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HIV/AIDS in Colorado: 2010

July 7, 2011

While the Federal government's investment in treatment and research is helping people with HIV/AIDS live longer and more productive lives, HIV continues to spread at a staggering national rate. The latest incidence data from the Centers for Disease Control and Prevention (CDC) estimates nationally there were 48,100 new HIV infections in 2009. The graph below depicts the HIV/AIDS epidemic in Colorado through 2010 according the Colorado Department of Public Health and Environment. They estimate that the total number of people living with HIV in Colorado increases at a rate of about 3% a year. Note that the following HIV/AIDS statistics only represent a portion of the epidemic in the U.S. -- those cases that have been both confirmed through testing and reported.i

Total Reported AIDS Casesii

Total Reported AIDS Cases

Demographic Trendsiii

The HIV/AIDS epidemic disproportionately affects those at risk from social factors such as disparity and discrimination. The following demographic numbers are from the Colorado Department of Public Health and Environment as of December 31, 2010.

Demographic Trends
Counties


Fiscal Year 2010 Funding for HIV/AIDS in Colorado

At-a-Glance

Fiscal Year 2010 Funding for HIV/AIDS in Colorado at a Glance

Prevention

The Centers for Disease Control and Prevention provided Colorado with $7,874,290 for HIV prevention programs in 2010. These funds were allocated to state and local health departments and community-based organizations to finance counseling, testing programs, health education/risk reduction activities, and surveillance/monitoring programs.v

Ryan White CARE Act

The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, enacted in 1990 and reauthorized in 1996, 2000, 2006, and 2009 is the centerpiece of the federal government's efforts to improve the quality and availability of care for medically underserved individuals and families affected by HIV/AIDS. The CARE Act, administered by the HIV/AIDS Bureau of the Health Resources and Services Administration, provides funding to states, territories, and other public and private nonprofit entities to develop, organize, coordinate, and operate more effective and cost-efficient systems for the delivery of essential health care and support services to people living with HIV/AIDS and their families.

  • Part A -- Eligible Metropolitan Areas (EMAs) and Transitional Grant Areas (TGAS): Part A provides funding to Eligible Metropolitan Areas (EMAs) and Transitional Grant Areas (TGAs), areas that are disproportionately affected by the HIV epidemic. To be considered EMAs, metropolitan areas must have more than 2,000 cumulative AIDS cases over the last five-years and a population of 50,000 or more. Cities are considered TGAs if they have at least 1,000, but not more than 1,999, cumulative AIDS cases in the last five years, and a population of 50,000 or more.

    In FY 2010, the state received $7,944,842 in Part A funding, all which went to its TGA (Denver).vi

  • Part B -- States and Territories: Part B helps state health departments improve the quality, availability, and organization of HIV health care and support services. In additional to base grant, Part B funds support the AIDS Drug Assistance Program (ADAP) which provides medications to individuals with low income, the Minority AIDS Initiative (MAI), and Supplemental Grants for Emerging Communities (EC), cities reporting between 500 and 1,999 cumulative AIDS cases in the past five years.

    In FY 2010, Colorado received $13,908,348 in CARE Act Part B funds.vii

  • Part C -- Early Intervention Services: Part C supports competitive grants to provide medical treatment and medical support services for people living with HIV including HIV testing, early intervention services, risk reduction counseling, case management, outreach, oral health, nutrition, and mental health services. Part C supports Early Intervention Services (EIS) grants that provide services for HIV positive individuals with low income who are uninsured or underinsured as well as grants for planning and capacity building to help rural or underserved communities develop high-quality HIV primary care. In FY 2010, the state received $1,754,772 in Part C funds.viii
  • Part D -- Capacity Building and Women, Infants, Children, Youth and Their Families: Part D focuses on the operation and development of primary care systems and social services for women and youth, who represent a growing share of the epidemic. In FY 2010, the state received $935,090 in Part D funds.ix
  • Other CARE Act Funding Programs:

    AIDS Education and Training Centers (AETC) Program: AETCs provide training, consultation, and information to HIV health care providers through a network of 1 international center; 5 national centers (the AETC National Resource Center, the National HIV/AIDS Clinicians' Consultation Center, the National Evaluation AETC, the AETC National Center for HIV Care in Minority Communities, and the AETC National Multicultural Center); 11 regional centers, each of which serves between two and ten states and/or territories; and over 130 local performance sites across all 50 states, the District of Columbia, and the U.S. territories. Funding is allocated to each of the 17 national and regional centers, which then distribute resources to local performance sites in each state.

