Q&A with COMPASS Coordinating Center Directors

Our first contributors need no introduction. Well-known in their respective fields, Patrick Sullivan, PhD, DVM, Nic Carlisle, JD, and Samira Ali, PhD, LMSW, are the Directors for the three COMPASS Initiative^® Coordinating Centers. Each brings unique expertise and perspective to the strategy and mission behind the COMPASS Initiative^®.

• Patrick Sullivan, PhD, DVM – a professor of epidemiology at Emory University’s Rollins School of Public Health, the Co-Director of the Prevention Sciences Core at the Emory Center for AIDS Research (CFAR), and a former member of the U.S. Presidential Advisory Council on HIV/AIDS, a federal advisory committee that provides advice, information, and recommendations to the President and the Secretary of Health and Human Services.
• Nic Carlisle, JD – the executive director of the Southern AIDS Coalition, a non-profit coalition of government, community, and business leaders working alongside local communities to prevent new HIV transmissions and to build a better South for people living with HIV, a former member of the Presidential Advisory Council on HIV/AIDS from 2016-2017, and the founder of Alabama’s first legal program for people living with HIV.
• Samira Ali, PhD, LMSW – an assistant professor of social work at University of Houston’s Graduate College of Social Work, and licensed master social worker, with over 10 years of experience working with community-based organizations around intersecting areas of HIV prevention and treatment, mental health, trauma-informed care, and coordinated care. 

For our kickoff post, we sat down with the three Coordinating Center Directors and asked them about the focus and long-term goals of the COMPASS Initiative^®:

Q: Can you start off by telling us about the need for the COMPASS Initiative^®, especially the emphasis on the South?

Patrick: The COMPASS Initiative^® is a response to the disproportionate impact of HIV on the South. The South accounts for about 37% of the US population, but over half of people newly diagnosed with HIV. Four of the five states with the highest rates of new HIV diagnoses are in the South. COMPASS is a way to invest in communities and in people responding to the HIV epidemic.

Nic: Year after year, more people are diagnosed with HIV in the South than the rest of the country combined. In 2015, the rate of new diagnoses for the South was 37% higher than the national average. Today, we are home to the most people living with and dying from HIV/AIDS, including the most women, youth, and people of color.

Samira: Thinking locally, Houston is the 4^th largest city in Texas, and this part of Texas is rarely used to leverage HIV-related work and is an underserved area with regards to the organizational capacity work being done. It’s also important that University of Houston’s Graduate College of Social Work was selected as a Coordinating Center because social workers by training bring a perspective of social justice and a multi-level approach to the table, specifically focusing on mental health, trauma and wellness.

Q: What will Emory’s focus be as part of this collaborative Southern initiative?

Patrick: Emory’s work will focus on three areas: (1) community investment, (2) communications, and (3) geospatial mapping to improve epidemic response. In terms of community investment, Emory will invest in Southern organizations serving heavily impacted communities in several ways, including providing training and grants to help build the capacity of local organizations to do the work of HIV prevention and improving support for people living with HIV. Our communications team will create multiple channels for both sharing information with organizations and communities, and on developing new tools that allow people working in response to the HIV epidemic to share new innovations and network to improve services. Additionally, our Mapping Core will make sure that our efforts are always guided by the data, using mapping and data visualization techniques to identify areas in the South that are particularly underserved.

Q: What will the Southern AIDS Coalition focus on as part of the COMPASS Initiative^®? 

Nic: The Southern AIDS Coalition, in partnership with the Southern HIV/AIDS Strategy Initiative at Duke University, will address HIV-related stigma and the resulting disparities and health inequities among our priority populations in the following ways: (1) partnering with community based organizations to pilot new HIV-related stigma reduction interventions; (2) funding community-led grassroots campaigns to promote awareness and real knowledge around HIV and AIDS; (3) replicating interventions that effectively address HIV-related stigma at the individual and community levels; (4) funding community-based organizations to implement and evaluate their own HIV-related stigma reduction interventions; and (5) training community-based organizations, government agencies, and healthcare delivery entities to provide culturally appropriate, non-stigmatizing services that support PLHIV and other communities disproportionately impacted by HIV in the South.

Q: Can you speak to the importance of focusing on stigma reduction?

Nic: HIV-related stigma is pervasive in the South and has been consistently identified as negatively affecting health outcomes among individuals living with HIV and willingness to participate in HIV testing among vulnerable populations. HIV and related stigmas, including LGBTQ and race/ethnicity biases, are present in many forms including internalized stigma, community-level stigma, and stigmatizing attitudes and behaviors by providers. Addressing stigma in all these forms is essential to improving well-being for individuals living with HIV and promoting the health of Southern communities, especially among our priority populations of gay, bisexual and other same-gender-loving men of color and women of color.

Q: Samira, you previously spoke about the needed perspective of social workers for this initiative, particularly in integrating a social justice approach and mental health, trauma, and wellness services. Is this what University of Houston Graduate College of Social Work will focus on?

Samira: All of the work we do is founded on intersectionality, social justice, and eliminating racial inequalities – that is the forefront in the line of work that we do. Our content area focuses on mental health, trauma informed care, and harm reduction – each of these content areas are thinking about the structural, organizational, and multi-level factors that shape an individual’s HIV-related experience. We can only address the Southern HIV epidemic if we change the structure of the landscape. Changing the structure means building organizational capacity and helping underrepresented groups have an equitable voice in their community.

Q: What do you hope will be the overall impact of the COMPASS Initiative^® in 10 years?

Samira: There are a couple of layers: to keep people HIV-negative and, for people who are living with HIV, to help them live a positive life and stay in care – care that is trauma-informed and will help them feel good about themselves. I think from the perspective of building organizational capacity, our goal is to help organizations thrive in what they do best. We will keep our focus Southern-specific because we need this to be by and for people in the South.

Patrick: The reason for that is because the Southern epidemic is different than epidemics in other parts of the United States. One important distinction is that the South has high rates and numbers of people living with HIV not just in big cities, but also in rural areas. I too hope that in 10 years, we have increased the number of organizations with high capacity to serve people at risk for HIV and living with HIV across the South. I also believe that the impact of the COMPASS Initiative^® will reach beyond the individual organizations that are funded or trained – that the sustained focus on HIV in the South will lead to greater awareness of the Southern HIV epidemic, reductions in stigma towards people living with HIV, and exciting new models for providing services that can be used throughout the region and the country.

Nic: Closing the gap between the South and the rest of the United States is essential to the health of our people and to the long-term success in ending the domestic HIV epidemic. We believe the COMPASS Initiative^® is an integral part of closing this gap. In ten years, we expect to improve outcomes at every step of the HIV care continuum, from testing to diagnosis, linking and engagement, and ultimately, viral suppression. We also expect to identify and re-engage Southerners who have been lost to care. Last, but certainly not least, we expect to prevent people from ever entering the care continuum by reducing new HIV infections, especially among gay, bisexual, and other same-gender-loving men of color and women of color.

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