Centers for Disease Control and Prevention (CDC)
As a part of its overall public health mission, CDC provides leadership in helping control the HIV/AIDS epidemic by working with community, state, national, and international partners in surveillance, research, and prevention and evaluation activities. These activities are critically important because CDC estimates that about 1.2 million Americans are living with HIV, and of those people, about 13%, or 1 in 8 do not know they are infected.
In addition, the number of people living with AIDS is increasing, as effective new drug therapies keep HIV-infected persons healthy longer and dramatically reduce the death rate. CDC’s programs work to improve treatment, care, and support for persons living with HIV/AIDS and to build capacity and infrastructure to address the HIV/AIDS epidemic in the United States and around the world.
The Division of HIV/AIDS Prevention (DHAP)
Most of CDC's HIV/AIDS prevention efforts are the responsibility of the Coordinating Center for Infectious Diseases (CCID) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). Within this Center is the Division of HIV/AIDS Prevention (DHAP), charged with the mission of preventing HIV infection and reducing the incidence of HIV-related illness and death.
The Division of HIV/AIDS Prevention−Intervention Research and Support (DHAP-IRS) provides national leadership and support for HIV prevention research and the development, implementation, and evaluation of evidence-based HIV prevention programs serving persons affected by, or at risk for, HIV infection. The five branches that make up DHAP-IRS are as follows:
- The Prevention Program Branch develops, plans, implements, and manages strategies and resources for HIV prevention with state and local public health departments, community-based organizations, and other nongovernmental organizations. Along with these comprehensive public health and private sector partners, the branch implements and monitors programs, policies, and activities in support of efforts to prevent HIV/AIDS.
- The Capacity Building Branch works with partner organizations to strengthen and sustain the capabilities of the HIV prevention workforce of the United States and its territories. The branch does this by ensuring the availability of science-based and culturally appropriate capacity-building assistance, which includes technical assistance, training, information, and technology transfer.
- The Program Evaluation Branch evaluates the effectiveness, costs, and impact of HIV prevention interventions, strategies, policies, and programs for improvement and accountability; develops and enhances evaluation methods and systems; and serves as a resource for building evaluation capacity.
- The Technical Information and Communications Branch develops, produces, and disseminates scientific, statistical, visual, and technical communications on HIV/AIDS for public and private providers, persons at risk, and the general public. Key projects include publications development, satellite broadcasts, public awareness campaigns, national conferences, Web sites, exhibits, and CDC-INFO, for HIV prevention information.
- The Prevention Research Branch conducts behavioral and operational research to develop, test, and synthesize sustainable interventions to prevent HIV transmission.
The Division of HIV/AIDS Prevention−Surveillance and Epidemiology (DHAP−SE) provides national leadership for HIV prevention research and surveillance and the development and testing of effective biomedical interventions to reduce HIV transmission and HIV disease progression in the United States and internationally. The purpose of these activities is to guide the development, implementation, and evaluation of evidence-based HIV prevention programs serving persons affected by, or at risk for, HIV infection. The five branches that make up DHAP-SE are as follows:
- The Epidemiology Branch designs and conducts epidemiologic, behavioral, and biomedical intervention studies in the United States and internationally to determine risk factors and modes of transmission of HIV infection and to reduce HIV infection and disease progression.
- The HIV Incidence and Case Surveillance Branch conducts a national program of surveillance and research to monitor and characterize the HIV/AIDS epidemic, and its determinants and impact, to guide public health action at federal, state, and local levels. This program includes surveillance of HIV infection and AIDS in collaboration with state and local health departments to provide population-based data for research, evaluation, and prevention at the national, state, and local levels.
- The Behavioral and Clinical Surveillance Branch implements scientifically rigorous HIV research studies and surveillance systems that meet critical local, state, and national HIV prevention needs for characterizing persons who are at risk for HIV infection or who have recently acquired HIV or have HIV-related morbidities. The branch also develops and demonstrates best practices of laboratory and prevention technologies to efficiently move them from development into public health practice.
- The Laboratory Branch supports DHAP’s goals in HIV prevention as they pertain to clinical studies, viral transmission, diagnosis and incidence and intervention research with microbicides, vaccines, and chemoprophylaxis as well as investigates other human and zoonotic retroviruses. The lab also develops new methodologies for HIV detection, quantification, isolation, evolution, animal modeling, and surveillance, including drug resistance.
- The Quantitative Sciences and Data Management Branch provides statistical, prevention economics, and informatics support for HIV/AIDS scientific and programmatic activities within the division.
Health Resources and Service Administrations (HRSA)
The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, is the primary Federal agency for improving health and achieving health equity through access to quality services, a skilled health workforce and innovative programs. HRSA's programs provide health care to people who are geographically isolated, economically or medically vulnerable.
