In business for 15 years, the HIV Prevention Clinic at the Muskingum County Health Department in Zanesville, Ohio, lost a $49,000 grant needed to keep its doors open. Rural AIDS Coordinator Tim Roe, who manages funding for the Zanesville site and others through the Portsmouth Health Department in Scioto County, said the cuts represent an unfortunate trend.

In 1991, the Portsmouth agency could afford to fund more than 26 HIV testing clinics with grant money from the Ohio Department of Health. This year, that number dropped to nine, Roe said. Independent reviewers "were asked to select the proposals that were going to give the people the most bang for their buck," Roe said. "We were thrilled to death we were able to fund nine. There's not a lot to go around."

The Zanesville clinic was among six applicants from a pool of 15 eligible agencies that did not get money this year through the Portsmouth program. Kevin Sullivan of the Ohio AIDS Coalition in Columbus said such funding cuts are not a good sign for rural residents. "It's a growing concern in southeast Ohio, where health care is not as good or up to par with the health care that people would receive in urban areas," he said. "Closing a clinic or test site puts them further behind the curve." Roe said he hopes the Newark Health Department can serve Zanesville-area clients. Newark is 25 miles northwest of Zanesville.

The HIV Prevention Clinic provides STD prevention education and free, confidential HIV testing to 400 patients annually. Clients traveled there from several nearby counties. Newark Nursing Director Mary Beth Hagstad said her department already serves five counties, but perhaps could provide a couple of half-day sessions a month in Zanesville. "This would be an extra burden on us but we are willing to do it," said Hagstad. But one employee handles the workload, she said, and that person could not handle another 400 clients a year.

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