Bil Browning

Indiana removes gay white men from HIV/AIDS funding priorities

Filed By Bil Browning | June 01, 2009 7:00 PM | comments

Filed in: Living, Living
Tags: CDC, Department of Health, HIV infection rate, HIV/AIDS, Indiana

The Indiana State Department of Health recently cut gay white men as an HIV/AIDS funding priority. African-American and Hispanic men who have sex with men are still included as priority populations. The decision was made by the department's advisory Community Planning Group (CPG).

The CPG is a Center for Disease Control (CDC) mandated process for funding HIV/AIDS prevention and treatment programs in the states; it aims to be politics-free and representative of the community. The Indiana State Department of Health (ISDH) administers CDC HIV/AIDS prevention funds. Indiana health activists charge that the Group ignored the CDC's criteria for defining community priorities.

This CPG defines the priority populations that the Indiana State Department of Health (ISDH) must use to solicit HIV/AIDS service providers for HIV prevention project proposals. The State of Indiana's 2008 Epidemiology Report shows that the number of cases as well as number of new diagnoses for White men having sex with men (MSM) continue to outnumber combined African-American and Hispanic MSM cases two to one.

So why aren't white gay men included as a community priority? According to Tri-State Alliance spokesperson Gary Essary, "The criteria for Community Planning Groups to set community priority populations include Prevalence (absolute number of HIV/AIDS cases in a target population) as well as Incidence (rate of HIV/AIDS cases within a target population). The CPG ignored these recommendations, basing their decision solely on Incidence."

"No one disputes that African-American and Hispanic MSM should be a priority. According to the State of Indiana's 2008 Epidemiology Report, the HIV/AIDS incidence rates for African-American and Hispanic MSM in Indiana (379 and 132 per 100,000 male population, respectively) are higher than for White MSM (111 per 100,000). However, prevalence shows 3,063 White MSM living with HIV/AIDS, more than double the combined African-American MSM (1024) and Hispanic MSM (216)," he said in an e-mailed statement.

The Community Planning Group also removed Hispanic women from the targeted heterosexual women demographic. Current targeted populations are:

  1. People living with HIV/AIDS
  2. Men Having Sex With Men (African-American/Hispanic)
  3. Heterosexual Women (African-American)
  4. Youth (Aged 13-24)
  5. Intravenous Drug Users

The CDC mandates that people with HIV/AIDS always be the number one priority.

"Only a Recommendation"

Indiana State Department of Health HIV Prevention Director Sarah Renner downplayed the changes. She was not at the CPG meeting and does not serve on the planning group's board. "According to the CDC guidance tool, the CPG makes a recommendation that we include in any planning documents. It's a recommendation. That's it," Renner told me.

The Dept of Health uses the CPG recommendations to encourage groups to apply for state funding by issuing a Request For Proposals (RFP). RFPs are driven from a methodology that allows people to use localized information.

Renner stressed that while the five groups were given a priority status, that doesn't mean no one else will be included. "Key is what defines a risk. Race doesn't define risk itself. There is so much fascinating data that folks can use to look at a population," she said.

"Don't think of it as 'What's up with white gay men in Indiana?' Think of it as 'How can we reach and define that community and how they're being infected?' Behavior is the primary function we look at," she continued. Renner stressed that prevalence and incidence were not the only source of epidemiological data used to determine rankings.

Critics charge, however, that when ISDH sends out the request for proposals, white gay men will not be listed as a priority; therefore, agencies applying for funding are much much less likely to target white gay men for HIV prevention services.

"...the practical impact of omitting White MSM as a priority in the Requests for Proposal is an overt discouragement for a service provider to write a proposal that includes White MSM. Those that do will be more likely to de-emphasize it. As a direct result, a population clearly in need of HIV prevention services will see fewer resources in their community, and the HIV cases and rates among White Gay males will surely increase," Essary said.

Personal Greed or Intractable Agencies?

While critics insinuate that the board voted along demographic lines to push funding towards their personal communities, others speculated that the issue stemmed from agencies angry at being forced to change their grant proposal process.

"As far as I know this is the first time we've used an RFP model for prevention funding so people will have to go through an application process. This is different from other times," Renner said. "The funding is driven by an RFP process that makes the algorithm very public as to how many apply, what type of intervention they apply for, how the scoring occurs and we report back who gets what type of funding."

"The process will be different so it really depends on our grant applicants writing qualified RFPs. It will be a new type of writing for some grantees. One of the targets is 'Individuals living with HIV.' White gay men fit that criteria," she said.

Indiana spends between $2-3 million dollars annually on HIV prevention. ISDH is currently waiting on a cost extension after the Indiana state legislature failed to pass a budget. Lawmakers will convene a special legislative session to pass a budget soon as per state law. Indiana spends approximately $35 million dollars annually on HIV/AIDS and STD issues.

Indiana publishes its 2008-2010 HIV Prevention Plan online. It also publishes the Community Planning Group's meeting minutes.

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Bil, thanks for this report -- I think there are similar changes in funding priorities going on in other states too, but I don't know enough about the details to offer any more info...

California has it pretty tough, what with the state wanting to just cut AIDS/HIV funding altogether. That's what happens when anti-tax maniacs run a government for 30 years....

Bill Perdue Bill Perdue | June 4, 2009 4:21 AM

That’s not quite the whole picture, Alex.

