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Ryan White HIV/AIDS Treatment Modernization Act: Does It Synchronize With Needs of Urban America

Ryan White, a 13 year-old, Caucasian boy, died of AIDS in 1990 (1). He contracted HIV via blood transfusion in 1984. From 1984-1990, Ryan and his family experienced a series of life-changing events that would ultimately bring necessary attention to the epidemic through legislative action. During the infancy of the AIDS epidemic in 1983 (CDC reported 1,025 cases) and Ronald Reagan's leadership during this crisis, propelled an environment of homophobia, fear and hostility (2). Ryan's profile did not fit the scope of the population that Reagan appeared to turn a deaf ear on. Primarily, those who were Caucasian, male and gay. Hence, Ryan White became a national story.

In 1990, Congress enacted the Ryan White Comprehensive AIDS Resource Emergency Act to improve the quality and access to care for low-income and those who were disenfranchised from the health care system.
The cumulative estimated number of deaths of persons with AIDS in the United States and dependent areas, through 2005, was 550,394. In the 50 states and District of Columbia, this included 525,442 adults and adolescents, and 4,865 children under age 13 (3). In addition, the estimated number of HIV/AIDS cases in 2005 for black, not Hispanic was 18,121 compared with White at 11, 559. Consequently, according to the 2000 census data, blacks (not Hispanic) made up 13% of the US population in 2005. The CDC estimated that 49% or 18,121 of 37,331 newly diagnosed cases in 2005 were Black (4). This unique trend among Blacks is truly alarming.
HIV longevity has been primarily been attributed to advances in medication therapy (primarily, protease inhibitors) and increased targeted marketing campaigns. As researchers grapple with the nuances of this unique trend, the newly enacted Ryan White HIV/AIDS Treatment Modernization Act of 2006 provides the Federal HIV/AIDS programs in the Public Health Service (PHS) Act under Title XXVI flexibility to respond effectively to the changing epidemic. Changes in the law were primarily economic in scope. Whereas, funding initiatives appear to be motivated by HIV epidemiology as represented by the designated area. For example, the formularies for urban areas like New York City reflect the number of individuals living with HIV/AIDS (138,000) (10). Funding formularies now called Part A (formerly, Title I) attempts to give priority to the hardest hit urban areas. What is

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