DOVER — The additional federal funding cuts to HIV testing in Delaware just adds another blow to the state’s already wilting public health funding.
“Sequestration is a problem, but it’s not the only problem or the biggest problem,” said Jim Dickinson, Delaware Division of Public Health’s HIV Prevent Program administrator. “We have lots of fund cuts coming.”
If Congress fails to act to stop the $85 million sequestration package from kicking in today, there will be across-the-board spending cuts in education, senior services and public health. More than $70,000 will be sliced from the state’s public health division funding, resulting in a loss of 1,800 HIV tests.
Mr. Dickinson said in a state as small as Delaware, the loss of 1,800 HIV tests would prove to be detrimental. As of January, 3,786 Delawareans are iving with HIV or AIDS, and there are potentially 800 individuals in the state living with HIV without knowing they have the disease.
There also may be, he said, an additional 800 individuals knowingly living with HIV and not seeking treatment.
“Sometimes you think 1,800 tests, maybe doesn’t sound like a lot, but if that’s 1,800 tests in a high risk area in which there’s likely to be unknown cases of infection that means that’s 1,800 chances that you're missing a new infection,” Mr. Dickinson said.
Mr. Dickinson said by going to www.hivtest.org, individuals can type in their ZIP code and see which of the state’s 52, free HIV testing sites are in their general vicinity. The Delaware HIV Consortium’s website, www.delawarehiv.org, also offers an electronic resource guide for individuals struggling with HIV.
A 10-minute HIV test, with one finger prick, can help to prevent up to five cases of HIV if found positive. In the last year the state performed 12,000 HIV tests. HIV testing, he said, is the most cost-effective, first line of defense.
“It’s very cost effective because [HIV] costs a lot to treat, so any time you are spending money on screening you are saving money in the long run,” he elaborated.
HIV medication could cost upwards of $20,000 a year to maintain, he said, but the state’s standard, HIV test costs between $12 to $14. If sequestration goes through, the government may offer rebates for specific kinds of treatment and counseling services to alleviate medication costs, but with restrictions on the types of care eligible for rebates, such as eye or dental treatments.
“But (we) can’t count on that long-term,” Mr. Dickinson said.
The state’s HIV testing programs have been taking funding cuts since 2010 through President Barack Obama’s National HIV and AIDS strategy and will continue feeling cuts until 2016. The strategy reallocates money between states to areas designated as “higher risk,” Mr. Dickinson said.
Since enacted, the mandate called for a $423,000 cut to the HIV testing programs in the first year, $300,000 in the second year, with each year after progressively slicing funding until the entire funding, currently at $1.2 million, is cut by 48 percent.
Mr. Dickinson said there will be decreases in condom distribution, testing and education as a result of the lowered funding. While there currently is no waiting list in Delaware for HIV-positive individuals seeking treatment, with sequestration cuts, there may have to be. Delaware’s 95 percent success rate of enrolling individuals in treatment programs could go down.
“We may actually see rises in infection rates because our program is cut in half,” he said.
Though across-the-board infection rates are decreasing, last year the state recorded an increase in cases among young, gay African American males ages 18-24, Mr. Dickinson said — the largest increase in nine years. He attributed the temporary maintenance closing of the Porter State Service in Wilmington, and an overall decrease in HIV testing to the additional 26 HIV cases. However, he said rates of HIV infection for women, heterosexuals and needle-users are down.
“For the most part, it's going down, but if we are not able to maintain our testing programs at sufficient levels that could change and other populations could be affected,” he said.
While unsure specifically how federal budget cuts could impact HIV testing delivered through his program at CAMP Rehoboth, Sal Seeley said any decrease in money would be detrimental, especially in the wake of funding cuts by the CDC.
Less money for programs leads to less services and ultimately decreased access, said Mr. Seeley, CAMPSafe program director.
“If there is one less agency that is giving testing, it may make it harder for someone to get a test,” he said.
CAMP Rehoboth, a nonprofit community organization based in Rehoboth Beach, began offering HIV testing about 10 years ago. Tests are available seven days a week year round.
That availability is critical, he said, to reaching people, raising awareness and getting residents tested. CAMPSafe has made access a priority, with daytime and evening hours, even on weekends.
“I want to see people get tested. Their courage will be zapped out of them and they won’t want to be tested” if a convenient appointment isn’t available when an individual first calls, he said.
While Mr. Seeley said awareness of HIV and HIV testing has “dropped off nationally,” due to less media coverage and public information campaigns, the demand for testing has continued to increase.
“Our numbers have gone up every year,” he said, with more than 400 tests given last year. “That’s a lot for an agency in a small community.”
In addition to the outreach through CAMP Rehoboth’s magazine, “Letters from CAMP Rehoboth,” its website and social media outlets, the CDC website, www.HIVtest.org, helps direct clients to the testing services.
Mr. Seeley credited Delaware public health officials for working to protect funding for HIV awareness and testing services. “They’re really on our side so money isn’t taken away,” he said. “It’s such a vital program for the community to get men and women tested."
Amelia Auner, vice president of public affairs with Planned Parenthood of Delaware said between April 2011 and March 2012 the organization performed 800 HIV tests. If the cuts go into affect, she said the state’s social safety nets will be dealt an uncertain, but significant, blow in a year Planned Parenthood is looking at expanding its HIV testing.
“We don’t know what this is going to look like down the road,” she said. “It is scary and it can impact how we do the preventive work in the community.”
News Editor Ashley Dawson contributed to this article.
Staff writer Jen Rini can be reached at 741-8250 or firstname.lastname@example.org.
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