Challenges In Care Of Multnomah Residents Living With HIV/AIDS
More than half of Oregon's 7,000 people living with HIV/AIDS (PLWH/A) reside in the Portland metropolitan area, where federal funding from the Ryan White HIV/AIDS Treatment Modernization Act of 2006 continues to decline. Funding in 2007 was eight percent less than it was in 2001, despite a 20 percent increase in the number of PLWH/A living in the Portland metro area during this time
Portland is a Transitional Grant Area (TGA) which is funded by Part A of the Ryan White Program. Multnomah County receives Part A funds to serve the needs of low income people who have no other resources to pay for their HIV care needs. The Portland TGA includes Multnomah, Clackamas, Columbia, Washington, and Yamhill counties in Oregon and Clark County in Washington.
According to a report issued by Multnomah County Health Department, the 2007-2008 Annual Client Services Data Report, over 4,000 people living with HIV/AIDS reside in the Portland TGA, the majority of whom are male and have acquired HIV through sex with other men. HIV/AIDS continues to disproportionately affect the African American community, who comprise eight percent of all HIV/AIDS cases, but only three percent of the metro population.
Multnomah County Health Department's HIV Care Services and its partner agencies provided community-based primary care and support services to 2,310 people living with HIV/AIDS in 2007. Clients continue to be affected by poverty, with 70 percent living below the federal poverty level; 20 percent lack stable housing; and an estimated 31 percent of clients were uninsured at some point during the last year.
Many PLWH/A in the metro area did not receive necessary primary medical services. One in five clients reported service gaps in dental care, over-the-counter medications, mental health counseling, rent and utility assistance, groceries and meals, and transportation.
Federal cuts to supportive services, such as housing, psychosocial support and food, impact a client's ability to remain in treatment and receive uninterrupted medical care. Clients accessing these services are more likely to be persons of color, female, poor, and without permanent housing. The need for food, utility and transportation assistance is expected to increase as food and gas prices rise.
Despite funding cuts, HIV Care Services and its contractors are available to provide medical and support services to those who need them. These programs are committed to supporting the health of PLWH/A and the community through using resources more effectively.
According to Lillian Shirley, Multnomah County Health Department Director, "Working in a resource-scarce environment has underscored the importance of collaboration among public and private organizations. We are all committed to a proactive health care environment, centered on keeping people healthy."