HIV conference participants praise targeted prevention, warn about underfunding

The 2011 National HIV Prevention Conference, which ended today in Atlanta, highlighted the need for more HIV prevention efforts for young black men who have sex with men.

Scott Bryan, a Centers for Disease Control and Prevention spokesman, tells The Florida Independent that the conference focused on “high-impact prevention efforts” to “target populations that are at most risk.” The CDC issued a report early this month that shows an “alarming increase” in HIV incidence “among young, black gay and bisexual men” that requires “urgent action.”

Stephen Fallon — executive director of Skills4, which provides community forums and training in areas of health promotion and disease prevention — attended the conference, and tells the Independent in an email:

CDC is going to allocate more of the prevention funding to follow where the epidemic is going (new HIV cases, called incidence). In the past, the model largely favored jurisdictions that had high cumulative cases of AIDS, even if these weren’t necessarily the locations where new HIV infections were occurring or cases of AIDS were still being diagnosed.

This is good news for Florida, which has always been underfunded relative to its overall case rates. In the most recent CDC data (through 2009) the Miami Metropolitan Statistical Area is #1 in both new HIV infections and new AIDS diagnoses. The Miami MSA includes Dade, Broward and Palm Beach counties. Within this overall MSA, Ft Lauderdale has the highest new rates, Miami the 2nd highest.

CDC is also planning to focus more on gay/bisexual men (MSM), particularly young men of color. They have a new funding announcement that’s being reviewed now.

Dr. Ronald Valdiserri, deputy assistant secretary at the U.S. Department of Health and Human Services, wrote on Monday: ”Without minimizing positive outcomes, several presenters – federal and non-federal alike – acknowledged that these are challenging times for HIV prevention activities in light of a federal discretionary spending freeze and state and local budget cuts that have resulted in the loss of an estimated 45,000 public health jobs and serious reductions in a variety of public health programs.”

The National Association of People with AIDS said in a written statement today that the organization “supports and applauds the CDC’s new HIV funding formulas making ‘the dollars follow the epidemic.’ Regions where the HIV epidemic is growing, like the South, will get a fairer share of the available funds. That’s a good thing.”

“The new formulas have the unintended result of pulling money out of the states that have been doing the best jobs at preventing new HIV infections,” the release adds, also pointing out that “what the new CDC formulas show us is that prevention is underfunded across the country. Making the same dollars ‘follow the epidemic’ doesn’t address the underfunding, it just spreads it more evenly across the states.”

The CDC’s Bryan tells the Independent that “we know that we need to make available resources, and our funding for HIV prevention has remained relatively stable.” He adds, “We have targeted resources where they are most needed in this country.”

Fallon agrees with the National Association of People with AIDS about the need for more funding: “HIV prevention in the U.S. is woefully underfunded, representing just 3% of the total HIV/AIDS budget for the nation.”

He adds that “each infection that we can avert saves society $355,000 in lifetime treatment costs” and that “many people don’t realize that we all pay for the treatment of someone living with HIV, either through increased health insurance premiums for the nation or through taxpayer-funded programs. The cost would be even higher if society did not shoulder some of the burdens. ”

Fallon concludes:

The CDC’s total HIV prevention budget is just shy of $800M per year for the nation. To put that in context, the U.S. is currently taking a firmer hand in its relations with Pakistan. The White House recently announced that it may withhold one-third of the annual funding we provide to Pakistani military (not one third of the total we provide to Pakistan overall; just one third of the military funding we provide). The amount we may withhold is $800M.