Impact of the Ryan White CARE Act on the Availability of HIV/AIDS Services |
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| Authors: | Thomas G Rundall Jennafer Kwait Katherine Marconi Stephanie Bender-Kitz David Celentano |
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| Institution: | Thomas G. Rundall is professor of health policy and management at the University of California, Berkeley;Jennafer Kwait is a researcher in the HIV/AIDS Bureau of Health Resources and Services Administration within the United States Department of Health and Human Services, where she is involved in studies to evaluate the impact of the Ryan White CARE Act and the delivery of services at programs funded under this legislation.;Katherine Marconi, Ph.D., is employed at the Health Resources and Services Administration, United States Department of Health and Human Services, Rockville, MD.;Stephanie Bender-Kitz received her Ph.D. in health policy and analysis at the University of California, Berkeley in 1998. Dr. Bender-Kitz currently is conducting independent research on AIDS service organizations in the Philippines.;David Celentano, Sc.D., is professor of epidemiology (infectious diseases program) in the Johns Hopkins University School of Hygiene and Public Health. |
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| Abstract: | This article assesses the extent to which the availability of HIV/AIDS services in the Baltimore and Oakland eligible metropolitan areas (EMAs) increased after receipt of funding under Title I of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. Survey data on the availability of HIV/AIDS services in each EMA were collected from samples of organizations at two points in time: 1 year before (1991) and 1 year after (1993) the Oakland and Baltimore EMAs received their first installments of CARE Act Title I funds. Cross-sectional and longitudinal analyses of the data were performed to assess changes in the availability of HIV/AIDS services. The results showed that after CARE Act Title I funding became available, the availability of ambulatory medical and social support services in the Baltimore and Oakland EMAs increased. However, the way service availability increased varied significantly, reflecting differing opportunities and constraints present in each community. In Baltimore, the increase in the availability of HIV/AIDS services was due largely to the creation of new organizations that used Title I funds to provide services (system expansion). In Oakland, relatively few new organizations were created, but existing organizations added new HIV/AIDS services (service line expansion). Our data also indicated that in both EMAs the majority of HIV/AIDS organizations receiving Title I funds expanded the capacity of their existing services to meet growing demand. |
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