Some lawmakers and AIDS advocates attending this week's 2003 National HIV Prevention Conference in Atlanta are seeking answers about possible funding cuts for some existing HIV/AIDS prevention programs under the CDC's new prevention strategy, the AP/Baltimore Sun reports. Under the new strategy, which was announced in April, the CDC plans to shift funding from traditional prevention programs to initiatives that offer testing and counseling for HIV-positive people (AP/Baltimore Sun, 7/27). Dr. Robert Janssen, director of the CDC's Division of HIV/AIDS Prevention, in April said that the government will invest most heavily in initiatives that focus on identifying people who are already HIV-positive, which could jeopardize approximately $90 million in annual federal funding for community groups. Janssen said that the changes could be in effect by July 2004. The CDC has said that the current emphasis on community outreach prevention programs has proven ineffective, citing an increase in the number of new HIV cases. The agency's new strategy calls for HIV to be included in routine testing for pregnant women and urges local health authorities to make widespread use of a new rapid HIV test (Kaiser Daily HIV/AIDS Report, 5/28). The new strategy could divert funds from 211 community-based organizations, according to the AP/Sun (AP/Baltimore Sun, 7/27). The organizations, most of which serve minorities, will have to seek funding from local governments, which are already facing budget deficits, according to the Chronicle (Russell, San Francisco Chronicle, 7/26).

Reaction
Debra Fraser-Howze, president of the National Black Leadership Council on AIDS, said, "You can't argue with an initiative that centers its AIDS prevention efforts on people who carry and can actually spread the disease. But one that only focuses on people who are already HIV-positive and takes no responsibility for prevention ... is insane and, I feel, genocidal" (AP/Baltimore Sun, 7/27). Tom Coates, director of the University of California-San Francisco AIDS Research Institute, said that concentrating funding on testing and convincing HIV-positive people to help prevent HIV transmission could provide "more bang for the buck." However, Coates questioned expanding HIV testing at a time when federal funding for treatment programs faces cuts under the Bush administration's fiscal year 2004 budget (San Francisco Chronicle, 7/26). Steven Tierney, director of HIV Prevention for the San Francisco Health Department, said, "The conservatives ... have worried that this kind of money for education and prevention efforts was just community-development money used for homosexuals and drug users." However, Janssen said that "[a]ll of the recommendations in the initiative we have been talking about for a number of years. This all started in the Clinton administration" (AP/Baltimore Sun, 7/27). A list of the agencies whose funding could be affected by the new policy can be found online (AP/Sacramento Bee, 7/27).

Webcasts of selected sessions of the conference will be available online through kaisernetwork.org's HealthCast.

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