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Funding Allocations for CDCSupported HIV Prevention Program Activities under Program Announcement PA

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Chicago, Houston, Los Angeles, New York City, Philadelphia, and San Francisco. Project Methods ... 04012 represents only part of total HIV prevention funding, ... – PowerPoint PPT presentation

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Title: Funding Allocations for CDCSupported HIV Prevention Program Activities under Program Announcement PA


1
Funding Allocations for CDC-Supported HIV
Prevention Program Activities under Program
Announcement (PA) 04012, 2005-2007 Choi Wan
Ph.D., John Beltrami M.D., and Cindy Lyles
Ph.D. Division of HIV/AIDS Prevention 2009
National HIV Prevention Conference Atlanta, GA
The findings and conclusions in this presentation
are those of the authors and do not necessarily
represent the official position of the Centers
for Disease Control and Prevention/the Agency for
Toxic Substances and Disease Registry
2
Background
  • CDCs Division of HIV/AIDS Prevention (DHAP)
    funds 650 million per year to address the
    domestic HIV/AIDS epidemic
  • DHAP funds 300 million to 59 health
    departments each year under Program Announcement
    (PA) 04012 for HIV prevention
  • these funds are supplemented by other programs
    specifically directed to communities of color and
    men who have sex with men (MSM)

3
Issue
  • Describe how health departments allocate CDC
    funds under PA 04012
  • HIV infected persons
  • HIV prevention program activities
  • Does not address other federal, state, or local
    funding for HIV prevention programs

4
Estimated HIV/AIDS Cases Diagnosed in 2007 34
states with confidential named-based reporting
by race/ethnicity
by HIV risk group
Other
Other
White
High-risk hetero.
Hispanic
IDU
African American
MSM
5
Setting
  • 59 health departments
  • 50 states
  • District of Columbia
  • Puerto Rico
  • U.S. Virgin Islands
  • 6 cities
  • Chicago, Houston, Los Angeles, New York City,
    Philadelphia, and San Francisco

6
Project Methods
7
Project Methods
  • Collaboration among CDC, the National Alliance of
    State and Territorial AIDS Directors (NASTAD) and
    the Urban Coalition on HIV/AIDS Prevention
    Services (UCHAPS)
  • CDC provided all health departments a template
    form to collect and report allocation information
  • Information collected was retrospective

8
Project Methods
  • Allocations for 2005
  • template provided in 7/07
  • information received from 8/07 to 12/07
  • Allocations for 2006 and 2007
  • template provided in 10/08
  • information received from 11/08 to 12/08
  • Quality assurance during and after reporting
  • feedback to grantees for any incomplete or
    inconsistent information
  • subsequently reported information was reviewed
  • for feedback

9
Project Methods
  • Allocations under PA 04012 were requested for the
    following
  • prevention with HIV infected persons
  • HIV prevention program activities
  • community planning (CP)
  • evaluation
  • health education and risk reduction (HE/RR)
  • counseling, testing, referral, and partner
    notification (CTRPN)
  • other

10
Project Methods
  • Health departments reported HE/RR allocations by
    race/ethnicity and by HIV risk group
  • CTR allocations for both race/ethnicity and HIV
    risk were estimated, using CDCs HIV Counseling
    and Testing System data

11
Project Methods
  • Race/Ethnicity
  • American Indian/Alaskan Native (AI/AN)
  • Asian/Pacific Islander (A/PI)
  • African American (non-Hispanic)
  • Hispanic
  • White (non-Hispanic)
  • Other
  • for HE/RR other race/ethnicity or not targeted
    by any race/ethnicity
  • for CTR other race/ethnicity, multiple races,
    undetermined, or unknown

12
Project Methods
  • HIV risk group
  • MSM
  • injection drug use (IDU)
  • MSM/IDU
  • heterosexual contact
  • for HE/RR all heterosexuals
  • for CTR high-risk heterosexuals
  • other
  • for HE/RR other HIV risk or not targeted by
    risk
  • for CTR other HIV risk or risk not acknowledged

13
Results
14
Budget Allocations for HIV Infected Persons
2005-2007
N 59 health departments each year
15
Budget Allocations for Prevention Activities
2005-2007
N 59 health departments each year
16
Budget Allocations for HE/RR by race/ethnicity,
2007
N 59 health departments
17
Budget Allocations for HE/RR by HIV risk group,
2007
N 59 health departments
18
Budget Allocations for CTR by race/ethnicity,
2007
N 54 health departments
19
Budget Allocations for CTR by HIV risk group,
2007
N 54 health departments
20
Summary of Findings
  • Largest budget allocations for HE/RR and CTRPN
  • From 2005 to 2007, budget allocations
  • increased slightly for HIV infected persons (9
    to13)
  • increased slightly for CTRPN (31 to 36)
  • decreased slightly for HE/RR (41 to 38)

21
Summary of Findings
  • Differences between national HIV epidemic and
    national level allocations of health department
    HIV prevention funds
  • In 2007, differences for MSM
  • 53 of new HIV/AIDS cases
  • 29 of HE/RR allocations
  • 11 of CTR allocations
  • In 2007, differences for African Americans
  • 51 of new HIV/AIDS cases
  • 39 of HE/RR allocations
  • 36 of CTR allocations

22
Lessons Learned/Limitations and Discussion
23
Lessons Learned/Limitations
  • Funding allocations provide proxy measure of
    populations served and services provided
  • PA 04012 represents only part of total HIV
    prevention funding, thus does not include
  • CDC funding for specific initiatives (e.g., 7768)
  • CDC direct funding (e.g., CBOs, Pacific Island
    jurisdictions)
  • funding from other federal agencies
  • funding from state or local governments
  • private sources

24
Lessons Learned/Limitations
  • Information was collected retrospectively
  • Overall CTR allocation was a true allocation
    however, CTR allocations by race/ethnicity and
    risk were estimates
  • High percentages of other or not targeted

25
Discussion
  • Understanding funding allocations helps CDC and
    stakeholders make policy decisions and program
    improvements
  • Additional measures that determine allocations
    should be considered
  • Other methods to compare allocations with
    epidemic may be needed

26
Discussion
  • More detailed allocation data collection may be
    useful
  • e.g., Black MSM, high-risk Hispanic heterosexuals
  • Documenting actual expenditures should be
    considered
  • Determining whether and to what degree programs
    are underfunded for MSM and African Americans is
    warranted

27
Acknowledgments
  • 59 health departments
  • NASTAD
  • - David Kern, Julie Scofield, Murray
    Penner, Natalie Cramer
  • UCHAPS
  • - Israel Nieves
  • DHAP, Office of the Director
  • - Rich Wolitski, Janet Cleveland, Craig
    Studer, Chris Cagle, Jono Mermin
  • DHAP, Prevention Program Branch
  • - Project Officers
  • - Wendy Lyon
  • DHAP, Program Evaluation Branch
  • - National Monitoring and Evaluation Team
  • - Data Systems and Analysis Team
  • - Dale Stratford, Gene Shelley, Jessica
    Gardom
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