FEBRUARY 12, 2016: President Obama released the final budget of his presidency this week. While several components of his proposed budget offer good news for women living with and vulnerable to HIV, Positive Women’s Network – USA (PWN-USA) remains concerned by the renewed proposal to eliminate Part D of the Ryan White HIV/AIDS Program, the only federal funding stream that prioritizes services for women, youth and families living with and affected by HIV.

President Obama’s budget maintains level funding of the Housing Opportunities for Persons with AIDS (HOPWA) program at $335 million. This program is critical for many low-income, unstably housed people living with HIV, and we are relieved that, under the President’s budget, it would remain in place and funded. Legislative language changes also modernize the program to ensure better distribution of funding to geographic areas where it is currently most needed.

PWN-USA commends President Obama for eliminating funding for abstinence only until marriage (AOTM) sex education, a policy that has proven completely ineffective and unrealistic. Studies show that states teaching AOTM have higher rates of teen pregnancy and sexually transmitted infections, a waste of taxpayer dollars which could be used to fund comprehensive and non-stigmatizing sex education that affirms people of all gender identities and sexual orientations.

Further, we applaud the addition of $9 million through a Special Projects of National Significance (SPNS) initiative in dedicated funding for Hepatitis C testing and treatment through the Ryan White Program. About a quarter of people living with HIV also have HCV; this new initiative will assist in identifying those individuals and making sure they have access to medications that can cure HCV.

We are pleased by the President’s ongoing commitment to the Ryan White Program, a crucial safety net for women living with HIV, a majority of whom are low-income–particularly in states which have refused to expand Medicaid.

As in years past, our primary concern with this budget is the proposed elimination of Part D of the Ryan White Program. Part D-funded programs provide coordinated care and support services to women living with HIV who may be juggling caregiving responsibilities to family members and children. They also ensure support and services for youth who acquired HIV perinatally or at a young age as they transition to adult care. These programs often function as crucial and culturally relevant entry points into care for underinsured women living with HIV — and for youth, the fastest growing population living with HIV in the U.S. For young people and women living with HIV, their ability to stay engaged in care and deal with the psychological aspects of living with HIV may depend on the availability of services which educate and support family members. Part D is the only Ryan White program which has historically had some flexibility for including affected family members in service delivery.

“We are pleased to see the President’s continued commitment to the Minority AIDS Initiative (MAI) and new efforts to address Hepatitis C co-infection, as well as eliminating outdated abstinence-only policies. However, in light of the failure of National HIV/AIDS Strategy 2020 to address sexual and reproductive health of people living with HIV, it is urgently important to ensure that high-quality sexual and reproductive health care is maintained in the Ryan White program and expanded to people with HIV of all ages and genders.  In addition, the Part D program has historically provided services that facilitate access to care for women and youth. Independently of the mechanisms to fund such services, they must be maintained,” says Naina Khanna, Executive Director of PWN-USA.

“Part D services are vital to meeting the needs of women, children and young adults,” adds Kari Hartel, co-chair of PWN-USA Colorado and a Client Advocate and Retention Specialist in a Part D program. “The reason we’ve seen a decrease in vertical transmission is because of the extraordinary efforts of these programs. Part D is uniquely equipped to focus on the needs of women living with HIV and provides a level of support to young people that cannot be matched in other parts of the program. As we continue to see increases in the number of young adults being diagnosed with HIV, cutting Part D would be catastrophic, especially at a moment when, for the first time ever, we have the tools in care and prevention to turn the tide.”

For more details on the President’s budget proposal, click here.