The Minority AIDS Crisis 

Congressional Black Caucus prompts Administration to launch $156 million


HIV/AIDS Initiative for Racial and Ethnic Minorities


By Jennifer Brooks


Closing the Gap, HIVS/AIDS • April 1999


Every day, seven people contract HIV. Of those, three are African American, according to Dr. Beny J. Primm, executive director of Addiction Research and Treatment Corporation. 

“African Americans are less likely to know their HIV status, get 

treatment, and be prescribed and take combination drug therapies for 

the disease,” Dr. Primm said during the Congressional Black Caucus’ 

(CBC) 1998 Spring Health Braintrust. It was his and other experts’ 

testimonies that prompted the CBC to urge President Clinton and 

Secretary of Health and Human Services (HHS), Donna E. Shalala, to 

declare HIV/AIDS in racial and ethnic minority communities a severe 

and ongoing health care crisis. As a result of intense discussions between the CBC and HHS, the Clinton Administration devoted an 

unprecedented $156 million for an initiative to battle America’s minority HIV/AIDS problem. 

“AIDS has always been one of the CBC’s priorities,” said Donna 

M. Christian-Christensen, MD, U.S. Virgin Islands Delegate and 

chair of the CBC’s Health Braintrust. “Initially, we took the traditional legislative and policymaking route to address the AIDS problem. We held an all-day hearing on HIV/AIDS last year,” she said. 

“But when we realized the epidemic was getting exponentially worse, 

we knew drastic changes had to be made,” she added. 

The Severity of the Minority HIV/AIDS Crisis 

There has been a recent decline in HIV/AIDS death rates due to 

new treatment therapies. But current data from the Centers for Disease Control and Prevention (CDC) show HIV/AIDS rates among 

minorities—particularly African Americans—are on the rise. AIDS is 

the number one killer of African American men between the ages of 

25 and 44, and is the second leading cause of death among African 

American women of the same age. 

Several factors contribute to the severity of the AIDS epidemic 

among some minorities, according to Eric P.Goosby, MD, director of 

HHS’s Office of HIV/AIDS Policy. “First, within our population, we 

have individuals and groups that continue to practice high-risk behavior. Second, mixing of the virus into the population has occurred 

in African American and Hispanic groups, whereas it hasn’t occurred 

in Asian and American Indian populations.” With Asians and American Indians, you have the same high-risk behavior taking place, but 

the virus has not been introduced into that population, according to 

Dr. Goosby. 

The third factor is the stigma of HIV and AIDS. “In our community, the stigma associated with revealing yourself as an HIV positive individual, or as an individual who is in a group that is at higher 

risk—homosexuals or intravenous drug users—causes many individuals 

consciously to remain clandestine,” according to Dr. Goosby. “It’s 

about the patients. But it’s also just as much, if not more, about the 

impact it will have on their families.” 

Americans in general are living longer and healthier 

lives with HIV/AIDS due largely to medical advances 

and better drugs. But racial and ethnic health disparities also exist in 

quality of life for those living with the disease. 

“No matter what health problem we have, African Americans are 

hit harder,” said Congresswoman Christian-Christensen. “It’s not just 

an AIDS problem,” she added. “It’s a health infrastructure problem.” 

The Congresswoman said more basic problems need to be addressed like the ineffectiveness of many prevention programs, lack of 

access to quality and culturally appropriate services, and how managed care has failed the black community. “We need to look carefully 

at recent studies that show African Americans don’t receive the same 

medical treatment by doctors as other Americans. Those are the systemic problems,” according to Congresswoman Christian-Christensen, 

who is former Assistant Acting Commissioner for Health in the Virgin 

Islands and has practiced family medicine in HIV/AIDS clinics and 

methadone programs. 

“The Department’s goals are to significantly decrease the number of new HIV infections in the next three year period to less than 

15,000 annually,” said Dr. Goosby. The current rate is somewhere 

around 40,000 new infections a year. 

