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According to a Kaiser Family Foundation report, women are responsible for 90 percent of the health care management for their children, including selecting their doctor, taking them to appointments, and choosing their health plans.38

HIV-Positive Women and the Ryan White HIV/AIDS Program: Milestones in Care

In August 1990, the Ryan White CARE Act, today known as the Ryan White HIV/AIDS Program, was signed into law. Passage of the CARE Act represented a breakthrough in access to services for women living with HIV/AIDS—indeed, for all people living with HIV disease. By providing funding for services through a variety of grant programs, the new legislation became a lifeline to necessary medical and social support services. The CARE Act offered comprehensive care to people who would not otherwise be able to afford it.

In some cases, the new program supported a continuation and expansion of services that had been funded through HRSA’s pre-CARE Act programs. In others, it brought Federal funding for serving people with HIV/AIDS into communities for the first time.

The CARE Act reached HIV-positive women through all of its grant programs. In addition, the new legislation reflected that women, children, youth, and families had unique needs that warranted special focus. That focus had been embodied in the Pediatric AIDS Demonstration grants which continued after the CARE Act’s passage and were eventually folded into the CARE Act in 1993 under Title IV (Part D).

Part D: Targeted Response to Women, Children, Youth, and Families

Most HIV-positive women (76 percent) are caring for children under age 18 in their homes. This fact alone highlights the special care needs of women and their children and may complicate women’s ability to manage their own illness.15 The responsibilities inherent in women’s central role in the family can affect their ability to make decisions about their own health and medical care, because they often prioritize the needs of others before their own, thereby causing a delay in—or complete avoidance of—treatment.16

The Part D program grantees provide an array of services reflecting their clients’ unique clinical, psychosocial, and support services needs. In the Part D Program, funds are used not only by the grantee but through a number of providers that constitute a cohesive network focusing on the same client base. Together, these providers

  • coordinate care for women and for other family members;
  • facilitate access to clinical care;
  • enlist women in programs such as WIC (Women, Infants, and Children), which offers nutritional services to pregnant women, new mothers, and young children; and
  • create co-located medical services for the entire family in some cases.

Support and care through the Ryan White HIV/AIDS Program was and is still considered funding of last resort for the most vulnerable women and children, who often have fallen through the cracks of other public safety nets. Without the Ryan White HIV/AIDS Program, many of these medically underserved women and children would not receive care and services.

In FY 2010, approximately $77.8 million in grants was awarded to 2,157 Part D providers across the country to offer family-centered outpatient or ambulatory care (directly or through contracts) for women, infants, children, and youth with HIV/AIDS. Grantees provide primary medical and specialty care, treatment, and support services to improve access to health care. The funding also helps grantee sites educate women about the benefits of enrolling and participating in research.


Ryan White HIV/AIDS Program Part D Bar Graph
View as a table
Ryan White HIV/AIDS Program Part D
Fiscal Year Appropriations ($ in millions)
1994 22   
1995 26   
1996 29   
1997 36   
1998 41   
1999 46   
2000 51   
2001 65   
2002 71   
2003 74.5
2004 74   
2050 73.4
2006 72.7
2007 71.8
2008 73.7
2009 76.8
2010 77.8
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