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No Time to Lose: Getting More from HIV Prevention
AIDS Cost and Services Utilization Survey (ACSUS), 56
AIDS Drug Assistance Program (ADAP), 169
AIDS Education Training Centers, established under the Ryan White CARE Act of 1990, 170
AIDS incidence
versus allocation of HIV prevention funds, 32
CDC-allocation of HIV prevention funds versus , 32
estimates of, 141
by state, 32
AIDS pandemic
global, 140
projecting, 15
AIDS Research Program Evaluation Working Group, 76-77
AIDS service organizations (ASOs), 68
improving organizational capacity of, 72-73
Alaskan Natives, HIV prevention programs for, 171
Alcohol use, 107 n
Alliance for Microbicide Development, 85-86 , 90
Alliances, for health departments, 193
Allocating resources for HIV prevention, 5-6 , 26-49 .
See also HIV prevention investments
versus AIDS incidence by state, 32
assessing the cost-effectiveness of, 32-35
calculations for, 175-177
at the community level, 39
current allocation of federal, 28-32
at the national level, 39-46
optimizing, 44-46
state and local, 3 , 46-47
a strategic vision for, 37
using epidemic impact as a measure of success, 35-37
Alternative barrier methods, 83-86
the female condom, 83-84
microbicides, 84-86
“America Responds to AIDS” (ARTA), 158
American Academy of Pediatrics, 118
American Foundation for AIDS Research, 90
American Indians, HIV prevention programs for, 171
American Journal of Public Health , 173
Anal intercourse, male condom use during, 36
Annual infections prevented
cost-effectiveness versus proportional allocation, 43
impact of investing in better, more expensive programs, 45
percentage improvement, 44
Antimicrobial therapies, advances in, 7
Antiretroviral therapies, 86-87
advances in, 2 , 7 , 14
HIV-infected persons receiving, 51
nevirapine, 34 , 156
optimizing patient adherence to, 53-54
Public Health Service Task Force recommendations for use of, 34
zidovudine, 34 , 142 , 156
ARTA. See “America Responds to AIDS”
ASOs. See AIDS service organizations
Assessing the cost-effectiveness of HIV prevention interventions, in allocating resources, 32-35
At-risk populations, 2 , 12 , 99-100
B
“Back calculations,” 148
Balanced Budget Act of 1997, 119
Barrier methods, alternative, 83-86
Barrier products, 171
Barriers to HIV care, 98-128
access to drug abuse treatment, 106-116
access to sterile drug injection equipment, 114-116
comprehensive sex education and condom availability in schools, 116-120
HIV prevention in correctional settings, 120-128
lack of leadership, 104-105
misperceptions, 103-104
poverty, racism, and gender inequality, 98-100
requests for public comment on, 189-190
the sexual “code of silence,” 100-101
stigma of HIV/AIDS, 101-103