Of the 600,000 in the U.S. who are HIV positive, approximately half of them—300,000—are not getting care, according to 

Dr. Goosby. “Our goal is to identify high risk populations; target 

them for testing; and move those that are positive, once tested, into a 

continuum of care and services. Those are our goals to increase the 

numbers of people getting treated.” 

The HIV/AIDS Initiative 

The Initiative to Address HIV/AIDS Among Racial and Ethnic 

Minority Populations was developed by HHS and the CBC to reduce 

the disproportionate impact HIV/AIDS has on racial and ethnic minorities. Working through five federal agencies, HHS will spend 

$156 million—in addition to $7 billion in discretionary funds for 

HIV/AIDS—to provide grants to community based organizations, 

research institutions, minority-serving colleges and universities, health 

care organizations, and state and local health departments. 

The HIV/AIDS Initiative is part of the Clinton Administration’s 

larger Initiative to Eliminate Racial and Ethnic Disparities in Health 

by the year 2010. HIV/AIDS is one of that initiative’s six focus areas. 

As part of the HIV/AIDS Initiative, HHS has divided the $156 

million among the CDC, Substance Abuse and Mental Health Services Administration, National Institutes of Health, Health Resources 

and Services Administration, and the Office of Minority Health. 

These agencies will in turn award grants for programs over the next 

three years dealing with HIV/AIDS prevention and education, research, faith-based initiatives, prison programs, expansion of treatment capacity, bilingual/bicultural services, Healthy Start, 

and other special projects. Who will monitor the funding 

and activities around the initiative over the next three years? 

continued>>>> 

Office of Minority Health Resource Center 1 U.S. Department of Health and Human Services 
The Minority AIDS Crisis 

Congressional Black Caucus prompts Administration to launch $156 million


HIV/AIDS Initiative for Racial and Ethnic Minorities


By Jennifer Brooks


Closing the Gap, HIVS/AIDS • April 1999


“It’s partly the job of the CBC through the Health Braintrusts,” said 

Congresswoman Christian-Christensen. “And we will continue meeting with HHS officials who have been instrumental in developing 

this initiative.” She said there will also be regular reporting of initiative 

activities. “We realize the AIDS problem is not the type of thing that 

will just go away if we give out funding,” said Congresswoman Christian-Christensen. “We need to know what was done with the money 

and what really worked.” 

President Clinton’s Advisory Council on HIV/AIDS 

In June 1995, President Clinton established the President’s Advisory Council on HIV/AIDS to advise and make recommendations 

to the President on issues related to HIV/AIDS including research, 

health care, prevention, services, and leadership for the nation. 

In keeping with its mandate and the President’s declaration to 

end all new infections, the Advisory Council established a Subcommittee on Communities of African and Latino descent, later expanded 

to the Subcommittee on Racial and Ethnic Populations. The Subcommittee set out to provide leadership on issues of race and ethnicity, 

and to identify racial and ethnic disparities throughout every aspect of 

the Council’s work. 

In April 1998 the Council constructed a strategic planning agenda 

that held as its overriding principles an obligation to respond to the 

needs of communities of color throughout the remainder of its term. 

Conclusion 

Dr. Goosby said through the HIV/AIDS initiative, we should 

focus our strategy on identifying individuals who are HIV positive 

and get them care. “But just as important,” said Dr. Goosby, “we have 

to have a concurrent strategy that focuses on changing the cultural 

context within the community in which individuals have to reveal 

themselves, and make that safe.” 

He said the stigma of revealing your HIV status to the community continues to be an overwhelming deterrent to those individuals 

who either are participating in high risk behavior and who do not 

know their status, or those who actually do now they are HIV positive 

but are afraid to receive treatment. 

“By targeting church leadership and organizations that do not 

have health as a centerplate issue, such as the National Urban League, 

NAACP, fraternities, sororities, and PTAs, those organizations can 

have HIV on their national agenda items and play a role in changing 

the context of the way we react to and perceive HIV positive individuals in our communities,” Dr. Goosby said.

Office of Minority Health Resource Center 2 U.S. Department of Health and Human Services