HIV prevention efforts a struggle after budget cuts

April 26, 2011

smael Morales, director of health services at the Center Long Beach, which serves the gay, lesbian, bisexual and transgender community. For now, the Center has survived state cuts to HIV and AIDS prevention and testing funding after receiving a three-year, $300,000 grant in 2009.

Ismael Morales, director of health services at the Center Long Beach, which serves the gay, lesbian, bisexual and transgender community. For now, the Center has survived state cuts to HIV and AIDS prevention and testing funding after receiving a three-year, $300,000 grant in 2009.

By Paul Eakins

State funding for treatment of HIV and AIDS has increased in recent years, but state money for education and prevention has disappeared entirely. This funding vacuum left health providers in many California cities, including Long Beach, scrambling to fill the gap, and worrying that the state’s funding priorities may have adverse long-term effects.

Concentrating money on treatment, but not prevention, is a lot like treating the symptoms of an illness rather than the cause, health advocates say.

“Maintaining a prevention strategy prevents the disease,” said Michael Johnson, support services manager for the Long Beach Department of Health and Human Services.

Although statewide HIV infection rates have been dropping, Johnson said that is no reason to cut prevention efforts. Johnson said he’s seen this cause-effect scenario before with other diseases.

“It’s been shown over the years, you see the rate of TB (tuberculosis) drop, so there’s incentive for reducing TB (prevention) funding, and then several years later you see the rate go up,” Johnson said.

Under former Gov. Arnold Schwarzenegger, state funding for HIV and AIDS programs was cut by more than half, $85 million, in the 2009-10 fiscal year. That included the entire budget for HIV prevention and testing, though about $12 million in federal funds was still available.

That trend has continued since then, and no state funding for prevention and testing is proposed in the next fiscal year either under Gov. Jerry Brown’s budget as California continues to face a financial meltdown.

In Long Beach, the cuts meant a loss of $800,000 for HIV treatment and testing, leaving just over $1 million from the state plus about $200,000 from Los Angeles County, Johnson said.

“That impacted both community education and the volume of HIV testing that we could offer,” Johnson said.

However, the state has actually increased funding for AIDS drug assistance programs and similar treatment services. Johnson and other health providers say that’s only one element of the services that are needed to tackle the disease.

The state cuts have impacted not just major HIV prevention and treatment centers such as the city’s Health Department, but also smaller community programs.

At Centro Community Hispanic Association, or Centro CHA, a Long Beach non-profit group that provides job training and leadership programs for about 3,000 mostly Latino youths each year, state cuts have reduced the program’s HIV education funds from $50,000 a year to nothing, said Executive Director Jessica Quintana. That puts the program’s participants, who as young minorities are among the populations with the fastest-growing rate of HIV infection, at even greater risk, she said.

“I think the state and the feds really don’t understand what they’re doing in cutting that funding, because we’re moving backwards, and we’re going to see a rise in those incidents,” Quintana said.

Statewide, the number of HIV cases reported has steadily dropped, for the most part, since 2007. However, November and December of 2010 saw a slight uptick, with around 750 cases reported each of those months, as opposed to about 500 reported monthly the rest of the year.

Quintana said HIV and AIDS rates among Latinos and youths are closely tied to teen pregnancy and other STDs, all of which her organization attempts to combat. Statewide, Latinos made up 25 percent of reported HIV and AIDS cases at the end of 2010.

“Unfortunately, specifically in the Latino community, we have higher incidence rates of all that among all populations,” Quintana said.

Some local organizations have been luckier than Centro CHA, finding new sources of HIV prevention funding – at least for now.

The Center Long Beach, which serves the gay, lesbian, bisexual and transgender community, was awarded a three-year, $300,000 state grant in 2009 to conduct free HIV testing, said Ismael Morales, director of health services.

The Center once relied largely on the Long Beach Health Department for HIV and STD testing. The department would send a mobile testing unit to the Center to provide free testing, Morales said.

However, that program was cut with the state funding reductions, and the Center had to find new avenues for providing services to its clients, he said.

Morales said that he considers his organization to be lucky to have gotten the grant, because there are fewer and fewer local clinics and organizations providing HIV testing, education and other services. His fear is that having fewer resources nearby will discourage people from getting tested.

“There isn’t much accessibility to services where people live,” Morales said. “I think people like to find something close, free and that’s connected to their community.”

Given that California’s budget deficits appear to have no end in sight, the future of HIV funding is just as murky, which means Morales doesn’t know what the Center will do once the grant runs out.

The organization could be left high and dry like Centro CHA.

Quintana said that with cuts to HIV prevention and other health and social services, fewer and fewer organizations will be able to offer the resources the community needs. Government officials, she said, just aren’t thinking about the repercussions.

“The message that they’re sending is that they really don’t care about public health and the reproductive health of our youth and young adults,” Quintana said.

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