Preventing HIV/AIDS transmission on Historically Black Colleges and Universities (HBCUs)

1. Preventing HIV/AIDS transmission on Historically Black Colleges and Universities (HBCUs) Peter Thomas, PhD, MPH Division of HIV/AIDS Prevention, Division of Adolescent and School Health Centers for Diseases Control and Prevention "The findings and conclusions in this presentation are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention."

7. Background: Risk of HIV/AIDS on Historically Black Colleges and Universities (HBCUs) • Poor data on HIV prevalence on HBCU campuses • Increased risk among some social networks that include HBCU students • North Carolina investigation (2002) • Mississippi investigation (2008) • Higher risk of infection among blacks/black students (particularly men who have sex with men) • Like other college-aged adults, HBCU students continue to practice high-risk sex behaviors

8. Rapid HIV Testing in HBCU Settings • September 2004 – June 2007 • 4 sites to provide HIV testing at 7 HBCUs • 2 year project • Demonstrate new models for HIV testing • Include testing in alternative venues • Use creative strategies to encourage people to be tested

9. New Models for HIV Testing on HBCUs • Testing Venues • On campus • Off campus • Event-based (social) • Testing Strategies • Walk-In testing on set days • Appointment testing • Direct recruitment • Streamlined pre-test counseling • Group testing

10. Tested and Surveyed Population • Total persons tested: 8,498 • Total interviewed: 6574 • Total HIV positive: 14 (0.2%) • Students and non-students • Mostly MSM (12 of 14) • Self-identified as heterosexual, bisexual, and gay • Lower HIV positivity among non-gay identifying (NGI-) MSM • Behaviorally bisexual and homosexual • Similar risk behavior to sexually active HIV negative persons (e.g., # of sex partners, use of condoms, perception of risk, high-risk behaviors)

11. Surveyed Population at HBCUs HIV risk perception and behavior among participants • Perceived themselves at no/low risk for HIV infection (62%) • Agree that HIV does not cause AIDS (34%) HIV Testing Among Participants • Asked their last partner’s HIV status before sex (52%) • Person’s not previously tested for HIV (34%) • Persons who were tested in the past 12 months (34%) • More likely to report high-risk behaviors • (e.g., MSM, women who have sex with MSM, history of STD)

12. Risk Behavior Among Participants • Men who have sex men (14% of sexually active men) • 54% of AA MSM in self-identified as gay or bisexual (GI-MSM) • 46% were non gay-identifying-MSM (NGI-MSM) • NGI-MSM less likely than Gay-Identified MSM to report • Behaviors associated with HIV testing • Being tested within past 12 months • Condom use with last partner • High perception of risk • Exclusively male sex partners • Women who had sex with MSM (10% of 2040 sexually active women) • Age 21 years or older • >1 sex partners in past 12 months • No condom for last intercourse • In a committed relationship • Increased perception of risk for HIV infection • Never or infrequently attending church

13. Key - Best Practices for Implementing HIV Testing I • Social marketing • Support from top administration • Peer educators • Prepping testing supplies • Incentives

14. Successful/ Best Practices for Implementing HIV Testing II • Using the same testing place on campus rather than rotating to different campus locations • Extending invitation to collaborate with other campus organizations • Partnering with already scheduled events (e.g., social events, fraternity/sorority parties, etc.) • Consider academic calendar in planning

15. Barriers / Challenges • Recruitment for testing • Student fear, stigma • Institutional support (prioritization) • Higher risk student recruitment • Males • Off-campus students • MSM

16. Limitations • Self reported risk • Variation in project sites • Testing and survey strategies • Recruitment practices • HIV testing options in the community • Not generalizable (non randomly sampled, cross-sectional)

17. Summary • HIV infection on HBCU campuses • Is a function of HIV risk among black sub populations • Not exclusive to individuals reporting the most high-risk behavior • May be related to social networks and the community • HBCU students • Are accepting of HIV testing • Don’t see personal risks being related to HIV infection • Continue to practice high-risk behaviors • MSM students and non students in HBCU settings • Are diverse and may not identify as gay or bisexual • Have risk behaviors like others • Effective HIV testing in HBCU settings • Requires innovative strategies and methods • Can reach high-risk persons and can identify new HIV infection • Includes strategies that address stigma and ways to reach MSM

18. Albany State University Brenda Williams, RN Mattie Shiloh, RN Fort Valley State University Joanne Nobles, RN Jefferson Comprehensive Care Dr. Michelle Smith Philander Smith College The University of Arkansas at Pine Bluff Philander Smith College Howard University AdaBabino Dr. Denyce Calloway Dr. Carolyn Goode Dr. Lynette Mundey Jackson State University Dr. Kaye Sly Kevin Paterson Dr. Leandro Mena CDC/NCHHSTP/DHAP/BCSB Many staff Acknowledgements

19. Thanks Peter Thomas: pbt7@cdc.gov