Supervisor Mark Ridley-Thomas’ opening remarks at a meeting on HIV Prevention with Centers for Disease Control and Prevention (CDC) Director Dr. Robert Redfield and other federal and Los Angeles County public health officials.
“The fact that Dr. Redfield– a preeminent leader in HIV research and programs–is the director of the CDC says a lot about CDC’s commitment to eradicating HIV, and LA County is dedicated to being a partner in its efforts.
“HIV and STIs have been, and will continue to be, my priority policy areas, especially considering their disproportionate impact among communities of color.
“To that end, my staff and I have worked closely with many of you here for years. And while there has been a mix of good news and bad news over the years, I want to recognize the progress that we’ve made and must continue to make.
“For example, it cannot be taken for granted that as government agencies, we are addressing HIV in the context of health equity, and squarely acknowledging the sexism, racism, homophobia and classism that impact our systems of care. DPH continues this conversation through the Office of Health Equity, and also by publishing its City and Community Health Profile Report which compare and contrast the health data of various communities throughout Los Angeles County.
“This report looks at the various social determinants of health, which show that life expectancy, disease transmission and other health factors are complexly intertwined with access to food, parks, and housing security. Activities like this continue to push the dialogue on health disparities and social determinants in a way that is interdisciplinary and comprehensive.
“Additionally, we are seeing more youth engaging in advocating for their own reproductive health, and leading the conversation about their bodies, their safety, and their health. This is why we must continue to invest more in school-based health centers, as well as outreach, education, and empowerment programs for our youth. To that end, our Departments of Public Health and Mental Health are working collaboratively with school districts to see how we can bring more investment into our schools.
“While we celebrate these markers of progress, we also understand the gravity of the work yet to be done. For example, the advancement of biomedical tools has increased our arsenal to combat HIV infection, and have also contributed to the repeal of California’s HIV Transmission Law last year. And yet, despite the availability of PrEP and PEP, new infections among certain communities are still high, particularly among African-American men and women.
“Preliminary findings from a National Institutes of Health-funded study by Dr. Cynthia Davis at Charles Drew University demonstrated that there is a need for greater education on PrEP and PEP in the African-American community among at-risk individuals. Major concerns expressed with PrEP and PEP had to do with the cost of use these interventions; side effects; PrEP’s inability to provide protection from other STIs; difficultly of maintaining adherence; and stigma. Study participants also mentioned that there was limited education available on the benefits of PrEP, and there was almost total lack of knowledge on PEP. These preliminary findings give us great cause for pause, and to reevaluate our messaging and outreach to at-risk communities. We must invest more in targeted and culturally-competent outreach programs.
“On top of these continuing health disparities, new challenges are posed by the dramatic changes in the ways individuals connect via new technology and media. Government programs often do not lead on these trends, but we must act faster if we want to make our messages relevant. That means using social media, producing culturally relevant messaging, and working collaboratively with technology, media and entertainment companies.
“Additionally, like many other cities, LA County is contending with an unprecedented homelessness crisis, which directly impacts the work that DPH and other services providers are doing to protect the health of our residents, both housed and unhoused.
“While we will dive deeper into many of these challenges today, I commend the work and dedication of everyone here to meet those challenges. I look forward to what I’m sure will be a robust and meaningful discussion on this issue, and for future collaborations.”