Community Health Centers will need sustained funding and additional resources to support the Trump Administration's recent initiative to stop new HIV infections in the United States by 2030, according to a report released today. Health centers care for 16 percent of people living with an HIV diagnosis in the U.S. and 22 percent of all people with HIV who are receiving HIV-related care. That is why the Trump Administration has assigned health centers a leading role in the national effort to fight HIV/AIDS. Now a new analysis by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University Milken Institute School of Public Health (GW Milken Institute SPH) says such an effort will require long-term and secure funding support to boost prevention, treatment and management services.
"Community Health Centers provided over 2 million HIV tests in 2017 and are a key point of entry for those at high risk for HIV," said Tom Van Coverden, President and CEO of the National Association of Community Health Centers (NACHC). "It is commendable that their important work advancing evidence-based clinical strategies to fight HIV has won recognition from the Administration. However, meeting the demands of this multiyear initiative will require sustained and secure long-term funding for health centers. At this time last year, health centers were confronting a funding cliff and forced to cut back hours and staff."
The president's pledge to end new HIV infections in the U.S. was announced earlier this month during the State of the Union Address. According to the U.S. Department of Health and Human Services (HHS), the plan calls for reducing new infections by 75 percent in the next 5 years and by 90 percent in the next 10 years, averting more than 250,000 HIV infections in that span.
"Through this initiative, in 2020, HRSA would work with program recipients to expand evidence-informed interventions proven to increase engagement and retention in care, reduce stigma, and improve viral suppression for the hardest to reach individuals," said Health Resources & Services Administration (HRSA) Administrator George Sigounas, MS, PhD, in a press release. "HRSA's Health Center Program will play a major expanded role in providing Pre Exposure Prophylaxis (PrEP) to those populations at the greatest risk of acquiring HIV infection."
All health centers will face challenges expanding their services, but none more so than those located in states where the Medicaid expansion under the Affordable Care Act has not been adopted and there is a high concentration of people living with HIV/AIDS. In these states - Alabama, Florida, Georgia, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, and Texas - thousands of low-income, at-risk people may not be covered by Medicaid, which forces additional burdens on health centers to identify sources of sustainable financing to support expanded care.
The Geiger Gibson/RCHN Community Health Foundation Research Collaborative analysis recommends a 10-year reauthorization of the Health Center Fund, with additional funding targeted to HIV/AIDS prevention and treatment efforts, as well as expanded Medicaid coverage in the 10 high-burden, non-expansion states.
The analysis, "Community Health Centers and the President's HIV Initiative: Issues and Challenges Facing Health Centers in High-Burden States and Communities" can be accessed here.