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HIV/AIDS in the District of Columbia: 2009-2010

July 19, 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 latest data from the CDC on the HIV/AIDS epidemic in the District of Columbia. Unless otherwise indicated figures are CDC estimates based on statistical adjustments for delays in reporting. 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.

Reported AIDS Casesi

Reported AIDS Cases

Demographic Trendsii

The HIV/AIDS epidemic disproportionately affects those at risk from social factors such as disparity and discrimination. The following demographic numbers represent adults and adolescents living with HIV/AIDS at 2008 year-end as reported from the D.C. Department of Health. Please note that the data sets differ from above.

Demographic Trends
Counties


Fiscal Year 2010 Funding for HIV/AIDS in D.C.

At-a-Glance

Fiscal Year 2010 Funding for HIV/AIDS in D.C. at a Glance

Prevention

The Centers for Disease Control and Prevention provided D.C. with $21,602,202 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.iv

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, D.C. received $31,452,528 in Part A funding, all which went to its EMA (Washington, DC-MD-VA-WV).v

    *The $31,452,528 was divided up in different amounts for each member of the EMA.

  • 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, D.C. received $20,080,038 in CARE Act Part B funds.vi

  • 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 district received $2,913,384 in Part C funds.vii
  • 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 district received $1,384,833 in Part D funds.viii
  • 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. Note that international, national, and local AETC programs may receive funding from HRSA through non-Ryan White grants.

    Total Statewide AETC Fundingix: $3,525,000

    AETCsx

    National:

    AETC National Multicultural Center
    Howard University College of Medicine
    1840 7th Street, NW, 2nd Floor
    Washington, DC, 20001
    Phone: 202-865-8146
    Fax: 202-667-1382
    Web Site: www.aetcnmc.org

    AETC National Center for HIV Care in Minority Communities
    HealthHIV
    2000 S St., NW
    Washington, DC, 20009
    Phone: 202-232-6749
    Fax: 202-232-6750
    Web Site: www.NCHCMC.org

    Regional:

    Pennsylvania/MidAtlantic AIDS Education and Training Center
    University of Pittsburgh Graduate School of Public Health
    130 DeSoto Street A427 Crabtree Hall
    Pittsburgh, PA, 15261
    Phone: 412-624-1895
    Fax: 412-624-4767
    Web Site: www.pamaaetc.org
    Serves: DE, DC, MD, OH, PA, VA, WV

    Local:

    Howard University, College of Medicine
    520 W. Street NW, Room 4004
    Washington, DC, 20059

    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 D.C.'s dental program was $234,578, of which all went to the Dental Reimbursement Program.xi

    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 Fundingxii: $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 D.C. a total of $14,118,841 in FY 2010 HOPWA funding.xiii

HOPWA Funding

District Issues

Enhanced Comprehensive HIV Prevention Plan (ECHPP) -- In 2010, the Centers for Disease Control and Prevention (CDC) released a plan for prevention targeting twelve cities, including Washington, D.C., that compromise 44% of all infections in the United States. In accordance with the National HIV/AIDS Strategy, the Department of Health and Human Services (HHS) built upon the program with what is known as the twelve cities. project by coordinating cross-departmental collaboration with the Centers for Medicare and Medicaid Services (CMS), Health Resources and Services Administration (HRSA), Indian Health Service (IHS), National Institutes of Health (NIH), and Substance Abuse and Mental Health Services Administration (SAMHSA).

Syringe Exchange -- In 2007, President George W. Bush signed an omnibus spending bill that lifted the nine-year ban on use of D.C. local funds on Syringe Exchange Programs (SEPs). In 2009, the nationwide ban on a state's use of federal funds for SEPs was also 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.xiv There are currently exchange programs operating in D.C.xv

Policy and Law

The District of Columbia does not have any HIV-specific statues that allow for criminal prosecution based on HIV status and HIV has not been known to be applied in prosecution for other non-HIV specific criminal statutes. The criminalization of individuals with HIV is often dependent on known HIV status and creates barriers to testing along with discouraging disclosure and fostering stigma.xvi

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.

