A projected $5 billion state budget gap and cuts in federal social service spending are threatening Ohio's inner-city AIDS counseling, testing, and education programs. In a memo last month, the state Department of Health asked the division heading Ohio's AIDS Drug Assistance Program to asses the consequences of state cuts that could go as deep as 25 percent.

Richard Aleshire, who oversees Ohio's ADAP, said he does not believe the new budget Gov. Bob Taft releases next week will cut as much as 25 percent from state ADAP funding. "But at this point, it's really in the hands of the legislature," he said. Some 2,850 low-income Ohio residents receive federal or state support for their HIV medications, said Aleshire.

"We're all sweating here," said Kevin Sullivan, executive director of the private Columbus-based Ohio AIDS Coalition. Sullivan wondered how long ADAP could survive without imposing eligibility restrictions. Ohio's ADAP offers nearly every antiretroviral drug and has never had a waiting list.

While the Ryan White Care Act is likely to be reauthorized in June, federal community development money for AIDS prevention has been declining for five years. Cleveland, which has Ohio's highest percentage of people with HIV/AIDS, is facing its first reduction in federal housing assistance for people with AIDS. "We don't know in 2005 if we can pay for case management for people with AIDS," said Earl Pike, executive director of the AIDS Taskforce of Greater Cleveland. But the budget forecast could also affect Columbus, where new HIV cases exceed those in Cleveland, and Cincinnati, which also draws patients from Kentucky.

On Thursday, local AIDS agency leaders will gather in Cleveland to campaign against budget cuts and ask the Department of Health to shift $500,000 from its expanding abstinence program to AIDS treatment and prevention.

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