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Editorials |16 October 2001

Twenty Years into the HIV Epidemic, Do We CARE Enough To Manage It Well?

William C. Holmes, MD, MSCE; Kevin R. Conare, MTS

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Author, Article, and Disclosure Information
Copyright ©2004 by the American College of Physicians
Requests for Single Reprints: William C. Holmes, MD, MSCE, 733 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021; e-mail, holmeswc@mail.med.upenn.edu.
Current Author Addresses: Dr. Holmes: 733 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021.
Mr. Conare: ActionAIDS, 1216 Arch Street, 6th Floor, Philadelphia, PA 19107.
  • Dr. Holmes: University of Pennsylvania School of Medicine; Philadelphia Veterans Affairs Medical Center; Philadelphia, PA 19104-6021 Mr. Conare: ActionAIDS, Inc.; Philadelphia, PA 19107
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Requests for Single Reprints: William C. Holmes, MD, MSCE, 733 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021; e-mail, holmeswc@mail.med.upenn.edu.
Current Author Addresses: Dr. Holmes: 733 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021.
Mr. Conare: ActionAIDS, 1216 Arch Street, 6th Floor, Philadelphia, PA 19107.
Since the first case of AIDS was reported 20 years ago, maintaining broad access to high-quality HIV-related health care has been a major challenge of the HIV epidemic. This continues to be the case as the number of low-income persons who are HIV seropositive increases. This challenge is attenuated, however, by the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act (Public Law 101–381), which was enacted by the U.S. Congress in 1990.
The Act comprises four Titles. Title I provides emergency relief grants for health care and support services to 51 eligible metropolitan areas (EMAs); Title II provides grants to states and territories to improve the quality, availability, and organization of health care, medications, and support services; Title III supports early, outpatient-based intervention services; and Title IV aims to improve the system of services for children, youth, women, and families affected by HIV infection or AIDS (1). A portion of the funds for each of the Titles is earmarked for case management, a core feature of the Titles that allows impoverished HIV-infected persons to be guided through a highly fragmented health system. No federal bureaucracy has evolved to micromanage the Title programs. Instead, in keeping with the belief of current federal leaders that...
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Holmes WC, Conare KR. Twenty Years into the HIV Epidemic, Do We CARE Enough To Manage It Well?. Ann Intern Med. 2001;135:610–612. doi: 10.7326/0003-4819-135-8_Part_1-200110160-00012

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Published: Ann Intern Med. 2001;135(8_Part_1):610-612.

DOI: 10.7326/0003-4819-135-8_Part_1-200110160-00012

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