On Monday, July 21, 2014, the 30 for 30 campaign and Congresswoman Barbara Lee hosted a Congressional briefing titled, "Sustaining Care, Treatment and Essential Services for Women Living with HIV and the Future of the Ryan White Program."  The moderator and panelists included: C. Virginia Fields (Executive Director, National Black Leadership Commission on AIDS), Vignetta Charles (Senior Vice President, AIDS United), Robert Greenwald (Director, Treatment Access Expansion Project and Director, Center’s Health Law and Policy Clinic, Harvard Law School), Margot Kirkland (Senior Program Associate, DC Care and Health Advocate for the Ryan White Program), Ivy Turnbull (Deputy Executive Director, AIDS Alliance), and Alison Yager (Supervising Attorney, HIV Policy at HIV Law Project).

The 30 for 30 Campaign is dedicated to ensuring that the unique needs of women living with and affected by HIV are addressed in the national HIV response.

In the United States, approximately 24% of all people living with HIV are women.  In addition to poverty, women living with HIV must navigate through intimate partner violence, trauma history, reproductive health issues, childcare concerns, and many other barriers to care.  This complex combination creates a very unique need that women living with HIV require in a specifically targeted health program.

The Ryan White Program was first authorized in 1990, and administered by the U.S. Department of Health and Human Services, Health Resources and Services Administration, and HIV/AIDS Bureau.  It was created to support primary medical care through a variety of programs, each labeled as a separate Part:

• Part A: Emergency assistance
• Part B: State-targeted grants
• Part C: Primary care in outpatient settings
• Part D: Family-centered care for women, infants, children, and youth (WICY)
• Part F: Program-specific funding

Briefing Panelists

As briefly listed above, Ryan White Program Part D provides services that address family-centered primary medical care in a culturally and linguistically competent manner.  Although Part D accounts for less than 6% of total Ryan White funding, more than 37% of women receiving medical care in Ryan White Programs do so through Part D.  This amounts to more than 90,000 women, infants, children, youth, and family members that rely on Ryan White Part D-funded program services each year.  Part D programs are the entry point for many HIV-positive youth and women, including pregnant women.  Therefore, Part D also contributes significantly to the reduction of mother to child HIV transmissions.

On March 4, 2014, President Barack Obama released his fiscal year (FY) 2015 budget.  Along with many new changes - the FY 2015 budget eliminated funding for Ryan White Part D, by moving the funding to the Part C category.  The services Part D provides are unique and not currently being provided by Ryan White Part C.  This 30 for 30 campaign-sponsored Congressional Briefing was focused on explaining the negative consequences of eliminating Ryan White Part D on women, infants, children, and youth. 

Questions from the Audience

Although the Affordable Care Act (ACA) may replace Part D's contributions to helping women living with HIV, there are still many unknown effects of a rapidly changing healthcare system.  Many states with higher HIV rates are choosing not to expand Medicaid.  New copayment requirements may increase access barriers.  The lack of inclusion of healthcare providers in private insurance that have experience with HIV - these are all issues Dr. Greenwald mentioned as potential challenges to reliance of the ACA to replace Part D.

As there is currently not enough data-driven evidence showing how the ACA will meet the needs of women living with HIV, the 30 for 30 campaign was created as an alliance between dozens of organizations to find an explanation for the change in the Ryan White Program.

Fortunately, the 30 for 30 Campaign's resilience and hard work is paying off.  On June 10, 2014, the Senate Labor, Health and Human Services and Education (LHHS) Subcommittee on Appropriations approved their FY 2015 spending bill by a voice vote.  This spending bill will reject President Obama's plan to eliminate Ryan White Part D.  Although this bill still must be still considered by the Senate Appropriations Committee, the quick mobilizing of advocacy groups and organizations shows how large of an influence constituents have on changing federal funding.

This e-mail address is being protected from spambots. You need JavaScript enabled to view it  is an MPH student at the UC Berkeley School of Public Health. Her research interests include routine HIV testing, health disparities, women's reproductive issues, and sexually transmitted infections.