Chip Somodevilla/GETTY IMAGES - A health educator massages a drop of blood from a man's finger while conducting an HIV test at the Whitman-Walker Health Elizabeth Taylor Medical Center Sept. 27, 2012 in Washington, DC.
Cities such as Washington and New York also receive tens of millions a year from other Ryan White funding specifically designated for metropolitan areas hardest hit by the epidemic. Metropolitan Washington, for example, will receive about $54 million in total Ryan White funds this year; last year the amount was $56 million.
Most of the 19 cities receiving new funds for HIV-positive women and children don’t receive that category of funding, Kramer said.
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The awards were announced in August. Many providers who received smaller grants are scrambling to adjust.
“There’s winners and losers because there was no new money added,” said Michael Ruppal, executive director of The AIDS Institute, a national nonprofit.
Advocates say it’s too soon to know the impact in Washington. The nation’s capital has a higher HIV infection rate than any state and among the highest for cities. There are 14,465 adolescents and adults, or about 2.7 percent of the population, diagnosed as living with HIV. That is well above the 1 percent considered by the World Health Organization to be a general epidemic.
Unlike other cities where the at-risk population might be concentrated among intravenous drug users or men who have sex with men, the District has a mixed epidemic, with a huge burden falling on heterosexual African Americans. Officials have said 90 percent of all women with HIV are black.
In previous years, the $1.4 million in safety-net funds was awarded to Children’s National Medical Center. It partnered with several community organizations to help about 1,200 HIV-positive women, infants, children and youth.
“Overwhelmingly, these are people who are living below the poverty line,” said William Barnes, director of the project. The funds helped pay for mental health services and case management, services not often covered by insurance. That support is critical to keeping HIV-positive people in treatment.
Adolescents need special support, said Adam Tenner, executive director of Metro Teen AIDS, one of the community groups that received past funding to work with dozens of HIV-positive youth. For the short term, the group has received funding from other sources to continue the work.
This year, an arm of the parent company that owns MedStar Washington Hospital requested about half a million dollars to serve the same population and same service area as Children’s; it was awarded $350,000 a year for a five-year project. The hospital’s infectious diseases clinic will be the primary source of care. It plans to partner with some of the same community groups.
Leon Lai, an infectious disease doctor at the hospital, said final details are still being worked out.The hospital plans to “do the best we can to use these funds wisely and maximize the best care possible,” he said.
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