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Southern AIDS Coalition Policy Statement




 

 

There is an emergency underway in the southern states of the United States. The disparate impact of the HIV/AIDS epidemic on southern citizens in the South – especially within communities of color – must be addressed.  The epidemic is changing; the face of HIV/AIDS is becoming increasingly rural, minority and poor.  Neither federal nor state policy or funding are adequate to enable the South to successfully address this emergency.  

·      Whereas… Southern states account for a little more than 1/3 of the US population, but account for about 40% of the people estimated to be living with AIDS and 46% of the estimated number of new AIDS cases; 

·      Whereas… This difference in new AIDS cases between the South and other regions of the country is increasing.  The percentage of new AIDS cases diagnosed in the South rose from 40% of the national total in 1996 to 46% of the national total in 2001; 

·      Whereas… Seven of the 10 states with the highest AIDS case rates are in the South;

·      Whereas… Six of the metropolitan areas with the highest AIDS case rates are in the South;

 ·     Whereas… Eight of the 10 states with the greatest percentage of the population living below the
       federal poverty level are in the South; and,

 ·      Whereas… Almost 38% of the cumulative cases and almost 49% of the 2001 newly reported
        cases of AIDS have been within the African American population yet only 19% of the southern
        population (19 million out of a total of 100 million) are African American.  The region with the next
        largest total of African Americans within their population is the Midwest, with about 6.5 million out
         of a total of 65 million (about 10%).

 Therefore, be it Resolved, as a result of this emergency occurring in the South, the Southern AIDS Coalition has adopted the following policy positions and recommendations, and encourages the support of all in achieving these goals:

 Prevention:  The Southern AIDS Coalition believes that, in order to reduce the spread of HIV/AIDS and the diseases commonly associated with it such as sexually transmitted diseases and hepatitis, and to improve the health status of those already infected by these diseases, all persons living in the United States, regardless of their geographic location, must have access to culturally- and linguistically-appropriate community-based services, including: outreach and prevention services; testing and counseling opportunities; and linkages to healthcare.  Therefore,

(1)   We call upon the Federal Government to develop program policies to ensure greater equity in the provision of comprehensive and appropriate HIV/AIDS prevention services within all states, and specifically within all areas of the South.

(2)   We call upon State and Local Governments within the South to increase human and financial resources directed to communities bearing a significant and disproportionate impact of HIV/AIDS as determined by epidemiological data and community assessments.  Communities of color and men who have sex with men are disproportionately affected; addressing these disparities requires focused efforts and the dedication of special resources. 

Care: The Southern AIDS Coalition believes that all persons living with HIV/AIDS across the United States, regardless of their geographic location or income, must have access to appropriately trained HIV-specific primary medical care providers, to services necessary to sustain medical care, and to a medication formularies consistent with United States Public Health Service guidelines.  This goal is consistent with the vision of a compassionate society, and contributes to the prolongation and improvement of peoples’ lives, facilitates their positive contributions to family and society and helps to reduce the further spread of this pandemic. 

(1)   It is imperative that the Federal Government provides emergency funding to assure the availability of HIV-related medical care services and medications for persons living in the South.  Federal policy must be modified/adopted to assure that funds are used to establish and support a basic “standard of care” for all states and territories.  This “standard of care” must assure that all eligible individuals (i.e., those who are HIV+, whose income is at/below 300% of the federal poverty level and who have no other third party source to pay for these medications), have access to a basic HIV/AIDS medication formulary which includes all FDA-approved anti-retrovirals and an adequate selection of medications for the prevention and treatment of opportunistic infections and co-infections. 

(2)   It is similarly imperative that the Federal Government support and fund the availability of safe, affordable and otherwise appropriate housing – consistently demonstrated to be one of the most critical support services to facilitate improved health status and successful health care outcomes – for all people living with HIV requiring such assistance.

The Southern AIDS Coalition supports these concepts for all regions of the country and also recognizes the need to maintain existing public health infrastructure nationwide.  However, the HIV/AIDS epidemic in the South must be addressed by providing and targeting new federal, state and local resources to prevention and care services in the South.  This must be done while holding harmless federal funding to all regions of the country. 

In order to accomplish these policy and human goals, the Southern AIDS Coalition has determined that a special HIV/AIDS appropriation totaling $121,806,000 1 be provided to Southern AIDS Coalition states in federal Fiscal Year 2005 and every year thereafter, within the following categories, until parity is reached. 

  Prevention
Care
Essential Medications
Housing 		$ 25,548,000
$ 34,564,000·
$ 48,619,000·
$ 13,075,000		  


Southern AIDS Coalition c/o Florida AIDS Action
PO Box 16705 Tampa, Florida 33687-6705
813-232-5886  813-232-0857 FAX
EMAIL  SouthernAIDScoal@aol.com
www.southernaidscoalition.org

1.  The estimates of funding required for Prevention, Care and Housing were developed by determining the total federal (CDC Cooperative Agreement, HRSA Ryan White Title I/II [non-ADAP], and HOPWA) funds available/expended, and determining an average “$ per capita” (i.e., $ available/expended per person estimated to be living with AIDS).  For the purpose of this analysis, Ryan White Title I (EMA formula and supplemental funding) and Title II (state base and emerging communities funding) were summed, and this new total was counted as received by the appropriate state.  Similarly, CDC cooperative agreement funds going to states and cities were summed, as were HOPWA funds going to states and SMSAs.  The amount a state would hypothetically “be entitled to” under this approach was calculated, and the difference between the amount a state (including their cities) actually received and would “be entitled to” receive if this approach was adopted was determined.  The positive differences were summed, and the totals requested in each separate category represent the sum of these differences.   For the Essential Medications component, an estimate was developed for what it would require to bring each SAC state to a funding level to assure access to the PHS-recommended formulary of medications for all HIV+ individuals at/below 300% of the federal poverty level.  Finally, the amounts for each state were summed to calculate the amount needed for the entire region.

Under this “special appropriation” approach, no state would actually lose any funding, since the additional funds would be part of the requested new special appropriation'.

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Southern AIDS Coalition Policy Statement

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