HIV/AIDS in the United States
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 of over 40,000 new infections per year. The following data represent the total reported AIDS cases in the United States through year-end 2002, the most current information available as of June, 2004:
Total Reported AIDS Cases1
It is the position of AIDS Action that the current HIV/AIDS statistics represent only a portion of the epidemic in the U.S. The data below only captures the HIV cases that were confirmed through testing and reporting; thus, it does not reflect the demography and size of the HIV positive population that has not yet been tested or reported.
|Total Reported AIDS Cases by Gender, 2002|| ||Percentage of Total AIDS Cases Reported by Gender, 2002|
|Total Reported AIDS Cases by Race/Ethnicity, 2002||Percentage of Total AIDS Cases Reported by Race/Ethnicity, 20022|
|White, Not Hispanic||364,458|
|Black, Not Hispanic||347,491|
|American Indian/Alaskan Native||2,875||
|White, Not Hispanic||41%|
|Black, Not Hispanic||39%|
|American Indian/Alaskan Native||<1%|
The Rate of HIV/AIDS Per 100,000, by State, 20023
Total Reported AIDS Cases by Key States, 20024
| ||Total Cases|
Fiscal Year 2003 Funding for HIV/AIDS in the United States
At a Glance5
|HIV Prevention||Health & Human Services||Centers for Disease Control & Prev.||$320,142,357|
|Ryan White - Title I||Health & Human Services||Health Research & Services Admin.||$626,649,000|
|Ryan White - Title II||Health & Human Services||Health Research & Services Admin||$1,066,940,000|
|Ryan White - Title III||Health & Human Services||Health Research & Services Admin||$200,925,000|
|Ryan White - Title IV||Health & Human Services||Health Research & Services Admin||$74,497,000|
|Ryan White - AETC||Health & Human Services||Health Research & Services Admin||$35,550,000|
|Ryan White - Dental||Health & Human Services||Health Research & Services Admin||$13,405,000|
|Ryan White - SPNS||Health & Human Services||Health Research & Services Admin||$19,684,600*|
|HOPWA||Housing & Urban Dev.||Office of HIV/AIDS Housing||$285,464,628|
|* FY 2002 Funding Level, the FY 2003 Funding level for SPNS is unavailable (as of June 2004)|
The Centers for Disease Control and Prevention provided the United States with $320,142,357 for HIV prevention programs. These funds were allocated to state and local health departments and community-based organizations to finance counseling and testing programs, public information and health education/risk reduction activities, and monitoring/surveillance programs.6
Ryan White CARE Act
The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, enacted in 1990 and reauthorized in 2000, 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.
- Title I -- Eligible Metropolitan Areas (EMAs): Title I provides funding to eligible metropolitan areas disproportionately affected by the HIV epidemic. The United States provided $626,649,000 in Title I funding.7
- EMAs: Atlanta, Austin, Baltimore, Bergen-Passaic, Boston, Caguas, Chicago, Cleveland, Dallas, Denver, Detroit, Dutchess, Ft. Lauderdale, Ft. Worth, Hartford, Houston, Jacksonville, Jersey City, Kansas City, Las Vegas, Los Angeles, Miami, Middlesex-Somerset-Hunterdon, Minneapolis, Nassau-Suffolk, New Haven, New Orleans, New York, Newark, Norfolk, Oakland, Orange County, Orlando, Philadelphia, Phoenix, Ponce, Portland, Riverside-San Bernardino, Sacramento, St. Louis, San Antonio, San Diego, San Francisco, San Jose, San Juan, Santa Rosa, Seattle, Tampa, Vineland-Millville-Bridgeton, Washington [D.C.]., West Palm Beach.
- Title II -- States: Title II helps state health departments improve the quality, availability, and organization of HIV/AIDS health care and support services. This title also contains the AIDS Drug Assistance Program (ADAP), which provides low-income individuals with life-prolonging medications. The United States received $1,066,940,000 in CARE Act Title II funds, which includes a proposed $714,326,000 for ADAP as well as $6,954,000 to support educational and outreach services to help disproportionately impacted communities of color improve their participation in ADAP through the Minority AIDS Initiative.8
As of April 2004, the U.S. faced the following restrictions in ADAP services:
- Capped enrollment: Alabama, Alaska, Arkansas, Colorado, Idaho, Indiana, Kentucky, Montana, North Carolina, South Dakota, West Virginia
- Reduce Formulary: Colorado, Oklahoma
- Monthly or Annual Expenditure Cap: Idaho, Oklahoma, South Dakota
- Imposed Cost-Sharing: Washington
By the end of FY 2004, the U.S. anticipates facing new or additional restrictions in the following states:
- Alabama, California, Iowa, Missouri, New Hampshire, New Jersey, New Mexico, Oregon, South Carolina, Texas9
- Title III -- Early Intervention Services and Planning: Title III supports Early Intervention Services (EIS) grants to provide services for low-income, uninsured, and underinsured HIV-infected individuals. Title III also funds planning grants to help rural or underserved communities develop high-quality HIV primary care. The United States provided $200,925,000 in Title III funds.
- Title IV -- Women, Infants, Children, and Youth: Title IV focuses on the operation and development of primary care systems and social services for women and youth, two groups that represent a growing share of the epidemic. The United States provided $74,497,000 in Title IV funds.10
- Other CARE Act Funding Programs:
AIDS Education and Training Centers (AETC) Program
AETCs provide training, consultation, and information to providers through a national network of over 70 local performance sites that cover all 50 states, Puerto Rico, and the Virgin Islands.
Total AETC Funding: $35,550,00011
Location of Regional AETCs:12
Dental Reimbursement Program
The Ryan White Care Act Dental Reimbursement program provides reimbursement to dental schools, postdoctoral dental education programs, and dental hygiene programs for oral health care of individuals living with HIV.
