Health Department Funding Allocations Under Program Announcement 04012 for CDC-Supported HIV Prevention Activities, 2008-2009
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Health Department Funding Allocations Under Program Announcement 04012 for CDC-Supported HIV Prevention Activities, 2008-2009

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    Health Department Funding Allocations Under Program Announcement 04012 for CDC-Supported HIV Prevention Activities, 2008-2009 Health Department Funding Allocations Under Program Announcement 04012 for CDC-Supported HIV Prevention Activities, 2008-2009 Presentation Transcript

    • Health Department Funding Allocations Under Program Announcement 04012 for CDC-Supported HIV Prevention Activities, 2008-2009 Argelia Figueroa M.S., Choi Wan Ph.D., and Mesfin Mulatu Ph.D., M.P.H. Division of HIV/AIDS Prevention 2011 National HIV Prevention Conference August 15, 2011The findings and conclusions in this presentation are those of the authors and do notnecessarily represent the official position of the Centers for Disease Control andPrevention/the Agency for Toxic Substances and Disease Registry National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention
    • Background CDC’s Division of HIV/AIDS Prevention (DHAP) funds about $650 million per year to address the domestic HIV/AIDS epidemic  About $300 million through Program Announcement (PA) 04012 for HIV prevention  Funding for HIV prevention projects is supplemented by other program awards focused specifically on communities of color and men who have sex with men (MSM)
    • Issue Describe how health departments allocate CDC PA 04012 funds  HIV prevention program activities  Prevention interventions designed for persons living with HIV Compare distribution of allocations with patterns of the HIV epidemic by race/ethnicity and by risk categories
    • Setting 59 Health Departments  50 states  6 cities  District of Columbia  Chicago  Houston  Puerto Rico  Los Angeles  U.S. Virgin Islands  New York City  Philadelphia  San Francisco
    • Methods
    • Methods Collaboration among CDC, the National Alliance of State and Territorial AIDS Directors (NASTAD), and the Urban Coalition on HIV/AIDS Prevention Services (UCHAPS) Data collection template provided by CDC to report PA 04012 2008 and 2009 allocation information  Template provided in April 2010  Information received between April and June 2010
    • Methods Allocations under PA 04012 were requested for:  HIV prevention program activities • Community planning (CP) • Evaluation • Health education and risk reduction (HE/RR) o by race/ethnicity and by risk (reported) • Counseling, testing, referral, and partner services (CTR+PS) o by race/ethnicity and by risk (estimated for CTR) • Other  Prevention interventions designed for persons living with HIV
    • Methods Race/Ethnicity  HIV risk  American Indian/Alaska  MSM Native (AI/AN)  Injection drug use (IDU)  Asian  MSM/IDU  Black (non-Hispanic)  High-risk heterosexual  Hispanic contact  Native Hawaiian/Pacific  Other Islander (NH/PI)  White (non-Hispanic)  Other
    • Methods Quality assurance during and after reporting  Checks for any incomplete or inconsistent information  Requesting additional information when necessary  Provide feedback on submitted data
    • Results
    • Proportion of Allocated PA 04012 Funding for Prevention Interventions Designed for Persons Living with HIV, 2005-2009 15% 14% Proportion of Allocated Funding 13% 12% 12% 11% 9% 9% 6% 3% 0% 2005 2006 2007 2008 2009 YearN= 59 state and local health departments
    • Proportion of Allocated PA 04012 Funding for HIV Prevention Activities, by Year, 2005-2009 45% 2005 41% 40% 40% 39%39% 2006 38% Proportion of Allocated Funding 36% 35%35% 35% 2007 35% 31% 2008 30% 2009 25% 20% 18% 17%17% 17%17% 15% 10% 6% 5% 5% 5% 5% 4% 4% 4% 4% 4% 4% 0% CP Evaluation HE/RR CTR+PS Other Prevention ActivitiesN= 59 state and local health departments
    • Proportion of Allocated PA 04012 Funding for HE/RR, by Race/Ethnicity, 2009 White (non- Other Hispanic) 21% 17% American Indian or Alaska Native 1% Native Hawaiian or Pacific Islander <1% Asian 1% Hispanic 22% Black (non- Hispanic) 38%N= 59 state and local health departments
    • Proportion of Allocated PA 04012 Funding for HE/RR, by Risk Group, 2009 Other 20% High-risk heterosexual contact 38% MSM 27% MSM/IDU IDU 2% 14%N= 59 state and local health departments
    • Proportion of Allocated PA 04012 Funding for CTR, by Race/Ethnicity, 2009 White (non- Hispanic) Other 31% 7% American Indian Native Hawaiian or Alaska Native or Pacific <1% Islander <1% Asian <1% Hispanic 18% Black (non- Hispanic) 37%N= 49 state and local health departments
    • Proportion of Allocated PA 04012 Funding for CTR, by Risk Group, 2009 High-risk MSM/IDU heterosexual 1% contact 45% IDU 4% MSM 10% Other 40%N= 49 state and local health departments
    • Estimated HIV Diagnoses in 2009(N = 40 states with confidential name-based HIV infection reporting) Race/Ethnicity HIV risk group High- Other risk Other 3% hetero- 3%White sexual28% 32% Hispanic Black IDU MSM 17% 52% 9% 56%Source: CDC HIV Surveillance Report, 2009
    • Comparison of Allocations from PA 04012 with the National HIV Epidemic, 2009 HIV/AIDS Diagnoses80% HE/RR Allocations CTR Estimated Allocations60% 56% 52%40% 38% 37% 27%20% 10%0% Black MSM
    • Summary Largest budget allocations for HE/RR and CTR+PS From 2005 to 2009, budget allocations  Increased slightly for prevention interventions designed for persons living with HIV (9% to 11%)  Increased for CTR+PS (31% to 39%)  Decreased for HE/RR (41% to 35%) Differences between national HIV epidemic and national level allocations of HIV prevention funds distributed under PA 04012
    • Lessons Learned Limitations and Discussion
    • Lessons Learned/Limitations Funding allocations provide proxy measure of populations served and services provided PA 04012 represents over one half of total CDC HIV prevention funding and does not include:  CDC funding for specific initiatives (e.g., 07-768)  CDC direct funding for specific grantees (e.g., CBOs, Pacific Island Jurisdictions)  Funding from other federal agencies, state or local governments, or private sources Change in budget allocation reporting requirements to allow for a relatively comprehensive analysis
    • Lessons Learned/Limitations Information was collected retrospectively Level of detail of data collected Overall CTR allocation was a true allocation; however, CTR allocations by race/ethnicity and by risk were estimates High percentages of estimated CTR allocations by risk categorized as “other”
    • Discussion Understanding funding allocations helps CDC and stakeholders make policy decisions and improve prevention programs and resource targeting Documenting actual expenditures should be considered Determining whether and to what degree programs are underfunded for black and MSM populations is warranted
    • Acknowledgments Health Department Grantees  DHAP, Office of the Director  Jonathan Mermin NASTAD  Rich Wolitski  Julie Scofield  Janet Cleveland  Natalie Cramer  Chris Cagle  Prevention Advisory Committee  June Mayfield Members  DHAP, Prevention Program Branch UCHAPS  Wendy Lyon  Anna Ford  Project Officers  Coalition Representatives  DHAP, Program Evaluation Branch  Dale Stratford  Janet Heitgerd  John Beltrami
    • Thank you!National Center for HIV/AIDS, Viral Hepatitis, STD, and TB PreventionDivision of HIV/AIDS Prevention