Children's National Medical Center (AmeriCorps)
Family and Medical Counseling Service, Inc. (FMCS), (Syringe Access, AmeriCorps)
Georgetown University Hospital Division of Infectious Disease (AmeriCorps)
HIPS (Syringe Access, AmeriCorps)
La Clínica del Pueblo (AmeriCorps)
Latin American Youth Center (AmeriCorps)
Joseph's House (AmeriCorps)
National Alliance for HIV Education and Workforce Development (PPC)
Our Place (AmeriCorps)
Metro TeenAIDS (AmeriCorps)
Miriam's House (AmeriCorps)
UCHAPS -- Urban Coalition for HIV/AIDS Prevention Services (PPC)
Washington AIDS Partnership (A2C, Community Partnerships, Syringe Access)
Whitman-Walker Health (AmeriCorps)

District AIDS Director

AIDS Director
Gregory Pappas
Senior Deputy Director
HIV/AIDS, Hepatitis, STD and TB Administration
DC Department of Health
899 North Capitol Street, NE
4th Floor
Washington, District of Columbia, 20002
Phone: 202-671-4843
Fax: 202-671-4860
gregory.pappas@dc.govxvii


References

  1. District of Columbia HIV/AIDS, Hepatitis, STD, and TB Epidemiology Annual Report (2010, 2009, 2008, 2007), D.C. Department of Health, available from: http://doh.dc.gov/doh/cwp/view,A,1371,Q,598650,dohNav_GID,1802,dohNav,|33200| 34259|,.asp.
  2. a>District of Columbia HIV/AIDS, Hepatitis, STD, and TB Epidemiology Annual Report 2010, D.C. Department of Health, available from: www.washingtonpost.com/wp-srv/metro/docs/2010-Integrated-EPI-Annual-Report_FINAL.PDF.
  3. Image from District of Columbia HIV/AIDS, Hepatitis, STD, and TB Epidemiology Annual Report 2010, D.C. Department of Health, available from: www.washingtonpost.com/wp-srv/metro/docs/2010-Integrated-EPI-Annual-Report_FINAL.PDF.
  4. 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.
  5. 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.
  6. Find Grant Awards: District of Columbia, HRSA, US Department of Health and Human Services, available from: http://granteefind.hrsa.gov/; Breakouts provided by NASTAD: Part B total includes Base, ADAP, MAI, and EC; base includes base supplemental; ADAP includes supplemental and emergency funds.
  7. Find Grant Awards: District of Columbia, HRSA, US Department of Health and Human Services, available from: http://granteefind.hrsa.gov/.
  8. Find Grant Awards: District of Columbia, HRSA, US Department of Health and Human Services, available from: http://granteefind.hrsa.gov/.
  9. Find Grant Awards: District of Columbia, HRSA, US Department of Health and Human Services, available from: http://granteefind.hrsa.gov/.
  10. About the AIDS Education & Training Centers, AETC National Resource Center, available from: www.aids-ed.org/aidsetc?page=ab-00-00.
  11. 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.
  12. Find Grant Awards: District of Columbia, HRSA, US Department of Health and Human Services, available from: http://granteefind.hrsa.gov/.
  13. HOPWA Report, US Department of Housing and Urban Development, available from: www.hudhre.info/hopwa/index.cfm?do=viewHopwaRptsSelect&opt=Awards#tab.
  14. 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.
  15. Syringe Exchange Programs in the United States 2011, amfAR, available from: www.amfar.org/uploadedFiles/On_The_Hill/SEPS.pdf?n=3826%29.
  16. 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.
  17. State HIV/AIDS Program Directory, National Alliance of State and Territorial AIDS Directors, available from: www.nastad.org/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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