    Total Statewide AETC Fundingx: $2,057,675

    AETCsxi

    Regional:

    Mountain Plains AIDS Education and Training Center
    University of Colorado Denver
    Department of Medicine, Division of Infectious Diseases
    12631 East 17th Avenue, MS 8204
    Aurora, CO, 80045
    Phone: 303-724-0867
    Fax: 303-724-0875
    Web Site: www.mpaetc.org
    Serves: CO, ND, SD, KS, NE, NM, UT, WY

    Local:

    Colorado AETC
    University of Colorado Denver
    Department of Medicine, Division of Infectious Diseases
    12631 East 17th Avenue, MS A-089
    Aurora, CO, 80045
    Phone: 303-724-0646
    Fax: 303-724-0875
    Web Site: www.coloradoaetc.org

    Dental Program: The Ryan White Care Act Dental program provides funding to the Community Based Dental Program, which aims to increase HIV-positive individuals' access to oral health care services while providing education and clinical training for dental care providers. The Dental program also provides funding for a Dental Reimbursement Program which reimburses dental schools, postdoctoral dental education programs, and dental hygiene programs for oral health care of individuals living with HIV.

    In FY 2010, the total funding allocated to the state's dental program was $310,210 all of which went to the Community Based Dental Program.xii

    Grant Recipients in FY 2010 - Dental Reimbursement

    Special Projects of National Significance (SPNS): SPNS is the research and development aspect of the Ryan White CARE Act. SPNS is responsible for assessing the effectiveness of certain care models, providing support for innovative models of HIV/AIDS service delivery and for assisting the replication of effective models across the nation.

    Total SPNS Fundingxiii: $0

Housing Opportunities for Persons With AIDS

The Housing Opportunities for Persons with AIDS program (HOPWA) provides housing assistance and related supportive services for HIV positive persons with low income and their families. Funding is provided in the form of formula grants, which are awarded to eligible states and cities on behalf of their metropolitan areas, and competitive grants, which are awarded to model projects or programs.

The Department of Housing and Urban Development (HUD) provided the state a total of $1,998,180 HOPWA funding in FY 2010.xiv

HOPWA Funding

State Issues

ADAP -- AIDS Drug Assistance Programs save lives by providing HIV-related medications to uninsured and under insured individuals. Over 2010, the economic recession put increased pressure on states budgets, at the same time also caused an increase in clients seeking to enroll in ADAPs, putting many State ADAPs in crisis. As a result, Colorado has reduced its formulary and has considered other cost-containing measures such as client cost-sharing and establishing a waiting list.xv

Syringe Exchange -- In 2009, the nationwide ban on a state's use of federal funds for Syringe Exchange Programs (SEPs) was removed through appropriations legislation and signed by President Barack Obama. Numerous studies have indicated that SEPs offer vital care and services to intravenous drug users and reduce risk behavior. Yet, despite long held support from the CDC, NIH, and the majority of the medical and scientific community, syringe exchange programs remain politically targeted.xvi There are currently exchange programs operating in Boulder and Denver.xvii

Policy and Law

Criminalization of HIV, which is often dependent on known status, creates barriers to testing along with discouraging disclosure and fostering stigma. Colorado has three HIV-specific statutes that allow for criminal prosecution and HIV has been prosecuted under other non-HIV specific criminal statutes and several documented arrests and/or prosecutions have been made since 2008.xviii

AIDS United Partners and Grantees

AIDS United promotes collaborative local planning and provides strategic grants and technical support to more than 400 direct service organizations annually through our Community Partnerships, Public Policy Committee, and targeted initiatives such as AmeriCorps, Access to Care (A2C), GENERATIONS/Women's Initiative, Southern REACH, Puerto Rico grantmaking, and the Syringe Access Fund.

