July 25, 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 Rhode Island according to the latest data from the CDC. 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.
The HIV/AIDS epidemic disproportionately affects those at risk from social factors such as disparity and discrimination. The following demographic numbers are from the State of Rhode Island Department of Health through 2008.
The Centers for Disease Control and Prevention provided Rhode Island with $2,032,934 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
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.
In FY 2010, the state received $0 Part A funding.v
In FY 2010, the state received $3,794,189 in CARE Act Part B funds.vi
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 Fundingix: $0
The Miriam Hospital of Rhode Island
164 Summit Avenue
Providence, RI, 02906
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 $0.xi
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: $399,991
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 $2,856,164 HOPWA funding in FY 2010.xiii
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.xiv There are currently exchange programs operating in Providence.xv
Rhode Island does not have any HIV-specific statues that allow for criminal prosecution, and there are no known arrests or prosecutions for HIV transmission in the state. The state has a communicable disease control statue, but has not targeted HIV. Criminalization of HIV, which is often dependent on known status, creates barriers to testing, along with discouraging disclosure and fostering stigma.xvi
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. There are no current grants in Rhode Island.
Paul Loberti, MPH
Office of HIV/AIDS and Viral Hepatitis
Division of Disease Prevention and Control
Rhode Island Department Health
3 Capitol Hill, Room 106
Providence, Rhode Island, 02908