Total Dental Reimbursement Funding: $13,405,00013
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 Funding: $19,684,600*14
* FY 2002 Funding Level
Housing Opportunities for Persons with AIDS
The Department of Housing and Urban Development (HUD) provided the United States with $259,304,000 in formula grants under the Housing Opportunities for Persons with AIDS (HOPWA) program in 2003.15 HOPWA provides housing assistance and related supportive services for low-income persons with HIV/AIDS and their families. Ninety percent of funding is provided through "formula grants" to qualified states with the largest number of AIDS cases, and the remaining ten percent is provided on a competitive basis, to projects that are of potential national significance. The United States provided $9,809,626 nationwide in competitive funding and $1,500,000 in technical assistance grants for 2003.16
Beginning in 2002, HUD began providing additional competitive funding to support existing programs that address permanent housing and service challenges for persons with HIV/AIDS and their families. The United States provided selected programs $14,851,002 in permanent housing renewal grants for 2003.17
|HOPWA Grant Type||Funding Amount|
|Competitive -- Project of National Significance||$9,809,626|
|Competitive -- Permanent Housing||$14,851,002|
|Community Development Technical Assistance||$1,500,000|
The United States does report HIV infection rates.18
- Total number of Adults Living with HIV infection through December 2002: 142,713
- Total Number of Children < 13 Years Old Living with HIV infection through December 2002: 1,41619
HIV reporting requirements indicate that a state requires HIV to be reported. All states require all AIDS cases to be reported to local and state health departments. The data above only include persons reported with HIV infection who have not developed AIDS and includes only persons reported from areas with confidential HIV reporting.
U.S. AIDS Leadership
Chairperson, National Alliance of State and Territorial AIDS Directors
Administrative Director, HIV/AIDS Program
Louisiana Office of Public Health
234 Loyola Avenue, 5th Floor
New Orleans, LA 70112
Phone: (504) 568-7474
Fax: (504) 568-8393
- 1998-2002 data taken from HIV/AIDS surveillance report. Division of HIV/AIDS and Prevention. Centers for Disease Control & Prevention, (Website). www.cdc.gov/hiv/stats/hasrlink.htm. Volumes 10-14, Tables 1 and 2 (1998-2001), Tables 11 and 14 (2002). (Retrieved June 2003).
- Ibid. Table 3.
- HIV/AIDS surveillance report. 2003. Division of HIV/AIDS and Prevention. Centers for Disease Control & Prevention, (Website). www.cdc.gov/hiv/stats/hasr1302/table3.htm. Vol. 14. Map 1. (Retrieved June 2004).
- Basic statistics, areas reporting most cases. Division of HIV/AIDS Prevention. Centers for Disease Control & Prevention (Website). www.cdc.gov/hiv/stats.htm.
- Ryan White CARE Act. Funding History. HIV/AIDS Bureau. Health Research and Services Administration (Website). ftp:/ftp.hrsa.gov/hab/fundinghis03.xls. (Retrieved June 2004).
- CDC HIV prevention funding for state and local health departments. National Alliance of State and Territorial AIDS Directors (Website). www.nastad.org/PublicPolicyResources/PrevHistFund.xls. (Retrieved June 2004).
- Ryan White CARE Act. Funding History. HIV/AIDS Bureau. Health Research and Services Administration (Website). ftp:/ftp.hrsa.gov/hab/fundinghis03.xls. (Retrieved June 2004); Title I -- Grants to Eligible Metropolitan Areas. Fact Sheet. HIV/AIDS Bureau. Health Research and Services Administration (Website). http://hab.hrsa.gov/programs/factsheets/title1fact.htm. (Retrieved June 2004).
- Ryan White CARE Act Title II fiscal year 2003 grant awards. Health Research and Services Administration Newsroom. (Website) www.hhs.gov/news/press/2003pres/20030410.html. (Retrieved June 2004).
- National ADAP Monitoring Project Annual Report. 2004. The national ADAP Monitoring Project (Website) www.nastad.org/documents/ public/pub_careandtreatment/
2004519TheNationalADAPMonitoringProjectAnnualReport.pdf. (Retrieved June 2004).
- Ryan White CARE Act. Funding History. HIV/AIDS Bureau. Health Research and Services Administration (Website). ftp://ftp.hrsa.gov/hab/fundinghis03.xls. (Retrieved June 2004).
- AETCs Services and Contacts. AETC National Resource Center. (Website) www.aidsetc.org/aidsetc?page=ab-00-00. (Retrieved June 2004).
- SPNS, AETC, and Community-based dental funding. April 4, 2003. Special data request. Holmes, B. Grants Management. Health Research and Services Administration. (Requested March 2003).
- 2003 HOPWA formula allocations. Housing Opportunities for People Living with AIDS. Department of Housing and Urban Development (Website). www.hud.gov/utilities/intercept.cfm?/offices/
cpd/aidshousing/programs/formula/grants/2003.pdf. (Retrieved June 2004).
- FY 2002 HOPWA competitive grants. Department of Housing and Urban Development (Website). www.hud.gov/offices/cpd/aidshousing/
programs/competitive/grants/fy03/index.cfm. (Retrieved June 2004).
- HIV reporting policy, 2003. State health facts online. Kaiser Family Foundation (Website). www.statehealthfacts.kff.org. (Retrieved June 2004).
- HIV/AIDS surveillance report. 2003. Division of HIV/AIDS and Prevention. Centers for Disease Control & Prevention, (Website). www.cdc.gov/hiv/stats/hasr1302/table3.htm. Vol. 14. Table 12. (Retrieved June 2004).
- Membership. National Alliance of State and Territorial AIDS Directors (Website). www.nastad.org/pdf/NASTADMembers.pdf. (Retrieved June 2004).