To ensure that the most effective HIV prevention programs get federal funding, the Texas Department of Health this year changed the competitive process for those dollars, resulting in several programs going unfunded next year. Of the 57 HIV prevention programs currently receiving federal funding, 19 will go unfunded next year. Each year, the state's Bureau of HIV and STD Prevention receives $9.5 million from the CDC to be distributed among local agencies for HIV prevention programs. The CDC is allocated $320 million for HIV prevention programs administered by Health Departments in all states and six major cities, including Houston.

Casey Blass, the DOH's HIV/STD Health Resources Division director, said the funding changes were precipitated by recent studies showing a shift in the at-risk population from white males to African-American men and women. He said at-risk populations are also more concentrated in urban areas and are younger. In 2000, the rate of HIV cases among African-Americans was 78 per 100,000 compared to 14.8 for whites and 13.8 for Hispanics. Blass said intervention programs that included repeated contacts with at-risk clients were given priority.

Some say the DOH shows a bias against rural regions, particularly in West Texas and the Panhandle, leaving some communities, even regions, with no or very limited HIV prevention programming. One HIV researcher, Dr. Mike Ross, said Texas does not evaluate HIV prevention programs to determine whether they are effective. Blass said the state does not have the funding or expertise to provide such evaluations, but that a program's effectiveness is based on models established by the CDC, which has a compendium of HIV programs that are effective.

Austin Health and Human Services of the Travis County Health Department secured a $594,194 contract for next year -- a $275,096 increase. The AIDS Outreach Center in Fort Worth saw its funding more than doubled to $370,000 from $174,070. Tarrant County Health Department's funding jumped to $554,000 from $389,600. Planned Parenthood of Houston/Southeast Texas garnered $103,145 in new funding. Planned Parenthood of Amarillo and the Texas Panhandle lost more than $98,446. The Bell County Public Health District's $110,349 contract was not renewed, while United Way of Greater Fort Hood Area had its contract doubled to $133,223 from $66,435.

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