SASI Calls On HRSA to Review Ryan White Supplemental Funding

SASI calls on HRSA to increase Ryan White Part B Supplemental funding to regions in most need.  Read the full  SASI Call to Action and consider signing on to the AIDS Institute’s Sign on Letter asking HRSA to Review Ryan White Part B Supplemental Grant Process.  Deadline is Tuesday, March 3rd

The nine-state Deep South region targeted by the Southern HIV/AIDS Strategy Initiative (SASI)[1] is one region in need of increased Ryan White Part B Supplemental funding to help address the significant HIV/AIDS burden and high death rates experienced by this region.

Significant HIV Burden faced by Targeted Deep South States:  SASI’s research team, in collaboration with authors from the Centers for Disease Control, recently published new research about the HIV burden and outcomes in nine Deep South states, including death rates and 5-year survival among persons living with HIV and AIDS in the targeted states region.

Researchers found that HIV positive people in the targeted states are dying at faster rates than in any other region of the country.  Twenty-seven percent of persons diagnosed with AIDS in the 9-state region had died within 5 years of diagnosis. In Louisiana, one-third of persons diagnosed with AIDS and 19% of those diagnosed with HIV had died within 5 years.

The death rate among persons living with HIV was higher in the targeted states than in any other US region, even after adjusting for age, sex, transmission category, and area population size. Living outside a large urban area at diagnosis significantly predicted greater death rates among persons living with HIV in the 9-state region, suggesting “..a disconnect between diagnosis and maintenance of HIV care in this region…”

In 2011, 38% of those diagnosed with HIV in the United States lived in the 9-state Deep South region. This region also has the highest number of persons living with HIV of any region in the US. More people diagnosed in this region are black/African American, female and aged 13-24 than in other US regions, and a higher percentage reported heterosexual contact as the transmission category. Living in the rural and suburban areas of the Deep South at the time of diagnosis significantly predicted higher death rates among persons living with HIV in the Deep South region when compared to urban residence. The Deep South Region also has high rates of uninsured compared to the US average.

Identifying effective prevention and care services to address common barriers to care such as geographic access and pervasive stigma is critical to improving HIV outcomes in the Deep South region.

Impact of State Decisions on Medicaid Expansion:  In 2015, adequacy of insurance will become more important than ever to people living with HIV.

  • In states that expand Medicaid, whole new classes of people with HIV will gain coverage, allowing use of Ryan White dollars for other services that identify people with HIV, keep them in care, enable them to live healthy, productive lives, and prevent transmission of HIV.
  • In states that do not expand Medicaid, some of the lowest-income people with HIV will be left out, risking even higher death rates and lower survival rates for HIV positive persons.

Call to Action:  If we are to achieve the goals of the National HIV/AIDS Strategy, federal and state public health officials and policy makers must focus attention and resources on this 9-state region where HIV diagnosis rates are highest, uninsured rates are highest, and more people are living and dying with HIV.  SASI’s research findings give us a deeper understanding of the dire consequences that having an HIV diagnosis in the Deep South has for too many. Without appropriate care, HIV is still deadly.  Increasing Part B funds, placing special emphasis on factors that limit access to health care, and studying the current utilization of funds can help provide needed services for people with HIV in a post-health-reform world.

SASI calls on:

  1. HRSA to re-examine how Ryan White Part B Supplemental funding is being allocated to ensure that funds are given to states where the need is greatest in order to improve health outcomes..
  2. HRSA to take into account when distributing Ryan White Part B Supplemental funds the demonstrated need as evidenced by high HIV incidence and prevalence, high uninsured rates, high death rates and low 5-year survival rates among persons living with HIV in the targeted Southern region.

[1] AL, FL, GA, LA, MS, NC, SC, TN, TX.

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