Changes at the Centers for Disease Control and Prevention (CDC) continue to have a potentially harmful effect on HIV/AIDS prevention throughout the nation. CDC recently announced proposed changes to HIV/AIDS guidelines that would require more information to be disclosed about patients as well as putting a greater emphasis on abstinence.

In two separate recent examples, long-standing recipients of CDC funding-Vermont CARES and the American Social Health Association (ASHA)-have both lost or rejected CDC federal funding for HIV/AIDS work.

Vermont CARES, an HIV/AIDS advocacy organization based in Burlington, Vermont, announced that it will not be reapplying for almost $100,000 in CDC HIV-prevention funds. The organization decided not to apply for the funding, which compromises approximately 8% of its annual budget, based on four concerns arising out of the CDC’s proposed changes to their guidelines. Kendall Farrell, executive director of Vermont CARES, stated that she is worried that accepting the funding would require the organization to disclose potentially identifying information about people requesting anonymous HIV testing; to ask clients to divulge personal information that they may not wish to share; to follow HIV prevention techniques that may work in large cities but would not work with Vermont’s more rural population; and to overly emphasize abstinence as a means of prevention and question the effectiveness of condoms when counseling clients.¹

Kurt Kleier, chief of the HIV/AIDS division of the Vermont Department of Health, which administers the CDC funding, agreed with Farrell’s concerns and stated that he and other Vermont public health officials will be lobbying the CDC to help ensure patient anonymity.²

Farrell and Kleier stated that to their knowledge Vermont CARES is the first organization to refuse CDC funding based on the aforementioned issues.

In a separate example, as a result of the CDC’s decision to incorporate all 40 of its health information hotlines into one consolidated hotline, the American Social Health Association (ASHA) has lost its long-standing contract with the CDC to run and staff national hotlines for people with questions regarding HIV/AIDS and other sexually transmitted diseases (STDs).

ASHA has run the HIV/AIDS and STD hotlines since the mid-1980’s and logged nearly 700,000 calls in the 2003 fiscal year alone. Approximately 115 employees work on the hotlines full time. Hotline operators must undergo 55 hours of initial training followed by two to 20 hours of evaluation before they can respond to hotline inquiries. Additionally, operators participate in 20 hours per year of continuing training. Both initial and follow up trainings deal with answering questions with sensitivity and objectivity. According to James R. Allen, ASHA’s president and CEO, the CDC grant provided three-fourths of the organization’s annual budget and ASHA will now have to sharply reduce its number of employees.³

Pearson Government Solutions will staff the consolidated hotline. Pearson Government Solutions, a for-profit company, already holds several government contracts that deal with health insurance enrollment, homeland security concerns, and student financial aid application. Under this new contract, Pearson Government Solutions was awarded $73 million dollars over seven years to run the hotline.⁴

Advocates are concerned that the special needs and sensitivities of the HIV/AIDS community will be lost. "A person living with HIV/AIDS has very different concerns and fears than someone who is worried about childhood immunizations or terrorism preparedness. Hotline operators must be trained in the special needs of this community, especially in issues such as homophobia and the isolation felt by many people living with HIV/AIDS," stated Bill Smith, director of public policy at SIECUS.

More information about Vermont CARES.

More information about the American Social Health Association.

References

1. Sutkoski, Matt. "AIDS organization spurns the chance for federal money," Burlington Free Press. September 15, 2004.
2. Ibid.
3. Bonnerm P. "Durham nonprofit loses health contract: job cuts expected as three-fifths of health group works in STDs call center." The Durham Herald Co. September 1, 2004.
4. "CDC invests $73 million to improve health information services for the public," CDC Press Release. September 8,2004. Accessed online on September 24, 2004.