Presentation Number: E08-3; Presentation Title: Red Eye ownz! Author(s): Alicia Carbaugh; Connie M. Jorstad; Abstract Content Background: The National HIV Prevention Inventory (Inventory), a joint project of the National Alliance of State and Territorial AIDS Directors (NASTAD) and the Henry J. Kaiser Family Foundation (KFF), is based on a survey of HIV prevention programs led by U.S. health departments. Data were collected and analyzed to better understand the ways in which HIV prevention is delivered and funded across the country and identify the challenges faced by health departments. Method: Between February and March 2008, all 65 jurisdictions that receive direct federal funding from the CDC Division of HIV/AIDS Prevention (CDC-DHAP) were surveyed. The survey questionnaire included 55 questions encompassing several areas. A total of 58 health departments responded to the survey. Follow up was conducted with specific jurisdictions and data were reviewed for completeness and accuracy. Results: In FY 2007, funding for prevention at health departments from all sources totaled $581.3 million. Nearly 60 percent, or $337 million, was provided by CDC-DHAP. State and local governments contributed 35 percent, or $205.3 million. Most funding was used to support HIV screening/testing, partner services and health education and risk reduction activities (HE/RR). All jurisdictions offered HIV counseling, testing and referral and most reported conducting routine HIV screening for pregnant women (42). Fewer provided this service for newborns (17) and adults (6). Health departments spent the greatest portion of their HIV prevention funding—more than one-third or $198M in FY 2007—on HE/RR services targeting populations at risk for or living with HIV. All health departments reported providing these services, with 25 spending more on HE/RR than any other HIV prevention activity or service. The top three challenges cited by health departments in implementing HIV prevention programs were funding, training and capacity building for local partners and limitations in the capacity of local partners to provide needed services. As a result of these challenges, health departments reported facing several consequences including the lack of prevention interventions needed to reach high-risk populations and an inability to recruit and retain clients for prevention programs. They also reported having to scale back some services as a result. Conclusion: HIV prevention programs in the U.S. receive funding from multiple sources. While state and local governments are not required to provide funding for HIV prevention, 38 did in FY2007, accounting for one-third of all HIV prevention funding in FY 2007 at health departments. Findings indicate that programs are implemented with great variability across the U.S. and show that, while identifying persons living with HIV and their partners is a key component of all HIV prevention programs, health departments spent the greatest amount of their resources on health education and risk reduction services. Findings also indicate that a range of prevention services is provided beyond those required and funded by the Federal Government. Health departments also report that they face many challenges in providing needed HIV prevention services, primarily due to funding and capacity limitations.