The fault for cuts in social services in California, as elsewhere lies with your party and your Republican cousins. California has one of the largest economies in the world and generates lots of taxes. The property tax relief bill of the seventies and similar pro-business bills definitely lay a heavier tax burden on working people. But it was the artificial oil shortage, part of the ENRON scandal that broke the back of California state finances, draining the surplus and throwing the state into debt. The ENRON crisis was the result of the deregulation of financial services, supported overwhelmingly by both parties and championed by Bill Clinton.

Clinton never had much ‘courage’ when it came to championing human and civil rights. Draconian cuts in welfare, an embargo of food, sanitary supplies and medicines that murdered roughly 500,000 Iraqi children, DADT and DOMA, huge police forces, overcrowded jails and a racist legal code are the hallmarks of his ‘Democratic administration’. But when it came to welfare for the rich he suddenly grew a pair and rode roughshod over Congress until NAFTA and deregulation were passed.

According to research articles in The Seattle Times “Enron's collapse cost investors an estimated $40 billion to $45 billion as its financial house of cards collapsed…”. The Times also revealed that “In late 2001… Citigroup and J.P. Morgan sought to arrange the company's sale to rival Dynegy so they could split a $90 million investment banking fee and stave off its likely bankruptcy. The suit said calls by Citigroup Vice Chairman and former (Clinton) Treasury Secretary Robert Rubin and J.P. Morgan Chairman William Harrison to credit-rating firm Moody's Investors Service were attempts to "strong-arm" the firm from downgrading Enron before a sale could be completed.”

Citigroup made billions from the ENRON scandal but like all capitalist businesses is run by the looter class and required an initial $25 billion dollar bailout, got a second handout from Obama is now slated for a third ‘bailout’. Obama is giving the money that could fund social services to the looters.

Obama economic advisors are largely acolytes of Robert Rubin and can be counted on to use their strong-arm tactics to deny aid for federal and state social programs and divert it to the rich who own the Democratic and Republican parties lock, stock and barrel.

With Democrats like these who needs Republicans?

diddlygrl | June 1, 2009 11:05 PM

Well, I had heard that the black community had the fastest growth in HIV AIDs for the last few years, based on population, so this could be some type of belated outreach that has historically been ill served by the government in health services. There could very easily be a triage effeect going on where they are trying to target the communities most in need from a steadily declining pool of funds.

But then that is my knee jerk reaction. If I really thought about it I could probably come up with some type of grand conspiracy involving Bush,Cheney, and featuring Sarah Palin as the dog headed boy Biff.

Glad my stroke had no effect on my sense of sarcasm, couldn't live without that.

African Americans and Hispanics may be affected disproportionately; however, White MSM are still the primary affected population. As a member of the Ryan White Part A Planning Council for this Transitional Grant Area, we have no impact on part B and C funding; none the less, I am concerned that the largest population of HIV/Aids infections are no longer given priority by the State of Indiana. For goodness sakes, it should go without saying that the gay community provides the most support to the ASOs serving the HIV/Aids population of the United States.

Bill Perdue Bill Perdue | June 2, 2009 2:57 AM

There are cutbacks going on everywhere as state and local governments feel the impact of the economic collapse caused by Clintons deregulation and the Bush-Obama giveaways to the looter rich.

The Obama administration is refusing to bail out California and insisting that unions giveback wages and medical coverage to management, including a provision that the UAW sign a six year no strike pledge after making these huge concessions.

The situation looks worse given this political context and as usual the administration and local governments will resort to divide and rule tactics to ease its austerity program. This is just one example.

Cutting prevention programs is a sentence of death for many of those excluded. The exclusion must be ended and we should demand a federal Manhattan Project for HIV/AIDS to fund research, prevention, treatment and social services including housing, food and meds for those unable to work. The money to fund it can be taken back from the bailouts funds not already spent on management bonuses.

Cutting prevention programs is a sentence of death for many of those excluded. The exclusion must be ended and we should demand a Man hattan Project for HIV/AIDS to fund research, prevention, treatment and social services including housing, food and meds for those unable to work.

Bill Perdue Bill Perdue | June 2, 2009 3:30 AM

I forgot to ask.

Is the prison budget being cutback or increased?

Did I just feel a tear in the fabric of the space-time continuum? After all it is doctrine with liberal groups that White men oppress everyone else and are responsible for all social ills.

Yet here we have an example of White men being allowed to die while their taxes support relief efforts for everyone else except for Hispanic women.

When is everyone going to wake up and appreciate that we all bleed the same when cut? HIV services should be available for anyone that needs them. As should all other social services. We need to stop limiting care due to people's race (yes, even if White), gender (yes, even when the person abused is a male and the abuser female), gender expression/identity, etc.

I have it on good authority that this will be reconsidered. Read this statement from someone who knows: "Basically, the board voted on a set of priority populations that did not explicitly include gay white men. As you know well, things like this can happen when people are voting on things. I believe that the group will be readdressing the issue soon."

Owen Eden | June 5, 2009 3:41 AM

I am a gay male who is currently working a low wage paying job in Los Angeles. Should my funds become tighter, I will get a second part time job in order to supplement my income. This sucks but hard work is what I have always known. I see so many men positive and negative who could work, but "Disability pays more." Some of those men really know how to "Work" the system. They know what doctors to go to and who to NOT go to and they really fight hard to get on disability and SSI claiming that they cannot work yet they are somehow able to go to the gym everyday. It is hard to feel sorry for them. They really took advantage of a situation.