This article was cross-posted from the AIDS.gov blog. Kevin Fenton, M.D., Ph.D., FFPHis the director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. (Cross-posted from Health Protection, Perspectives Blog.)

On September 24th, U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced that CDC allocated $30 million of the Affordable Care Act's Prevention and Public Health Fund to expand HIV prevention efforts under the President's National HIV/AIDS Strategy (NHAS). The funding includes nearly $22 million of grants for state and local health departments. Secretary Sebelius indicated that the funding will give a critical boost to our HIV/AIDS prevention efforts across the country by focusing on communities and geographic areas that have been hardest hit by this disease.

This funding will allow those of us working in HIV prevention at the federal, state, and local level to support innovative, evidence-based and high-impact prevention efforts in line with recommendations from the National HIV/AIDS Strategy. It is providing us with the opportunity to make critical investments that will make a real impact on prevention efforts, allowing us to reach further into those communities that are at highest risk.

Grants totaling $11.6 million will support demonstration projects to identify and implement a "combination approach" to enhance effective HIV prevention programming in 12 hard-hit areas across the country. These efforts will both supplement existing programs in these communities and help jurisdictions to better focus efforts on key at-risk populations and fulfill unmet needs.

In the first year, the 12 jurisdictions funded through the Affordable Care Act include: Chicago the District of Columbia, Florida, Georgia, Houston, Los Angeles, Maryland, New York City, Philadelphia, Puerto Rico, San Francisco, and Texas. The average award is approximately $960,000.

These funded state and local jurisdictions will work with CDC to determine what mix of HIV prevention approaches can have the greatest impact in the local area, based on the local profile of the epidemic and by assessing and identifying current gaps in HIV prevention portfolios. While the exact combination of approaches will vary by area, efforts funded under this program will follow a basic approach of:

• Intensifying prevention for individuals at greatest risk,
• Testing those individuals to reduce undiagnosed HIV infection,
• Prioritizing prevention and linkage to care for people living with HIV; and
• Directing these intensified efforts to communities with the highest burden of HIV.

Additional funding will allow CDC to expand upon successful existing efforts, as well as fill knowledge gaps to help guide evidence-based policies and approaches as a part of NHAS.

Awards to state and local health departments include:

• Increasing HIV testing: $4.4 million from the Affordable Care Act will allow CDC to further expand its successful HIV testing initiative, which we began in 2007 to increase knowledge of HIV status primarily among African Americans. It was recently expanded to reach more hard-hit communities and populations at risk, including Latinos, men who have sex with men (MSM), and injection drug users. In the first two years of the program alone, more than 1.4 million Americans were tested, and more than 10,000 individuals were newly diagnosed.
• Filling critical data gaps: $5.6 million from the Affordable Care Act will enhance local area data collection, to provide critical information to better monitor and target future HIV prevention and treatment programs. Specifically, the new funds allow areas to monitor disease indicators among HIV-infected populations to better understand access to care, prevention, and treatment services. The remainder of the funding is going to support additional activities for HIV prevention:
• Supporting evaluation for new activities: $6.6 million from the Affordable Care Act will support evaluation and monitoring of combination prevention approaches and other activities. Funding will also establish a web-based survey to quickly identify and respond to trends in risk behavior and exposure to HIV prevention services among MSM.
• Prioritizing underserved populations: $1 million from the Affordable Care Act will support work with tribal communities to improve HIV prevention and program integration for American Indians/Alaska Natives.

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