National Black HIV/AIDS Awareness Day: Taking Action to Improve Health Outcomes

Cross-posted from NIH Office of AIDS Research, Director’s Corner

On February 7th, the United States recognizes National Black HIV/AIDS Awareness Day (NBHAAD), an observance established to increase awareness and mobilize community involvement in combatting HIV among Black/African American people. NBHAAD highlights the critical need to address the high burden of HIV and AIDS on Black/African American communities and recommit efforts to sharpen the focus on HIV/AIDS research.

Since early in the 40-year HIV epidemic, Black/African American people have been disproportionately impacted by HIV. In 1988, the number of infections among Black persons surpassed the number of infections among White persons and remained higher than in any other racial/ethnic group.¹

According to the Centers for Disease Control and Prevention (CDC), in 2019 Black/African Americans accounted for 41 percent of the estimated 34,800 HIV infections in the United States and dependent areas, even though Black/African Americans represent only 12 percent of the U.S. population.^2,3

Societal and structural factors increase the risk of HIV acquisition and poor treatment outcomes, contributing to the disproportionate impact of HIV on Black/African American populations. A growing body of research shows that racism is deeply embedded in our society, creating inequities in access to a range of social and economic benefits, such as housing, education, wealth, employment, and health care. African Americans and other minority groups face disproportionate rates of HIV infection in large part because they experience significant barriers to accessing prevention and care services.⁴

NIH OAR coordinates a multidisciplinary NIH-wide HIV/AIDS research agenda to address inequities and improve health outcomes for all persons who are living with or are significantly affected by HIV. This approach—“to build human resource and infrastructure capacity to enhance sustainability of HIV research discovery and the implementation of findings by a diverse and multidisciplinary workforce”—is clearly stated in the Fiscal Year (FY) 2021–2025 NIH Strategic Plan for HIV and HIV-Related Research.

To fully respond to the impact of HIV on Black/African Americans, the HIV public health enterprise must increase Black/African American representation across the research, public health, and health services workforce. To that end, the NIH launched the UNITE initiative in 2021 to address structural racism and promote racial equity and inclusion at the NIH and within the larger biomedical research enterprise. NIH OAR supports UNITE and other NIH-wide efforts to advance diversity, equity, and inclusion in science.

NIH OAR is committed to addressing the root causes of health disparities and improving HIV-related health outcomes for Black/African American communities and other underrepresented minority groups and has acted to—

• Contribute HIV research objectives to the revised National HIV/AIDS Strategy for the United States 2022–2025 (NHAS), which provides a framework for research to reduce HIV-related disparities and health inequities. NIH OAR engaged NIH partners and advisors to identify scientific gaps and areas of research that are essential to Ending the HIV Epidemic in the U.S. (EHE).
• Advance the NIH Request for Applications titled Understanding and Addressing the Impact of Structural Racism and Discrimination on Minority Health and Health Disparities.
• Launch a series of listening sessions and community conversations to provide an open and transparent forum for stakeholders to communicate views on current and future research opportunities from a local and regional point of view. During recent listening sessions, NIH OAR received input on significant gaps in HIV research that are relevant to Black/African American populations.
• Co-organize an HIV-Related Intersectional Stigma Research Advances and Opportunities Workshop with the National Institute of Mental Health’s Division of AIDS Research.
• Support studies conducted by researchers within the National Institute on Minority Health and Health Disparities Research Centers in Minority Institutions (RCMI) Program to advance the EHE.
• Initiate a multi-pronged initiative to increase the cadre of early career HIV investigators across disciplines and institutions, with a focus on researchers from underrepresented minority groups and under-resourced institutions.

To understand the scope of past and current NIH-funded HIV research opportunities, see these examples:

• Limited Competition: Development and Renovation of Research Space for HIV/AIDS Research at Institutions Serving Underrepresented Populations or Located in Institutional Development Award (IDeA)-eligible States (C06 Clinical Trial Not Allowed)
• Innovative Multi-Level Approaches and Strategies to Prevent, Test and Treat HIV in Primary Care Settings in Health Disparity Populations in Geographic Hot Spots in the United States (R01 - Clinical Trial Required)
• Innovations in HIV Prevention, Testing, Adherence and Retention to Optimize HIV Prevention and Care Continuum Outcomes (R21 Clinical Trial Optional)
• Notice of Special Interest: Stigma or Other Social Determinants of Health (SDOH) in HIV Prevention and Treatment
• A Randomized Controlled Trial of an Antiretroviral Treatment Adherence Intervention for HIV+ African Americans
• Multilevel Determinants of HIV Pre-Exposure Prophylaxis (PrEP) Utilization and Health Disparities Among Black and Hispanic Women
• Getting to Zero: Understanding HIV Viral Suppression and Transmission in the United States (R01 Clinical Trial Optional)

NIH OAR remains steadfast in its commitment to support NIH-funded HIV research to improve HIV testing, prevention, and treatment for Black/African American people. NIH OAR uses information shared by our partners to guide the NIH HIV research agenda to address health inequalities, improve health outcomes for all people with HIV, and end the HIV pandemic.

To learn more about National Black HIV/AIDS Awareness Day and find resources on HIV testing, prevention, and treatment research, I encourage you to read the HIV.gov NHBAAD webpage, the HIVinfo.nih.gov Research webpage, and the CDC NBHAAD Toolkit.

Maureen M. Goodenow, Ph.D.
Associate Director for AIDS Research and
Director, Office of AIDS Research
National Institutes of Health

¹ Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report (MMWR). Estimated Annual Number of HIV Infections—United States, 1981–2019. Weekly, June 4, 2021, 70(22);801-806, Bosh KA, Hall HI, Eastham L, Daskalakis DC, Mermin JH. Estimated Annual Number of HIV Infections—United States, 1981–2019 | MMWR (cdc.gov)

² HIV Surveillance Report. Supplemental Report. Volume 26, Number 1. Published May 2021. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-26-1.pdf

³ 2020 Census Illuminates Racial and Ethnic Composition of Country. United States Census Bureau. August 12, 2021. https://www.census.gov/library/stories/2021/08/improved-race-ethnicity-measures-reveal-united-states-population-much-more-multiracial.html

⁴ Centers for Disease Control and Prevention. 2019 National HIV Surveillance System Reports. https://www.cdc.gov/nchhstp/newsroom/2021/2019-national-hiv-surveillance-system-reports.html