Thousands of HIV care and treatment leaders, including Ryan White HIV/AIDS Program (RWHAP) recipients from across the nation, reconvened for day two of the 2016 National Ryan White Conference on HIV Care and Treatment in Washington, DC. On Wednesday, the theme focused on health equity. The morning kicked off with a plenary session panel highlighting how social determinants of health, which is defined as the conditions which people are born, grow, work, live, and age, impact HIV care and treatment outcomes and how programs, policies, and people living with HIV can address these structural barriers to increase health equity.
In case you missed it, below is a recap of day two.
Day Two Plenary Spotlights Health Equity Issues
Heather Hauck, the HRSA HIV/AIDS Bureau Deputy Associate Administrator, opened the National Conference day two plenary session by highlighting Ryan White HIV/AIDS Program client-level data that demonstrates remarkable outcomes among Ryan White HIV/AIDS Program clients but also illustrates continued disparities clients face, particularly among black/African American gay men, youth, and transgender individuals. As for addressing disparities, Hauck noted that the Ryan White HIV/AIDS Program is “in and of itself a structural intervention” and the “data tell us what we as a Program collectively can do to utilize the RWHAP to improve health outcomes.”
Brian Smedley, Executive Director of the National Collaborative for Health Equity, provided data on the root causes of health inequity and how public health can help make improvements. “Where one lives” has an impact on health outcomes, said Smedley. He said potential solutions include place-based strategies (investments in communities, like increased food options, improving the physical environment) and people-based strategies (investing in early childhood education and increasing housing mobility options).
DeAnn Gruber, Program Director at the Louisiana Office of Public Health, summarized health disparities in her state, where the HIV rate is seven times higher among black/African Americans as compared to whites. She shared one approach Louisiana pursued to address this issue was a series of workshops titled “Beyond Racism,” which were planned and implemented as a multi-year strategy that resulted in strengthening Louisiana’s recruitment and hiring process, enhancing staff orientation and training, and creating new position to better serve LGBT populations.
The panel also featured Gina Brown, former coordinator for the New Orleans Regional AIDS Planning Council, who spoke of her experience as a young adult learning of her HIV diagnosis while facing stigma to her eventual path of education, employment, and support for other women at risk or living with HIV. Brown spoke of her personal journey with health equity and said, “I think of all the people who helped me get to where I am,” particularly Part D, concluding that “Part C is continuing to infuse me with life.”
David Holtgrave, Chair of the Department of Health, Behavior, and Society at Johns Hopkins University’s School of Public Health, summarized the National HIV/AIDS Strategy: Updated to 2020 goal to reduce homelessness and unstable housing for people living with HIV (Goal 2), which is one of the few benchmarks where improvement has not occurred. To examine determinants of housing gaps among people living with HIV, Holtgrave provided a summary of data analysis, which revealed a set of consistent findings on the experiences of poorly housed individuals living with HIV: 89 percent found worse health outcomes; emergency room usage was higher; and HIV risk behaviors were higher. Holtgrave concluded with a set of observations on the policy implications, among them: housing is a promising structural intervention to stop the spread of HIV and improve the health of those most affected by the HIV epidemic.
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