Federal Funding Cuts Hamper HIV Prevention Efforts In Michigan

By Todd A. Heywood

LANSING -

Leaders of state AIDS service organizations say federal funding cuts to HIV prevention are creating obstacles to addressing the epidemic in Michigan.

In July 2011, the Michigan Department of Community Health told organizations that by 2014, the state would have to shoulder the impact of a 33 percent decrease in federal prevention funds.

In fiscal year 2011, MDCH received $7.6 million in federal cash, but in 2012, it received just under $6.3 million. That's a 17 percent cut to federal funding in core HIV prevention services grants.

Core HIV prevention services include testing, outreach, and partner notification programs.

The reductions led the state to reduce contract lengths from annual to three month contracts, MDCH says.

"MDCH did not receive the full award for fiscal year 2011 from the federal level and also received notification of significant reductions in the federal HIV prevention funding for 2012," explained Angela Minicucci, spokesperson for MDCH. The statement was made in an email. "As a result of these unknowns and to prevent interruption of services, MDCH entered into a three month contract for prevention services Oct. 1, 2011. Contracts were extended until March 31, 2012 and once Michigan's CDC prevention allocation was received, contracts were extended and amended through Sept. 30, 2012."

A result of this move, AIDS service organiztions say they have been hampered in their efforts.

"As Barb Murray, of AIDS Partnership Michigan, indicated it is very problematic not only when you are endeavoring to make strategic plans for the agency not only in terms of programming, but, additionally, as you are considering staffing situations," said Jake Distel, executive director of the Lansing Area AIDS Network. "It is very difficult to hire permanent staff when you are uncertain of what the fiscal future might hold. This same level of uncertainty does little for the morale of an agency or as an agency is endeavoring to recruit new hires."

Stevi Atkins, executive director of Wellness AIDS Services in Flint, concurred with both Murray and Distel on the impact of the funding scheme on operations.

Adding to the financial woes, AIDS agency directors say is the high turnover of staff from the state's HIV/AIDS Prevention and Intervention Section.

MDCH confirms that 10 staff members have left the agency in the last two years, with eight of those staff exiting in the last year. Directors express concern about the loss of institutional memory at the exodus, but MDCH dismisses those concerns.

"As with any departure, institutional knowledge can be lost but MDCH has continued to provide prevention services and grants," said Minicucci in an email to Between The Lines.

The funding cuts and short-term contracts are not the only issues hampering HIV prevention efforts. Federal funding mandates that 75 percent of Michigan's prevention funding be spent on HIV prevention efforts for those living with HIV, and the remaining for reaching out to risk groups and general community testing.

Prevention for people who have tested positive for HIV specifically target them with tools to live with the virus, adhere to medication protocols and help prevent transmission of their virus.

However, 20 percent of Americans living with HIV are unaware they have the virus. That group is significantly more likely to transmit the virus according to various studies. This transmission issue is in part due to the uncontrolled viral activity in people without treatment. Recent studies have found that an undetectable viral load, or viral suppression, achieved through the use of anti-retroviral medications reduces transmission of HIV by 96 percent.

These findings have driven the federal government to prioritize the use of the medications, which continue to have significant side effects, as "prevention." That prevention method is called "treatment as prevention," and in at least one situation federal officials have called it "treatment is prevention." The focus on medications has led to increase funding of drug assistance programs, and funding decreases in effective prevention programs such as teaching safer sex techniques to high-risk populations and other techniques that had been funded previously.

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