This includes people living with HIV/AIDS, pregnant women, mothers, and their families and those in need of high quality primary health care. HRSA also supports the training of health professionals, the distribution of providers to areas where they are needed most and improvements in health care delivery.
HAB Overview:The HIV/AIDS Bureau (HAB) administers The Ryan White HIV/AIDS Program, which is the largest Federal program focused exclusively on HIV/AIDS care. The program is for people living with or affected by HIV/AIDS who do not have sufficient health care coverage or financial resources for coping with the disease.
The Ryan White Program works with cities, states, and local community-based organization to provide HIV-related services to more than half a million people each year. The program is for those who do not have enough health care coverage or financial resources to live with HIV/AIDS. The Ryan White Program fills gaps in care not covered by other sources.
The majority of Ryan White funds support primary medical care and support services, such as medical transportation, non-medical case management, and limited emergency financial assistance.
The Ryan White legislation created a number of programs, called Parts, to meet the needs of different communities and populations affected by HIV/AIDS. Each is described below.
PART A provides emergency assistance to Eligible Metropolitan Areas and Transitional Grant Areas that are most severely affected by the HIV/AIDS epidemic.
PART B provides grants to all 50 States, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, and five (5) U.S. Pacific Territories or Associated Jurisdictions.
PART C provides comprehensive primary health care in an outpatient setting for people living with HIV disease.
PART D provides family-centered care involving outpatient care for women, infants, children, and youth with HIV/AIDS.
PART F provides funds for a variety of programs:
- The Special Projects of National Significance grants fund innovative models of care and supports the development of effective delivery systems for HIV care.
- The AIDS Education and Training Centers Program supports a network of 11 regional centers and several national centers that conduct training programs for health care providers treating people living with HIV/AIDS.
- The Dental Programs provide additional funding for oral health care for people with HIV.
- The Minority AIDS Initiative provides funding to evaluate and address the disproportionate impact of HIV/AIDS on minorities.
Department of State Health Services (DSHS)
The Department of State Health Services (DSHS) HIV/STD Program has the duty to identify, report, prevent, and control HIV, AIDS, and STDs in the State of Texas. The Program is dedicated to preventing the spread of HIV and other STDs while minimizing complications and costs. This is achieved primarily through education, prevention counseling, screening and testing, partner elicitation and notification, and the provision of medical and social services. While some of these services are directly provided, most are provided through contracts with community-based agencies.
The HIV/STD Program is part of the TB/HIV/STD Unit and inlcudes staff from two branches and one group:
- Epidemiology and Surveillance Branch - responsible for surveillance, epidemiologic assessment, research and evaluation, planning, and data management.
- HIV/STD Prevention and Care Branch - responsible for HIV/STD policy development, field operations, monitoring, training and technical assistance, grants, contract development, and clinical resources.
- Health Communications and Community Engagement Group - responsible for Public information and education, social marketing, and community engagement.
HIV/STD Program Mission Statement
Our mission is to prevent, treat, and/or control the spread of HIV, STD, and other communicable diseases to protect the health of the citizens of Texas. In keeping with this mission, we procure, allocate, and manage fiscal and human resources so that we may:
- Provide HIV/STD education and information;
- Collect, interpret, and distribute data relating to HIV and STD;
- Provide guidance to those who oversee, plan for, or provide HIV and STD services; and
- Provide medication and supplies to prevent, manage, and treat communicable dieases.
In pursuit of this mission, we will make every effort to assure that the citizens of Texas receive quality services.
Metropolitan Health District
The San Antonio Metropolitan Health District is the public health agency charged by State law, City code, and County resolution with the responsibility for providing public health programs in San Antonio and unincorporated areas of Bexar County.
Although Metro Health is a City/County organization, administrative control is under the City of San Antonio and Metro Health is operated as a City department.
Services include health code enforcement, food inspections, immunizations, clinical services, environmental monitoring, disease control, health education, dental health, emergency preparedness and issuance of birth and death certificates to the public.
The Director of Health, Fernando A. Guerra, MD, MPH, serves as the chief executive officer of Metro Health and is the Health Authority for Bexar County. As Health Authority, the director is charged with administering state and local laws pertaining to public health within Metro Health's area of authority. The director, in consultation with the City Manager, City Council members and the County Judge sets public health priorities and guides the overall activities of Metro Health.
The mission of public health is to promote physical and mental health and prevent disease, injury and disability ( Source: Essential Public Health Services Working Group of the Core Public Health Functions Steering Committee, 1994, U.S. Public Health Service)
- Prevents epidemics and the spread of disease
- Protects against environmental hazards
- Prevents injuries
- Promotes and encourages healthy behaviors
- Responds to disasters and assists communities in recovery
- Assures the quality and accessibility of health services