Sibusiso- Sharing Blessings, Changing Lives

1) Identify and Engage leaders of sub-Saharan African communities within Massachusetts by sharing information on HIV/AIDS health and support services that are available and critical for referring their populations into care.

2) Assess the needs of the local Sub Saharan African community in order to develop community-specific and culturally relevant projects aimed at raising awareness on HIV/AIDS/Hepatitis B prevention, transmission, treatment, and support.

3) Educate Sub Saharan Africans who reside in Massachusetts on HIV/AIDS/Hepatitis, and services that are available for those infected and affected by these illnesses.

4) Refer Sub Saharan African community members for HIV and Hepatitis B testing and counseling, and if necessary refer to comprehensive quality care services.

Background on Sibusiso's Bridging Program
In 2007 an estimated 33.2 million people were living with HIV worldwide, with an estimated 2.5 million new HIV infections occurring that year (UNAIDS/WHO 2007). HIV/AIDS has had a particularly devastating impact on Sub Saharan Africans. Sub Saharan Africa remains the most seriously affected region by HIV/AIDS, with AIDS as the leading cause of death. In Sub Saharan Africa it is estimated that 1.7 million people were newly infected with HIV in 2007, bringing the total number of people living with HIV in this region to 22.5 million (UNAIDS/WHO 2007). This means that more than two thirds (68%) of all people with HIV reside in this region. Additionally, the estimated number of deaths due to AIDS worldwide in 2007 was 2.1 million, 76% of which occurred in Sub Saharan Africa (UNAIDS/WHO 2007). Access to HIV testing, care, and antiretroviral therapy is limited for a number Sub Saharan Africans (SSAs), and many leave their native country in search of access to such resources.

Although the actual number of Sub Saharan African (SSA) refugees residing in Massachusetts is challenging to accurately measure, according to the Massachusetts Department of Public Health approximately 44% of refugees in Massachusetts entering in 2006 were from Sub Saharan Africa. (Massachusetts Department of Public Health (MDPH) 2006). Many within this population will need access to healthcare and medical resources in Massachusetts, particularly with regard to testing, education, and counseling for HIV, Hepatitis, and other infectious diseases that they may not have had access to in their country of origin. Despite the fact that federally funded programs exist for individuals who qualify for refugee status, there are limited to no funds for those who fall outside the refugee category.

According to the recent Massachusetts Department of Public Health HIV/AIDS Bureau Report published in 2007, a growing proportion of persons living with HIV/AIDS in Massachusetts were born outside of the U.S. The proportion of non-US born among those with HIV infection diagnoses increased from 19% in 1999 to 28% in 2006 (Massachusetts Department of Health HIV/AIDS Bureau 2007) . Furthermore, Sub Saharan Africans represent 35% of those born outside of the United States who were diagnosed with HIV infection in Massachusetts between 2003 and 2005. In addition, 39% of non-US born individuals enter care with an AIDS diagnosis, with their immune systems severely compromised (Massachusetts Department of Health HIV/AIDS Bureau 2007). Factors influencing delay in care include the possibility of some non-US born individuals having lived with HIV for a longer duration of time and often having no treatment for HIV while in their countries of origin, and potentially because their HIV status is reported to Massachusetts authorities once they enter care (Massachusetts Department of Health HIV/AIDS Bureau 2007). Other factors may include relatively low levels of knowledge about HIV, and lack of linguistically and culturally appropriate outreach, prevention, and testing services. Still other reasons consist of ongoing immigration challenges and avoidance of formal health care systems out of fear of being reported to federal authorities, and the same patterns of economic and societal discrimination faced by other communities of color that compromise efforts to seek out public health services (Massachusetts Department of Public Health HIV/AIDS Bureau 2006). - World AIDS Day report

As the Sub Saharan African population continues to grow in Massachusetts, it is imperative that these individuals have access to health and education services within the Commonwealth. These services should be aimed at increasing awareness of HIV/AIDS and Hepatitis, promoting counseling and testing, referring individuals to treatment and supportive services, and working to empower the community at large to evaluate and improve their overall health and well-being. However, very few programs targeting the health concerns of this immigrant population exist, and further, many individuals encounter barriers to accessing such services.

Sibusiso has worked with the Sub Saharan African population residing in Massachusetts since its induction in 2003. Members of Sibusiso, who are dedicated to providing HIV/AIDS outreach and education in resource limited settings, informally referred individuals from the Sub Saharan African community into health care services and linked them with other critical resources available in Massachusetts. As the need for referrals began to grow, Sibusiso began to formalize the concept of the Bridging Program. Prior to 2007, no funding existed for the Bridging Program.

In 2007, with the assistance of a grant from Gilead Pharmaceuticals, the Bridging Program (BP) was officially created to formalize and enhance the relationship between Sibusiso and the Sub Saharan African community residing in Massachusetts. The BP was established to help disseminate information and connect SSA immigrants to comprehensive health services and resources. For the first phase of the program, the coordinators of the BP spent time identifying and meeting with key leaders and members of the Sub Saharan African community throughout the state of Massachusetts. The purpose of these meetings was to identify both the needs of this community and barriers individuals encountered with respect to access to education and health care. These meetings also served as a forum for coordinators of the BP to identify current resources and services available to the SSA community in Massachusetts, as well as to see if other organizations were present and open for collaboration or assistance.