Iowa prides itself on having one of the lowest HIV infection rates in the nation, but that positive statistic has triggered a negative consequence: federal officials are planning to take a chunk of the state’s HIV prevention funds and redistribute that money to areas with higher needs.
In the next five years, Iowa expects to lose half of its funding for HIV prevention. Worst case scenario, by 2016, Iowa would lose 54 percent of the money for HIV risk reduction and education it has been receiving for the past decade from the Center for Disease Control and Prevention.
Such a drastic cut is expected to hurt HIV programming statewide and eliminate some of the jobs central to educating non-infected members of the public, said Randy Mayer, chief of the bureau of HIV, STD and Hepatitis for the Iowa Department of Public Health.
“This is much more dramatic than anything we’ve experienced with any other departments,” Mayer said.
Iowa this year received $1.63 million for HIV prevention and distributed that money to programs like momentum in Johnson County, which focuses on outreach to men who have sex with men. Federal funding to Iowa could drop by as much as $470,000 in 2012 and by another $250,000 in 2013, Mayer said.
“They are doing it pretty fast,” he said. “We lose about 25 percent the first year.”
Exact funding allocations won’t be announced until November, Mayer said, but states have been notified of funding ranges as part of the National HIV/AIDS Strategy. The strategy fulfills President Barack Obama’s vow to create a national plan addressing the spread of HIV, according to Mayer. The strategy calls for funding to follow the epidemic.
“We are supportive of that concept,” Mayer said. “However, the devil is in the details.”
Most of the money is being funneled into cities like Los Angeles and New York City. Conversely, federal officials chose 16 states with the lowest HIV prevalence rates, including Iowa, to cut down to a minimal funding level.
“This is going to be pretty drastic and pretty stark for a lot of states,” Mayer said.
State health departments have been directed to use the federal funds in four areas: HIV testing, condom distribution, helping people with HIV reduce their risk of transmission and creating policies around HIV prevention and treatment.
“What is not in there that we used to fund heavily is prevention for people who are not yet positive,” Mayer said.
Johnson County is a leader in such programming, Mayer said, and the federal cuts could have a big impact on the university community’s continued education efforts. Eventually, he said, state and federal funding for prevention programs geared toward people without HIV “will go away completely.”
“Those are no longer a priority,” he said.
Such cuts are expected to result in a loss of jobs, and Mayer said the funding Iowa expects to lose supports portions of 30 positions.
“This is going to be devastating for a lot of programs,” he said.
Johnson County Public Health Director Douglas Beardsley said he’s trying to remain hopeful, but the department is moving forward on the assumption there are going to be cuts. Beardsley said he’s considering local funding sources as a way to make up for the loss in federal funds.
“We have been looking at some of the other organizations and folks around town to see what they can do to partner with us,” Beardsley said.
His staff is rearranging its budget to try and maintain HIV prevention programming using county money.
“It’s imperative,” Beardsley said. “Johnson County is an area that needs that.”
But, he said, should HIV prevention funding vanish, it’s “unlikely” Johnson County will be able to maintain the same level of programs. And, Beardsley said, that will affect a number of employees.
“If we don’t have a way to pay people, then jobs will be lost,” he said.
Linn County Public Health officials aren’t expecting to take as much of a hit as Johnson County because it’s focused more on testing, according to Barbara Chadwick, director of personal health services for Linn County. But, Chadwick said, the reduction in funding for Iowa is likely to have some impact on what Linn County can continue to do, and she called that “disheartening.”“We have a low prevalence rate for a reason,” Chadwick said. “We would like to stay low, and keep the community awareness out there.”