HIV prevention community planning and communities of color: do resources track the epidemic?
The Centers for Disease Control and Prevention (CDC) funds provided to state, local, and territorial health departments for HIV-prevention activities are prioritized with the substantial involvement of HIV-prevention community planning groups (CPGs). This article examines whether or not these funds (more than $261 million in fiscal year 1998) are allocated in a way that mirrors the HIV/AIDS epidemic in terms of race/ethnicity. AIDS prevalence data were used to reflect disease burden, and were compared to budget data submitted by health departments to the CDC. The budget data report expenditures by race/ethnicity for two major types of activities: (1) health education and risk reduction (more than $104 million); and (2) counseling, testing, referral, and partner notification (more than $91 million). The rank order correlation between funding and AIDS prevalence data for the five specific racial/ethnic categories was .900 (n = 5, p < .05) for health education and risk reduction (HERR) activities, and 1.000 (n = 5, p < .05) for counseling, testing, referral, and partner notification (CTRPN) activities. From 1997 to 1998, the proportion of funds targeted and accounted for by race/ethnicity increased from 79 percent to 88 percent for HERR, and from 71 percent to 84 percent for CTRPN activities. With regard to race/ethnicity, health departments and CPGs appear to be actively targeting and accounting for HIV prevention resources, and we will argue that relatively small changes in counseling and testing resources for African-American and Latino/Latina communities would result in a close match between AIDS prevalence data and devoted resources.
Holtgrave
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Division of HIV/AIDS Prevention-Intervention Research and Support, Centers for Disease Control and Prevention, National Center for HIV, STD, and TB Prevention, Atlanta, Georgia, USA.
Thomas
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CW
Chen
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Edlavitch
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Pinkerton
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SD
Fleming
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D002487:Centers for Disease Control and Prevention, U.S. / Q000191:economics*; D003153:Community Health Services / Q000191:economics / Q000458:organization & administration*; D003365:Costs and Cost Analysis; D003376:Counseling; D005006:Ethnicity; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D006266:Health Education; D006291:Health Policy / Q000191:economics*; D006801:Humans; D015995:Prevalence; D014481:United States / Q000453:epidemiology