A successful federal program that has kept women living HIV engaged in medical care is in danger of being cut.
The funds in question are distributed to local community groups and clinics across the nation through the Ryan White Care Act of 1990, a federal law established to help people who don’t have the financial resources to access HIV/AIDS medical care. “Part D” of that program, which last year delivered $68.9 million to 115 local organizations catering to women and children, is slated to be consolidated with “Part C,” a section that funds primary health care for those living with HIV.
The Obama administration says consolidating the two programs will reduce redundancies and relieve administrative burden. (Last year, 67 percent of groups funded by Part D also received funding from Part C.) It also says the consolidation will increase points of access for the population.
But advocates for women and children with HIV say they’re concerned the new proposal doesn’t specify what portion of federal dollars would fund services for women and children, who have unique health-care needs.
The proposed cuts reveal “a lack of understanding what it’s really going to take to keep women with HIV engaged in care,” said Naina Khanna, executive director of the Positive Women’s Network, a group of women living with HIV who lobby for HIV policies that consider gender.
Part D funds provide what supporters call culturally relevant care for women and children, including a full range of services specific to women that include mental health care, specialized OB/GYN care, support groups, and even help with transportation to medical facilities.
“It’s a social disease, especially for women and youth” says Gina Brown, who received services funded by Part D funds when she was diagnosed with HIV in 1994. She says the funds are particularly helpful for women and youth because of the stigma they face.
“I stressed out a lot, because I had this disease, but I didn’t have insurance at the time. I had no way of getting insurance because back then they were still looking at pre-existing conditions,” Brown says. “With the part D program the client can be assisted getting those services and getting them paid for.”
Today Brown is a coordinator at the New Orleans Regional AIDS Planning Council.
The proposed consolidation still has to go through Congress, which did not approve the consolidation when it was proposed last year.
More than 1.2 million people in the United States are living with HIV. Women account for one in four people of those, according to the Center for Disease Control. Many of them are poor women of color in the South and Northeast. The HIV diagnosis rate for black women is more than 19 times the rate for white women.
The Ryan White Act is the largest HIV-specific grant program in the U.S. The program is named after an Indiana teen who was expelled from his middle school and shunned from his town when his classmates learned he was living with HIV. The act was signed into law by George H.W. Bush months after White passed away.
It has been reauthorized every four years since it became law. “Some communities still experience unacceptably high rates of infection,” Obama said at a October 2009 press conference when he signed the latest extension.
Neither the White House Office of National AIDS Policy or the Office of Management and Budget provided comment for this story.
“We need to make sure the capacity to fund these programs [for women and children] doesn’t go away. But if there are some funding inequities we have to address them,” said Jeffrey Crowley, a distinguished scholar at the Georgetown University Law Center who served as as the Director of the White House Office of National AIDS Policy from 2009 to 2011.
“We need to recognize that the HIV epidemic is concentrated in key groups across the country. That includes black women but it also includes black, white, and Latino gay men.”
The vast majority of new HIV infections in 2013 were through male-to-male sexual conduct, disproportionately affecting black men.
Advocates Fusion spoke to say the Office of National AIDS Policy can still make sure there are funds that go specifically to women and children by making explicit commitments to women in the new National HIV/AIDS Strategy which will be released later this year.