The Impact of the Economy On STD/HIV Program Capacity: 2006-2008

Background:  In February 2009, as part of the CDC, Division of Sexually Transmitted Disease Prevention (DSTDP) response to the potential for economic stimulus funding, project areas submitted information on how changes in federal, state, and local funding levels from 2006 – 2008 impacted their programs.

Objectives: To provide a snapshot of the impact of changes in federal, state, and local funding from 2006 – 2008 on STD/HIV program capacity.

Methods:  65 STD Project Areas were asked to report information on position and service reductions. Position categories included clinical, surveillance, administrative, Disease Intervention Specialists (DIS), supervisory, managerial. In addition, services assessed included outreach, corrections, schools, provider visitation, lab, courier, and partnerships. Information on hiring freezes was also collected. Project areas were asked to estimate the funds needed to restore their programs to full capacity.

Results: Eighty-two percent (53/65) of project areas responded. Annual funding cuts ranged from 0 to 20%. From 2006 – 2008, 263 total positions were lost with 239 in the position categories cited above. Of the 239, 42%, 20%, and 11% were from DIS, clinical, and surveillance, respectively. 62% had experienced hiring freezes. Of other services negatively impacted, 72%, 66%, and 62% cited outreach, lab, and partnerships, respectively. Comments provided by project areas added great context to the data, demonstrating the severity of how the reductions impacted STD/HIV services. A total of $61,454,632 was stated to be needed to restore program capacity, with a range of $0 - $28,000,000 per project area.

Conclusions: Federal, state, and local funding reductions had significant impact on STD/HIV program capacity and reduced program ability to deliver basic prevention and control services.

Implications for Programs, Policy, and/or Research:   Decreases in STD/HIV morbidity are unlikely unless program funding is restored. STD/HIV programs and DSTDP will need to focus on cost-effective strategies with the greatest impact on disease control.