Origin of the Minority AIDS Initiative and SMAIF
In 1998, the Centers for Disease Control and Prevention (CDC) held a meeting to brief service providers and community leaders on public health surveillance data showing extremely high rates of HIV among African Americans. Following the release of this data, the Administration, HHS, the Congressional Black Caucus, and the Congressional Hispanic Caucus secured Federal funding for the creation of the Minority AIDS Initiative (MAI) in the Omnibus Consolidated and Emergency Supplemental Appropriations Act of 1999, and President Bill Clinton declared HIV/AIDS to be a “severe and ongoing health care crisis” for racial and ethnic minorities. The MAI provided new funding designed to strengthen organizational capacity and expand HIV-related services in minority communities.
A total of $166 million in funding was allocated to MAI in that first year. Over the years, the annual Congressional appropriation for the MAI has continued to grow. In FY2016, the MAI received more than $400 million in funding. The legislation allocates MAI resources to the CDC, Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), and the HHS Secretary’s Minority AIDS Initiative Fund (SMAIF). The HHS Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) administers SMAIF on behalf of the Office of the Assistant Secretary for Health (OASH) and the Office of the Secretary.
The principal goals of SMAIF are to reduce new HIV infections, improve HIV-related health outcomes, and to reduce HIV-related health disparities for racial and ethnic minority communities. SMAIF funds cross-agency demonstrations, and agency-administered projects that are awarded to HHS agencies and offices for innovative HIV prevention, care and treatment, outreach and education, and technical assistance activities serving racial/ethnic minorities. The activities funded through SMAIF are particularly designed to encourage capacity building, innovation, collaboration, and the integration of best practices, effective strategies, and promising emerging models in the response to HIV among minority communities.
Following the release of the National HIV/AIDS Strategy (NHAS) in 2010 and its specific request for the HHS Office of the Secretary to enhance the effectiveness of the MAI, OHAIDP restructured SMAIF to better align with the goals, objectives, and priorities of the NHAS. With the release of the National HIV/AIDS Strategy: Updated to 2020, SMAIF will continue to support the Strategy’s goals of reducing new infections, improving access to care, reducing HIV-related disparities, and achieving a more coordinated national response to HIV.
Since the inception of MAI, about $50 million has been annually appropriated to and administered by SMAIF. In FY2016, SMAIF was funded at $53.9 million, which was used to support two demonstration projects, 20 continuation projects, 8 new projects, and administrative costs. Read more about activities currently supported by SMAIF.
How Is SMAIF Different?
Overall, HIV-related health outcomes have improved over time, but racial and ethnic minority populations continue to be disproportionately impacted by HIV infection. Significant HIV-related disparities still exist. In an effort to address these disparities and related gaps in programs and services, SMAIF supports innovative programs that are designed to yield lessons and results that lead to sustainable changes in the Federal response to HIV prevention, care and treatment that better serve racial and ethnic minorities.
SMAIF has been at the leading edge of addressing social determinants of HIV through programs like the Care and Prevention in the United States Project (CAPUS), Partnerships for Care (P4C) and THRIVE, which promote cross-agency collaboration and respond to the NHAS goal of reducing HIV-related disparities and health inequities. SMAIF activities break down silos and develop new avenues for agencies to work together to quickly test innovative strategies and models that address newly emerging issues. The successes generated from SMAIF activities create lasting changes across the Federal HIV prevention and care portfolio.
SMAIF awards funds for projects that seek to prevent HIV infection and improve health outcomes for black/African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, and Asian and Pacific Islander populations at risk for or living with HIV/AIDS. Projects prioritize those that are disproportionately affected by HIV/AIDS, including racial and ethnic minority gay, bisexual, same-gender loving, and other men who have sex with men; transgender persons; black/African American women; and individuals in the southern U.S. and other geographic areas disproportionately affected by HIV/AIDS. Additionally, SMAIF funds projects for populations of special concern, including racial and ethnic minority youth; immigrants; individuals in rural communities; and those affected by substance use, mental health concerns, and previous incarceration.