The Georgia Department of Public Health is cutting 26 jobs in HIV prevention statewide, including two in Macon that served Middle Georgia, after losing federal funding that covered the salaries.
The Centers for Disease Control and Prevention, which had provided the funds, announced last year that it would begin focusing its HIV prevention efforts in 10 cities with the highest infection rates -- including, for the first time, Atlanta -- and would base state funding on the number of people living with HIV in 2008.
That resulted in Fulton County Health and Wellness receiving a direct grant of $4.5 million for use in Fulton and DeKalb counties, while the state of Georgia received a $3.7 million reduction, said Connie Smith, health communications specialist for the public health department.
The reduction in funding will have a substantial impact on the states HIV prevention work, and the department is currently working to mitigate the situation, she wrote in an e-mail, adding that existing staff will take over some of the duties.
Twenty of the positions being eliminated are in the states regional health districts. Through those districts, the public health department provides services to about half the 42,000 Georgians living with HIV or AIDS, Smith said.
The North Central Health District handles about 1,800 cases, she said. Fulton County alone has 10 times that many.
Dr. David Harvey, director of the North Central Health District based in Macon, said if HIV prevention is concentrated in Atlanta, well see more HIV cases here, or they will be sicker by the time theyre identified, which makes it harder to treat.
Ronnie Boone, infectious disease supervisor for the North Central Health District, said the 13-county district is losing two employees: a clerical support worker who was also the Spanish-language translator for HIV-positive patients and their families, and an employee who notified sex partners of those who have the virus. The latter employee, who has worked for the health district for 30 years and was due to retire in April, also conducted HIV field tests and supervised other employees who did so.
Its the kind of work where you have to go into the neighborhood and knock on doors, Harvey said. It can be a very political job at times and requires the type of person who can fit into different types of environments and talk to people about something they may not want to talk about.
Both jobs are set to be eliminated by the end of the month, Boone said, although the state is working to transfer the employees.
Smith said the state public health department, which learned of the CDC funding reduction just before Christmas, now expects to preserve some of the district jobs beyond Jan. 15.
Harvey said the cuts wont result in some HIV-positive people going unserved.
It will just take us longer to get there, he said.
But taking longer to notify people that they have been exposed to the virus may mean more people becoming infected in the meantime.
Dr. Mike Smith, director of AIDS education and research for Mercer University School of Medicine, noted that President Barack Obama set the goal of ending HIV in our generation on World AIDS Day last month.
Thats not going to happen if we reduce HIV prevention, Smith said. Weve hit a plateau at 60,000 new cases a year (in the U.S.), but that will go back up if we stop funding it.
Smith noted that studies in recent years have proven that early testing and treatment of HIV reduce the chance of transmitting the disease to others, even if the infected person engages in high-risk behavior.
But, he said, The CDC and the nation is focusing on high-risk populations, so theres going to be less and less screening and education for people that dont self-identify as high risk.
For example, black women are a high-risk group in Georgia that dont generally see themselves that way, Smith said.
And although rural Georgia areas see fewer HIV cases, the rate of infection per 1,000 residents can be high, he said.
Harvey said the employee who is fluent in Spanish likely will be moved to another job in public health but will no longer be available to translate for the districts HIV and AIDS treatment clinic.
We have such a large Hispanic population that the translators are just extremely crucial, Smith said.
Of the $6.9 million the state receives from the CDC for HIV prevention, Georgia will use $1.5 million in local districts and health departments, Smith said. The rest is spent on community-based organizations, health care centers, contracts and state personnel.