Community Summit: Group B session

Group E- Effective Resource Development: Creating and Sustaining Collaborations That Work

This group was charged with discussing ways to increase or stabilize resources for HIV/STD prevention, and enhance collaborations among institutions in the GBM community.

1.	What are the current perceptions of funding needs? The group felt that as funding decreases, we must target dollars more strategically. We need to increasingly allocate resources to the most effective interventions based on solid science. A primary prevention strategy should be to target HIV positive men. We should also re-assess our funding mandates. Mandates around anonymous testing are unclear - they might be met by home testing kits. Pierce County has relied on this as a way to save dollars. People want clearer accounting of the amount of money going to HIV counseling and testing (HIV C/T). They were aware that a lot of the resources are going to counseling and testing, and wonder if this service is overfunded. One strategy is to figure out the requirements for care dollars to be used for prevention targeting HIV positive men, in order to free up prevention resources. We should consider zero-based budgeting for external and internal prevention resources.
2.	How do we make HIV and STDs a compelling issue for funders? We need to more carefully demonstrate care-prevention dollar ratios, so legislators understand the paltry amount available for prevention. In addition, we need to educate legislators about the cost-savings from prevention. We need many groups to buy into a concrete proposal with a sense of urgency based on evidence. We also need to address why we are not redirecting funding to the most critical needs, or we should pledge to redirect funds. We need to address the perception that prevention may be failing and replace it with the notion that it isn't working in certain populations.
3.	How do we link with potential funders? We need community advocacy coalitions to package supplemental proposals to local government. We must develop a package of what we want and get the community to sell it. We need to be as assertive in describing program efficacy to city/county funders as we are to private funders. We must be more effective in exploring potential resources in private foundations: Gates, Kellogg, Kaiser Family Foundation, Nesholm Family, RWJ, and Ford Foundation were mentioned. We should also explore potential funding from Centers for Disease Control and Prevention (CDC), the National Institute on Drug Abuse (NIDA), and local government resources. Rising syphilis prevalence may make us eligible for more CDC dollars. We should link with national coalitions to lobby so that Health Resources and Services Administration (HRSA) care dollars can be used for HIV C/T, arguing that case finding is a care service, and for use in prevention case management activities.
4.	What kinds of coalitions should be developed? The group believed that we must work with mental health and substance use treatment programs and arrive at a unified vision with multiple groups including current AIDS coalitions and constituencies, safe schools, medical directors of insurers/managed care, United Way, and managed care plans. We should emphasize need to broaden the health agenda beyond STD/HIV for GBM and emphasize a broader wellness framework.
5.	How do we enhance collaborations with marginalized communities? We may need to think beyond slicing up the pie along traditional lines of age, sex and race, including such variables as class, Hepatitis C status, mental health status, and substance use status. There needs to be better exchange of information/communication.

Recommendations:

Protect and maintain current HIV/AIDS funding, and review and realign current programs with evidence-based practices.
Convene a broad-based coalition to develop a funding proposal to local government.
Work to assure the use of HIV care resources to target HIV positive men with prevention messages.