Description
The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Prevention (CSAP), is accepting applications for fiscal year (FY) 2010 Capacity Building for Substance Abuse (SA) and HIV Prevention Services for At-Risk Racial/Ethnic Minority Young Adults (Short Title: Capacity Building Initiative) grants. The Capacity Building Initiative (CBI) is one of CSAPs Minority AIDS Initiative (MAI) programs. The purpose of the MAI is to provide substance abuse and HIV prevention services to at-risk minority populations in communities disproportionately affected by HIV/AIDS. The purpose of the CBI program is to support an array of activities to assist grantees in building a solid foundation for delivering and sustaining quality and accessible state of the science substance abuse and HIV prevention services. Specifically, the program aims to engage colleges, universities and community-level domestic public and private non-profit entities to prevent and reduce the onset of SA and transmission of HIV/AIDS among at-risk racial/ethnic minority young adults, ages 18-24.SAMHSAs mission is to reduce the impact of substance abuse and mental illness on Americas communities. Over the years, SAMHSA - in collaboration with other Federal agencies, States, local organizations, and individuals including consumers and the recovery community - has demonstrated that prevention works, treatment is effective, and people recover from mental and substance use disorders. To continue to improve the delivery and financing of prevention, treatment, and recovery support services, SAMHSA has identified 10 Strategic Initiatives to focus the Agencys work on people and emerging opportunities. SAMHSA expects CBI grantees to address the following Strategic Initiative: Prevention of Substance Abuse and Mental Illness. SAMHSAs initiative will prepare and enable communities to learn skills, strategies, and programs to better understand and recognize the behaviors that connect substance abuse and mental illness in overall health and wellness.[NOTE: Complete references for statements followed by numerals in footnote format throughout this document can be found in Appendix K of this RFA.]HIV remains a major health concern that disproportionately affects young, minority populations. In 2007, there were 571,378 people living with HIV/AIDS in the U.S. However, people of color accounted for 70% of all HIV cases in the U.S. that year. African Americans make up the largest U.S. population affected by HIV, with 21,509 cases of the 42,318 HIV cases reported in 2007. African Americans comprise about 13% of the U.S. population, yet they account for 50% of new HIV infection diagnoses (1).In addition, in 2007, there were 1,703 HIV infections reported among 15-19 years olds, and 4,907 infections reported among 20-24 year olds. Among persons 13-24 years old, African Americans account for 55% of all HIV infections. Among women ages 13-24, African American and Hispanic females account for over 75% of reported HIV infections. Together, they represent only 26% of the U.S. women in this age group (1). One factor contributing to these disproportionate numbers is health care disparities for youth of color, especially reduced access to health services. Approximately 20% of African Americans are uninsured compared to 11% of whites (2). Among all Hispanics, about 33% lack health insurance (the highest rate of any group). People who lack adequate health care are less likely to be tested for HIV and, thus, less likely to know their HIV status. People who do not know they are HIV-positive may fail to take appropriate precautions against spreading the disease.College students, who comprise of one-third of the 18-24 year old population in the United States, are particularly at risk. According to data from SAMHSAs National Survey on Drug Use and Health, college students in America are more likely to use alcohol in the past month, binge drink, and drink more heavily than their peers not enrolled in school. A recent peer reviewed journal article written by leading alcohol researchers, entitled Magnitude of Alcohol-Related Mortality and Morbidity among U.S. College Students Ages 18-24, indicated that frequent, heavy, episodic drinkers were 21 times more likely than were other drinkers to experience five or more of 12 alcohol-related problems, including risk behaviors associated with sexual activity (3). In this study, which focused on heavy episodic or binge drinking among college students, 44% reported at least one heavy drinking episode in the past year. About one fourth (23%) drank this way frequently (three or more times in the past 2 weeks). In a 2004, the U.S. Centers for Disease Control and Prevention (CDC) and the North Carolina Department of Health conducted an epidemiological investigation on the characteristics of HIV-positive and HIV-negative college student groups compared to non-college peers. This was the first investigation conducted on young black college men who have sex with men (MSM) outside of large urban settings. The study indicated that black college students who are MSM and non- students in North Carolina had high rates of HIV risk behaviors, underscoring the need for enhanced HIV-prevention programs for young black MSM both on and off campus (4). The study indicated the following characteristics of the participants: both HIV-positive and HIV-negative college student participant groups (hereinafter called college student groups) were younger than the HIV-negative non-student participant group; the mean number of lifetime sex partners was lower for the college student groups as compared to the non-student group; the majority of both steady and casual sexual partners for all three groups were black and aged 18-30 years; approximately 20% of study participants had a female sex partner during the preceding 12 months; nearly one third of HIV-positive college students met sex partners on college campuses as compared to the majority who met their sex partners at gay nightclubs or over the Internet; fewer college students than non-students identified themselves as gay or disclosed their sexual identity to everyone or to most people. Nearly 70% of study participants previously had been tested for HIV, and 70% believed they were unlikely to have been infected with HIV at the time of their most recent HIV test.Both MSM study participants and college student discussion group participants provided similar explanations for why MSM specifically, and young black people in general, continue to engage in high-risk sexual behavior. The most common reasons were 1) lack of sustained prevention messages targeting young blacks, 2) feeling personally disconnected from the reality that they might contract HIV, and 3) believing that physical characteristics and appearance can inform one about their partner's HIV status. SAMHSA, therefore, is particularly interested in eliciting the interest of college and university clinics/wellness centers and community-based providers who can provide comprehensive substance abuse and HIV prevention strategies. These strategies must combine education and awareness programs, social marketing campaigns, and HIV testing services in non-traditional settings with substance abuse and HIV prevention programming for at-risk racial/ethnic minority young adults, ages 18-24.The Capacity Building Initiative (CBI) is authorized under Section 516 of the Public Health Service Act, as amended. This announcement addresses Healthy People 2010 focus area 26 (Substance Abuse).