Colorado HIV/AIDS Community Partnership, Denver (Community Partnerships)

State AIDS Director

AIDS Director
Ralph Wilmoth
STI/HIV Section Chief
Colorado Dept. of Public Health and Environment
DCEED-A3
4300 Cherry Creek Drive South
Denver, Colorado, 80246
Phone: 303-692-2684
Fax: 303-782-0904
ralph.wilmoth@state.co.usxix


References

  1. HIV and AIDS in Colorado: Surveillance Report (4th Quarter 2010), Colorado Department of Public Health and Environment, available from: www.cdphe.state.co.us/dc/HIVandSTD/surveillance.html.
  2. HIV and AIDS in Colorado: Surveillance Report (4th Quarter 2010), (4th Quarter 2009), (4th Quarter 2008), (4th Quarter 2007), Colorado Department of Public Health and Environment, available from: www.cdphe.state.co.us/dc/HIVandSTD/surveillance.html; electronic mail communication, Colorado Department of Public Health and Environment.
  3. HIV and AIDS in Colorado: Surveillance Report (4th Quarter 2010), Colorado Department of Public Health and Environment, available from: www.cdphe.state.co.us/dc/HIVandSTD/surveillance.html.
  4. State & County QuickFacts, US Census Bureau, available from: http://quickfacts.census.gov/qfd/index.html.
  5. DHAP HIV Prevention Funding Allocations by State and Dependent Area (Fiscal Year 2010), Centers for Disease Control & Prevention, available from: www.cdc.gov/hiv/topics/funding/state-awards/index.htm.
  6. Ryan White Part A Awards to Eligible Metropolitan Areas (EMAs) and Transitional Grant Areas (TGAs) for FY 2010, HRSA, US Department of Health and Human Services, available from: http://hab.hrsa.gov/data/reports/partaemastgas.html.
  7. Find Grant Awards: Colorado, HRSA, US Department of Health and Human Services, available from: http://granteefind.hrsa.gov/; Breakouts provided by NASTAD: Part B total include Base, ADAP, MAI, and EC; Base includes supplemental funds; ADAP includes supplemental and emergency funds.
  8. Find Grant Awards: Colorado, HRSA, US Department of Health and Human Services, available from: http://granteefind.hrsa.gov/.
  9. Find Grant Awards: Colorado, HRSA, US Department of Health and Human Services, available from: http://granteefind.hrsa.gov/.
  10. Find Grant Awards: Colorado, HRSA, US Department of Health and Human Services, available from: http://granteefind.hrsa.gov/.
  11. About the AIDS Education & Training Centers, AETC National Resource Center, available from: www.aids-ed.org/aidsetc?page=ab-00-00.
  12. The HIV/AIDS Program: Caring for the Underserved; Part F: Dental Reimbursement Programs 2010 Award Amounts, HRSA, US Department of Health and Human Services, available from: http://hab.hrsa.gov/abouthab/special/dental2010.html.
  13. Find Grant Awards: Colorado, HRSA, US Department of Health and Human Services, available from: http://granteefind.hrsa.gov/.
  14. HOPWA Report, US Department of Housing and Urban Development, available from: www.hudhre.info/hopwa/index.cfm?do=viewHopwaRptsSelect&opt=Awards#tab.
  15. ADAP Watch Update -- April 22, 2011, NASTAD, available from: www.thebody.com/content/art61861.html.
  16. Syringe Exchange and HIV/AIDS, AIDS United (published under formerly AIDS Action), available from: www.aidsunited.org/uploads/docs/Learn-Syringe_Exchange_and_HIV.pdf.
  17. Syringe Exchange Programs in the United States 2011, amfAR, available from: www.amfar.org/uploadedFiles/On_The_Hill/SEPS.pdf?n=3826%29.
  18. Ending and Defending Against HIV Criminalization: A Manual for Advocates, Volume 1, State and Federal Laws and Prosecutions, The Center for HIV Law and Policy, Fall 2010, available from: www.hivlawandpolicy.org/resources/view/564; Positive Justice Project: Prosecutions for HIV Exposure in the United States, 2008-2011, The Center for HIV Law & Policy, available from: www.hivlawandpolicy.org/resources/view/456.
  19. State HIV/AIDS Program Directory, National Alliance of State and Territorial AIDS Directors, available from: http://nastaddemo.dedicated.advansiv.com/About/res_state_Directory.aspx.



  
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This article was provided by AIDS United. Visit AIDS United's website to find out more about their activities and publications.
 
See Also
U.S. HIV/AIDS State Fact Sheets: Table of Contents

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