Guest Editors’ Introduction to the Volume

Since the beginning of the epidemic, drug abuse and addiction have been inextricably linked with HIV/AIDS. These conditions intertwine intricately, so that looking at either alone often amounts to skewing the data. Simultaneously, spurious accounts often draw direct causal lines from one to the others. Does a propensity for drug use lead to promiscuity or vice versa? Regardless of the directionality of the relationship—or even whether it makes sense to talk of single, direct causes in such cases—it is well established that racial minority groups are disproportionately negatively affected by both epidemics (HIV/AIDS and drug abuse/addiction). These circumstances in scholarly research on the subject motivated the federal Substance Abuse and Mental Health Services Administration (SAMHSA) in 2013 to issue a Call for Proposals to address these twin epidemics at minority-serving institutions in partnership with community-based organizations (MSI-CBO). The emphasis of this SAMSHA initiative was on young adults ages 18–24 on college campuses and surrounding communities. Alarmingly, the Centers for Disease Control and Prevention in 2013 noted that 60% of youth with HIV do not know they are HIV-positive, a lack of knowledge that increases their risk for sickness and early death.¹ These youth can also unknowingly transmit HIV to others. At the same time, daily marijuana use has steadily increased among college students in the past two decades and heavy alcohol use is higher among college students than non-college students, according to the National Institute on Drug Abuse in 2015.²

The primary aim of the SAMHSA initiative was to ramp up substance abuse prevention education and HIV testing programs and to equip and empower young at-risk emerging adults with prevention strategies to abate substance abuse problems and those at risk for contracting and transmitting HIV among African Americans, Hispanic/Latino, Asian American/Pacific Islanders, and American Indian/Alaska Natives within the target age group. For some of this population—and especially those in surrounding communities—hepatitis C has emerged as a major health concern along with HIV, due to shared modes of transmission.

The SAMHSA MSI-CBO initiative sought to address behavioral health disparities among these racial and ethnic minorities by encouraging implementation of strategies to decrease the differences in access, service use, and outcomes among these populations. These projects were authorized under Section 516 of the amended Public Health Service Act. The editors would be remiss to not acknowledge the pioneering work being done by the SAMHSA Center for Substance Abuse Prevention (CSAP) under the leadership of Kana Enomoto, Francis Harding, and Charles Reynolds. They have paved the way for the Boots-on-the-Ground approach of the MSI-CBO program, which facilitates collaboration between Town and Gown entities for realizing the vision expressed by this volume’s title: Power of Prevention: Reaching At-Risk Emerging Adults to Reduce Substance Abuse and HIV.

This special, supplemental issue of the Journal of Health Care for the Poor and Underserved (JHCPU) begins a preface by Kim Dobson Sydnor, Dean of the School of Community Health and Policy at Morgan State University. Dr. Sydnor presents a brief historical perspective on the HIV epidemic and advocates for a community centered ecological approach to being responsive to the epidemic in this new era. The issue continues with a tribute to Mario De La Rosa, PhD, a national and international thought leader in substance abuse/HIV prevention and intervention methodologies, especially among Hispanic populations. Dr. De La Rosa is a professor at the Robert Stempel College of Public Health and Social Work at Florida International University, and director of the Center for Research on U.S. Latino HIV/AIDS and Drug Abuse.

Two Reports from the Field come next, the first by Fenkl, Jones, and Oves, who report on a campus-based HIV intervention in south Florida for young African American and Hispanic men who have sex with men. The other Report from the Field—by Battiste, Engerman, and Ryan—describes prevention programming in the U.S. Virgin Islands These authors debunk the myth of the Virgin Islands as a paradise in...