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These early efforts included HRSA’s AIDS Service Demonstration Grants, established in 1986, and awarding monies to Los Angeles, San Francisco, New York, and Miami, cities that had a high proportion of AIDS cases. For these communities, the new resources could not have come soon enough. HRSA continued to add new grantees each year to meet expanding needs.

“We used the AIDS Demonstration Project as a model for building a real health services system,” explains Matthew McClain, who worked in HIV/AIDS care in the city of Philadelphia, which was awarded an AIDS Service Demonstration Grant in 1988. “Even though our first year grant was tiny, at the time we just thought it was an incredible victory. It was an amazing, beautiful thing. It had a huge impact on all these organizations and we saw it have an immediate impact on the community.”

The AIDS Service Demonstration Grants created a prototype for what eventually became the Ryan White Title I Program, known today as Part A. In FY 2011 there were 56 Part A recipients.

Responding to further need, in 1987 HRSA began the AIDS Drug Reimbursement Program, the precursor to the Part B AIDS Drug Assistance Program/ADAP, and provided $30 million in funding to increase access for people who could not afford medication. Those who were not eligible for Medicaid or who lived in States that did not cover AIDS treatment were eligible for the assistance.

Also in 1987, HRSA worked with Congress to create the AIDS Education and Training Centers (AETCs), originally housed in the HRSA Bureau of Health Resources Development. At that time, given the lack of meaningful treatment options, their focus was primarily on support services and death and dying. AETCs work to increase culturally appropriate clinical competency among HIV providers.

In the Spotlight

Though AIDS was one of the biggest public health developments in U.S. history, it received little attention from the media until 1985 when actor Rock Hudson, Exit Disclaimer who had been seeking experimental medical treatment in France, acknowledged that he had the disease. As time passed, other public figures – most famously Elizabeth Taylor – stepped forward as allies and advocates. There were others too, such as Elton John and Michael Jackson, all helping to draw public attention to a roaring stampede of suffering and death. Having straight athletes such as Magic Johnson and Arthur Ashe step forward with their diagnoses also created a positive impact in capturing the media and, therefore, the world’s attention about AIDS.

And then, in 1987, a 13-year-old boy with AIDS named Ryan White came forward. Ryan was a hemophiliac from Kokomo, Indiana, who was infected with HIV through tainted blood product and diagnosed with AIDS in 1984. Ryan had been barred from attending school and his battle to return received international attention. He made numerous media appearances and in 1988 shared his story before the President’s Commission on AIDS. Ryan willingly opened up about the discrimination he and his family endured as a result of the fear and panic about his attending school.

Ryan’s appearances and testimony did something that those of the thousands of gay men who had died had not been able to do. Because he had contracted the disease through no actions of his own, he put a widely acceptable human face on AIDS. But, as Senator Edward Kennedy would later note, “He never drew a line between himself and other people living with HIV/AIDS and always urged compassion and support for all people living with the disease.” Ryan’s mother, Jeanne White-Ginder, still speaks of the gay men who reached out to her and Ryan to offer assistance and support while many of those in her own small community––people she had known for much of her life––turned away.

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