AIDS-Prevention Programs

High-Risk Groups Still Prove Hard to Reach Gao ID: HRD-91-52 June 14, 1991

Pursuant to a congressional request, GAO reviewed the Centers for Disease Control's (CDC) Counseling and Testing Program, designed to prevent the spread of the human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS).

GAO found that: (1) many high-risk or infected people, specifically intravenous drug users, had not received counseling and testing services aimed at stopping the spread of AIDS; (2) CDC-sponsored testing services identified less than 20 percent of Americans estimated to be infected with HIV; (3) only about 40 percent of those tested returned for their test results; (4) CDC required the programs it funded to refer those people who tested positive for HIV infection to medical and psychosocial support services; (5) the extent of post-test counseling and the availability of long-term counseling for HIV-infected individuals varied widely between and within individual states; (6) limited detailed information was available on the function and effectiveness of HIV counseling and testing services, due to the failure to collect data on AIDS-related knowledge, attitudes, beliefs, and lack of program reviews; (7) resistance and fear of resistance from respondents or the local community hindered local health departments from conducting required surveys; (8) staff shortages hindered CDC ability to conduct formal, on-site, program reviews in individual locations; (9) although timeliness of fund commitments improved delays in hiring personnel and contracting continued to cause problems in committing funds; and (10) uncommitted funds were of concern since they represented HIV services that were not contracted for as planned in the budget year.

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