Grants are awarded for early intervention services for low-income, medically underserved people in existing primary care systems. To date, 166 facilities in 34 states, Puerto Rico, and the District of Columbia have been awarded funds. Nearly half of the funds have been given to community and migrant health centers; the other half have been distributed to homeless programs, local health departments, family planning programs, diagnostic and treatment centers for hemophilia, federally qualified health centers, and private nonprofits. In FY 1995, 39% of the programs targeted services to women and children.
Grants are awarded to (1) promote the development and operation of systems of primary health care, social services, and outreach that benefit children, youth, women, and families in a comprehensive, community-based, family-centered system of care; (2) emphasize prevention within systems to reduce the spread of HIV infection; and (3) link comprehensive systems of care with HIV/AIDS clinical research trials and other research activities, thereby increasing access to care. There are currently 65 projects funding 350 care sites in 27 states, Puerto Rico, and the District of Columbia, serving mostly poor, minority families with limited access to transportation and housing. Data from 1996 indicate that 11,200 adolescents were served, 14% of whom were pregnant. Approximately 100,000 adolescent and adult women were served through Title IV prevention, outreach, and education efforts.
In collaboration with the Special Projects of National Significance (SPNS) program, Title IV funds the Women's Initiative for HIV Care and Reduction of Perinatal HIV Transmission. Three-year cooperative agreements have been awarded to ten sites in ten states to develop models of care that enhance outreach and HIV counseling and testing services for women of childbearing age, especially during pregnancy. The program also offers perinatal ZDV prophylaxis and ongoing care for mothers with HIV and their children. Program goals include (1) facilitation of early identification through outreach, counseling, and voluntary testing; (2) facilitation of access to and utilization of a comprehensive system of care that includes ZDV prophylaxis to reduce perinatal HIV transmission; (3) promotion of consumer education; (4) training of providers; and (5) evaluation of the efficacy of strategies and models.
SPNS funding supports the development of models of HIV/AIDS care designed to address hard to reach populations and to be replicable. In 1996 there were 62 grantees focusing on a variety of issues—including, for example, managed care, infrastructure development, training, reduction of barriers for rural residents, women, adolescents, and children, integration of mental health and primary care services, and services for correctional populations.