States Spar Over Federal HIV/AIDS Funds

ADVANCE FOR APRIL 23; Graphic shows federal AIDS funding by state, and top ranked states in AIDS deaths, new cases, and rate. (AP Graphic) (AP)

There are more than 1 million people in the U.S. with HIV/AIDS, and they are living longer because of improved drug regimens. New York and California are home to the most AIDS patients.

When the disease is measured by cases per 100,000 residents, California is no longer in the top 10. Several Southern states move into the top rank, including Louisiana and Georgia.

Also, minorities account for a growing proportion of AIDS cases. Nearly 50 percent of new AIDS patients are black, compared with 30 percent who are white and 20 percent who are Hispanic, according to the Kaiser Family Foundation.

Congressional investigators found that the way money is distributed has led to great disparities in per-patient spending. For example, in 2004 a patient in California got $5,264, compared with $3,657 for a patient in Alabama.

"New York and San Francisco get all the funding," said Richard Williams, 32, an HIV-positive resident of Birmingham, Ala., who uses Ryan White funds to help pay for his medications. "Birmingham's a little city and we hardly get anything. That's not fair."

Activists and lawmakers in California and the Northeast say that analysis ignores factors such as quality of care and cost of living, and it does not measure all the grants made under the law.

"Big cities have more cases," said Richard Eastman, 52, of Los Angeles, who was diagnosed with HIV in 1994. "Sure, maybe some little town in Biloxi, Miss., or something might have 50 or 100 cases, but Los Angeles has 57,000 people in the system that we know about."

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On the Net:

Ryan White CARE Act background: http://hab.hrsa.gov/history.htm