Program to increase the capacity of minority communities in Manhattan to reduce the incidence of HIV, substance abuse (SA), and viral hepatitis among adult black and Latina women at risk (via sexual and/or drug-related behaviors) and among male and female ex-offenders