Redressing structural inequities for HIV CBOs to end the HIV epidemic

Issues: The plan to End the HIV Epidemic seeks to reduce new HIV infections by 75% in the next five years, and 90% in the next decade. Community-based non-profit organizations serving highly vulnerable populations living with and/or at higher risk of acquiring HIV (HIV-CBOs) are integral in achieving that goal. Unfortunately, because of structural inequities, many organizations that have been instrumental in responding to the HIV epidemic in the U.S. have not survived, including those with BIPOC leadership. Description: Structural inequities for HIV-CBOs are systems in which policies, institutional practices, organizational (mis)representations, and other norms produce and maintain inequities that impact CBOs’ ability to survive and thrive. HIV-CBOs have evolved with the HIV epidemic, yet many have experienced environmental and organizational challenges that have negatively impacted their sustainability and survival. Lessons Learned: Challenges that affect structural equity can be broadly categorized as (1) financial threats to viability, (2) limited organizational capacity-building opportunities, (3) local leadership and governance challenges, and (4) negative organizational biases toward HIV-CBOs. Recommendations: Collective achievements in reducing HIV rates would not be possible without HIV-CBOs, who are community-engaged by their nature. CBOs have been and continue to be critical in meeting the goals of the National HIV/AIDS Strategy. Naming HIV-CBO structural inequities is a necessary step to redressing the factors that can hinder efforts to effectively end the HIV epidemic. Investments should be made to support the critical work of HIV-CBOs. Specific examples of challenges and recommendations for addressing inequities will be shared.