Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116986

Curtis M. Coomes, JD, Kathryn Whetten, PhD, Malavika Prabhu, BS, and Sejal D. Shah, BS. Health Inequalities Program, Duke University, PO Box 90253, Durham, NC 27705, (919) 684-8012, kathryn.whetten@duke.edu

Background. Recent attention has been drawn to the severity of the HIV/AIDS epidemic in the South and perceived funding inequities. We analyzed HIV funding trends over a four-year period to determine if regional disparities existed.

Methods. We examined Ryan White CARE Act funding per person living with HIV and AIDS (PLWHA) for 1999-2002. States were divided into four regions as defined by the U.S. Census Bureau: South, Northeast, Midwest and West. We looked at the Deep South (AL, GA, LA, MS, NC, SC) separately. We also assessed burdens on state health care systems, specifically Medicaid, using FY 2001 census and state fiscal data.

Results. The Southern states, particularly the Deep South, received the fewest CARE Act dollars per PLWHA. Western and Southern states contributed the most in state funding to AIDS Drug Assistance Programs (ADAPs). The Deep South ADAPs were among the most restrictive in terms of financial eligibility and medications covered and experienced waiting lists more frequently. The Deep South collects less tax per person and commits less state funding to Medicaid programs than the country as a whole.

Conclusions. The South appears to receive less federal support for HIV/AIDS care than other regions, and Medicaid may not be as viable an option, especially in the Deep South, to pick up the slack. Federal funding formulas, adopted for what was initially an urban epidemic, should be modified to reflect the current nature of the epidemic and relative differences in costs of HIV/AIDS care among U.S. states.

Learning Objectives:

• Describe regional differences in HIV/AIDS care resources.
• Identify issues that may impact provision and cost of HIV/AIDS care in different parts of the country.
• Develop ideas to reduce funding disparities and ensure a basic, consistent level of HIV/AIDS care throughout the U.S.

Keywords: HIV/AIDS, Federal Policy

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.