HIV Planning Council

Broward County is Florida’s second largest metropolitan area, encompassing 30 municipalities and unincorporated areas, and has a population of more than 1.75 million people. Between 1990 and 2005, the population increased 33%. The Eligible Metropolitan Area (EMA) has become increasingly diverse, with substantial growth among racial and ethnic minorities

According to 2005 U.S. Census Bureau data, Florida ranks fourth in the nation in the percentage of foreign-born residents, with 18.5% of the state population being foreign-born. Broward County, however exceeds even the highest percentage of state foreign-born residents (California at 27.2%), with a 29.8% of its county residents foreign. Since 1991, South Florida's immigrant community has grown so substantially, that, according to new recently released U.S. Census figures, Broward County now has secured its status as a “minority-majority” county – now one of 22 large U.S. counties where Hispanic and Black residents outnumber white non-Hispanics. International migration is the most significant source of population growth in the South Florida Region, accounting for more than seven of every ten new residents in the last decade.

The Fort Lauderdale/Broward County (Broward County) EMA is impacted severely by the HIV/AIDS epidemic. New HIV/AIDS cases in the EMA have increased by 24.8% since 2000, while funding has remained relatively level with Title I funds increasing by only 8.3% for the same period. The EMA has provided highly accessible, culturally sensitive, expert HIV medical care to its diverse population despite funding constraints. It has become extremely difficult, however, to sustain this high quality system of HIV care in light of insufficient Title I funds, flat Title II awards, and significantly decreased Housing Opportunities for Persons With AIDS (HOPWA) funding.

In 2005, Broward County had the third highest annual AIDS incidence rate among EMAs, as well as the tenth highest number of AIDS cases. Nonetheless, this figure is the second highest AIDS incidence rate in Florida (46.5/100,000). (Statewide incidence is 32.1/100,000). The number of Broward County residents with HIV and AIDS is estimated to be 16,400. More than one-half (51%) of the total AIDS cases are non-Hispanic Black, 35% are non-Hispanic White, and 12% are Hispanic. Broward County non-Hispanic Black residents are impacted disproportionately by the HIV epidemic, constituting 23% of the County’s overall population but 52% of the PLWHA (PLWHA). One-half of the HIV-infected residents in this EMA are concentrated in the East-Central section, predominately home to a large gay community and many of Broward County’s poorest minority neighborhoods impacted by chronic conditions and other indicators of poor health status. Treatment of high rates of PLWHA with antiretroviral (ARV) therapy resulted in reduced death rates between 1994 and 1998 and longer survival rates for PLWHA. However, mortality rates have increased each year since 1999, with a 17% increase in 2005 over the 2004 rates, reflecting increased resistance.

The EMA has implemented an efficient HIV care continuum through highly coordinated planning, financing, and service delivery. Demonstrating the ability of the EMA to respond to the geographic dispersion of PLWHA, medical care clinics and support agencies are concentrated in high impact areas, especially in the EMA’s East-Central section, where many women, children, minorities, and men who have sex with HIV infected men live and are in need of care. Title I-funded primary medical care is provided to patients at 26 sites. These patients have access to the continuum of Title I core services through the facilitation of 46 diverse case management and support program sites. Many of these sites also house the EMA’s network of 70 counseling and testing Sites (CTS). Early intervention services (EIS), including outreach, have targeted minority, low income, largely uninsured communities. In FY 2005 alone, about 7,134 clients received Title I-funded core services comprising medical, outpatient specialty medical, dental, medications, case management, drug treatment, and mental health counseling. The FY 2007/2008 Implementation Plan sustains and moderately expands core services to address the existing needs and anticipated growth in caseloads. Moreover, the proposed budget approved by the Broward County HIV Health Services Planning Council represents 75% of the total funds targeting to core services, demonstrating a focus on medical, dental, pharmaceutical, mental health, substance abuse, and case management services. The Implementation Plan is linked to one or more Healthy People 2010 goals to increase both the quality and years of healthy life gained and eliminate health disparities among low income service consumers who are uninsured and underserved populations.