Through Part C (previously Title III), the Ryan White HIV/AIDS Program delivers services to help grantees strengthen their cultural capacity to address HIV, and carry out Early Intervention Services (EIS), such as testing, case management, and risk reduction counseling, ensuring their reach into underserved communities with high rates of seropositivity.
HRSA took note of the unique biological and cultural needs among women. Though women were—and still are today—served through other Parts of the program, it was clear more needed to be done.43 In an effort to raise the bar on culturally competent care, Congress created the Part D program (previously Title IV) specific for this population. Part D expands upon early efforts under the Pediatric AIDS Service Demonstration Grants in the late 1980s, which developed early models of care for infants, youth, and their families.
Wherever there has been a shortfall of culturally competent care responses, HRSA has worked to fill those voids. It was this pursuit that the program was borne out of, that the legislative changes throughout the years have reflected, and the Part D program is continued testament.
Part F includes the national and regional AETCs, which offer diverse training and resources to grantees nationwide around cultural competency. The National Multicultural Center AETC produced the seminal BE SAFE training manuals about providing culturally competent care to African-Americans; Asians and Pacific Islanders; Latinos; and American Indians, Alaska Natives, and Native Hawaiians, as well as published numerous resource guides geared to bolstering providers’ capacity to deliver services to populations vulnerable to HIV infection, such as homeless youth of color and injection drug users.44,45,46
Engaging patients in conversation about their health makes them feel like full-fledged partners in their care.
The Ryan White HIV/AIDS Program’s numerous AETC trainings have empowered providers with necessary information and insight, “making them feel more comfortable and equipped to work in communities outside their cultural norms,” says Bradley-Springer. In addition to direct prescriptive approaches to cultural competency, AETC trainings and resources leverage the tenants of cultural competency through case studies exploring how patients from diverse walks of life deal with HIV/AIDS.47,48
Also under Part F is the Special Projects of Programs of National Significance (SPNS) program. When needs arise in the epidemic, the SPNS program funds initiatives seeking innovative and replicable models of care. The findings from these “pilot projects” are disseminated to grantees across the country to further arm them in the latest battle against HIV. The dental programs on the other hand, address a health challenge mainstay for people living with HIV/AIDS: oral health.
The Minority AIDS Initiative (MAI) additionally falls under Part F. Its funds are earmarked to support capacity building activities in minority and minority-serving community-based organizations delivering HIV/AIDS services in communities of color. Through these mechanisms, the MAI has bolstered the infrastructure of the community-based response nationwide, in large part by enhancing the cultural competencies of their staffs.49,50 As Johnson explains, “the MAI has been the catalyst for other agencies that focus on communities of color to expand their work in minority-serving communities” and, together with SPNS initiatives, has shown them how to do so.