YOUNGSTOWN City to trace AIDS cases

Responsibility for identifying those who may have been infected with HIV or syphilis was shifted from state to local.
YOUNGSTOWN -- Don't be fooled by declining numbers. Fewer new cases of AIDS doesn't mean the disease is going away, city health officials say.
Thanks to a variety of new drugs that postpone the onset of full-blown AIDS, people are living longer with HIV, the virus that causes it, said Neil H. Altman, health commissioner for the Youngstown City Health District.
Identifying those infected with HIV, and those they may have infected, is imperative in halting the spread of AIDS, he added.
Once individuals have been diagnosed at a clinic, physician's office or hospital, Altman explained, they would be interviewed about sex partners and others they may have exposed to the disease. Then, those individuals would be sought out.
The Ohio Department of Health was once saddled with that job, but it was recently reassigned to local entities -- primarily city and county health boards.
The reassignment came as the result of local entities' desires to have their own employees, rather than state employees, responsible for identifying those who may have been exposed and encouraging them to seek treatment, said Barbara Bradley, chief of the Ohio Department of Health's Bureau of Infectious Disease.
At local level: "We wanted to push more money down to local communities," she said, explaining why responsibilities for identifying those who may have been infected with HIV or syphilis, another sexually transmitted disease, was shifted from the state to local entities.
Altman told the city health district's board Monday that the city would receive about $50,000 in additional grants to pay for the service.
Originally, he said, the health board proposed hiring four nurses to provide the service in Mahoning, Trumbull, Columbiana and Ashtabula counties. The request for funding, Altman continued, was in the range of $250,000 and the plan was to provide a more comprehensive service, identifying not only those who may have been exposed to HIV and syphilis, but also those exposed to sexually transmitted diseases chlamydia and gonorrhea.
When the state offered $50,000, he said, "I told them we could only do it for Mahoning County."
Instead, the state assigned Youngstown City Health District to identify those who may have been exposed to HIV or syphilis, the two diseases designated by the Centers for Disease Control, in five counties -- Mahoning, Trumbull, Columbiana, Ashtabula and Jefferson.
"I told them we couldn't do it for that and to keep their money," Altman told the board. But, he said, the state threatened to pull the city's grants that fund AIDS and sexually transmitted disease education and intervention programs.
Programs: Youngstown receives $188,455 in state grants for its AIDS programs; $20,000 for programs targeting other sexually transmitted diseases, Altman said.
"I didn't want to lose our AIDS educators, so I agreed," he said. "I feel like we've been blackmailed into it."
When asked if the city health department is obligated to provide the service for five counties, Bradley stated, "We have to have one system throughout the state."
She said eight city and county health departments will receive funds through grants targeted for sexually transmitted disease programs; nine will receive funds for HIV programs.
Youngstown, Akron and Canton all will receive similar grants to provide services in northeast Ohio, she said. Grant amounts were determined by the number of AIDS, HIV and syphilis cases in the region each provider will serve, Bradley added.

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