Congress seeks more equitable distribution of money for patients

The South and rural areas get less help than urban centers, some activists say.
WASHINGTON (AP) -- AIDS started as a big-city epidemic infecting mostly gay white men, and now it's prevalent in the South and among minorities. Yet the federal law that helps the neediest patients has not kept up with that evolution.
By some measures, AIDS patients in California and the Northeast get more money per capita than those in the South, where activists are lobbying for a bigger share.
With hundreds of millions of dollars at stake, Congress is attempting for the first time since 2000 to amend the Ryan White CARE Act of 1990. It is named for the Indiana teenager who died that year after contracting AIDS from treatments for hemophilia.
"We haven't seen the money shifting with the epidemic. I don't believe a person should be punished because of where they live geographically, and that's what's happening," said Kathie Hiers, head of AIDS Alabama, a nonprofit group that provides housing and other services to HIV/AIDS patients.
Dollar disparities between cities and rural areas have been exaggerated, counters Phil Curtis of AIDS Project Los Angeles. To Curtis, "This remains largely an urban epidemic."
Provides $2 billion per year
The federal law sends about $2 billion a year to local and state programs that give health care, drugs and other aid to the uninsured or those needing help on top of Medicaid or private insurance. These services reach more than 500,000 people per year, making it the largest federal program specifically for people with HIV.
"It's served as a lifeline to so many people with HIV who would not have gotten services elsewhere," said Jennifer Kates, HIV policy director at the Kaiser Family Foundation.
The law gives money to states as well as to 51 "eligible metropolitan areas" with concentrations of AIDS patients. Congress is seeking a way to distribute money more fairly without suddenly depriving any one area of dollars.
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