White House Develops Program To Break The Silence In Caribbean American Communities

Caribbean American communities are incredibly diverse and have contributed greatly to the growth of this Nation.  I learned from watching my mother, who worked as a nurse taking care of sugar cane plantation workers, not only the importance of hard work and dedication but also the importance of family and community.  As a community, we face a significant challenge in tackling HIV. Even though Caribbean Americans comprise less than 10 percent of the total U.S. population, they are included in the disproportionately high rate of new HIV/AIDS diagnoses that occur in Black Americans. As a clinician and a professional in the field of public health, I have seen those challenges first hand. Yet as member of the community, I also know what we can accomplish if we work together. Caribbean American leaders can play an especially important role in the community to promote HIV awareness to address this public health issue. To help prevent HIV/AIDS, community leaders and care providers need to communicate about HIV in culturally relevant and linguistically appropriate ways.

As with other racial and ethnic minority communities, many Caribbean Americans have taboos against discussing sexual matters related to HIV risk. There is stigma associated with men having sex with men in some Caribbean American communities, and this challenge may influence some individuals to avoid getting tested for HIV.  Delayed HIV testing and diagnosis among Caribbean Americans seriously endangers their health and the health of their sexual partners. We must be clear and open in discussing the risk factors associated with HIV and all work to reduce barriers to testing and treatment. With regular testing to identify new HIV infections, individuals who test positive can have the opportunity to receive appropriate care and treatment to prolong their lives and reduce the chances of infecting others.

Federal partners including HHS have been working with the White House Office of National AIDS Policy (ONAP) to develop a National HIV/AIDS Strategy using input from the public, to improve our response to the epidemic in the U.S.  Active involvement by individuals and stakeholders including state, territorial, and local governments will be important in implementing the national strategy. The HHS Office of Minority Health will continue to partner with other agencies and organizations to support capacity building in hard-hit communities, improve care providers’ cultural competency, conduct outreach, and help people to get educated about HIV, get tested, and get treated. We are targeting those hardest hit by the epidemic – for example, our HIV/AIDS Health Improvement for Re-entering Ex-Offenders Initiative (HIRE) program bridges healthcare gaps that exist with the AIDS epidemic to improve the HIV/AIDS health outcomes of ex-offenders re-entering the mainstream population by supporting community-based efforts to ensure their successful transition from state or federal incarceration back to their communities.

Today, we recommit with others around the country to improve the lives of people living with HIV/AIDS. I learned a saying from my mother that not all silence is golden, and silence isn’t golden when it costs lives. On this Caribbean American HIV/AIDS Awareness Day, let’s raise our voices together to empower Caribbean American communities to challenge the stigma surrounding the disease in order to help reduce new infections and better serve people living with HIV. Let’s aim to reach our communities with a message focused on prevention and testing, understanding that if we work together we can continue to achieve great things, one of the greatest being an end to the HIV epidemic.　　

Garth Graham, M.D. is the Deputy Assistant Secretary for Minority Health at the U.S. Department of Health and Human Services.