The state of Tennessee is planning to use state funds to provide sexual health services and treatments to people living outside of downtown Nashville, TN. A spokeswoman for Governor Bill Lee said that this would be more efficient than receiving federal dollars. However, some organizations are concerned that they will be isolated if they don't align with the conservative politics of the state. The state has not yet announced which groups will receive the funds or what regulations will be in place for how they can be used.
However, the governor's office has indicated that its priorities include “vulnerable populations, such as victims of human trafficking, mothers and children, and first responders.” Public health experts have noted that these groups represent only a small fraction of the new HIV cases in Tennessee, according to a recent report by the AIDS charity amfAR. The highest-risk groups in the state are sexually active gay men, transgender women, and people who inject drugs, according to Greg Millett, director of amfAR and epidemiologist. In a letter sent last month to the Centers for Disease Control and Prevention (CDC), which awards the grants, the state's health commissioner Dr. Ralph Alvarado cited Governor Lee's desire to reduce the state's “dependence” on federal funds and “assume greater independence.” Jade Byers, spokesperson for Governor Lee said that the new approach would also be more efficient than the “cumbersome process of receiving CDC grants in dollars, which require organizations to spend their own money and then request reimbursement from the federal government.” Tennessee currently depends on the non-profit organization United Way of Greater Nashville to select beneficiaries and distribute federal grant money.
No other state has rejected CDC prevention and monitoring funds, according to a federal health official. At a state Senate committee hearing last week, Senator Jeff Yarbro asked Dr. Alvarado if the new funding approach would allow Tennessee to “continue to concentrate most of these efforts where most of the risk lies.” Dr. Alvarado said that “you would imagine the same populations that currently benefit from CDC funds will continue to receive benefits” but he did not say if organizations and programs that focus on LGBTQ populations would be affected by the change in funding.
Governor Lee has faced questions from within his own party about his decision to cut off access to CDC funds for Planned Parenthood of Tennessee and North Mississippi, another beneficiary of federal HIV funding. In a statement released in January, Planned Parenthood said it had “tried to work with the governor's office after this latest effort” but the state abruptly announced its total withdrawal from the federal program. The decision to eliminate funding from the Tennessee Transgender Working Group is seen as part of a broader attack on trans rights in Tennessee. Governor Lee passed a law that prohibits all gender-affirming treatments, hormonal therapies, and referrals for transgender children from receiving medical care in the state.
He also called for research into the Transgender Health Clinic at Vanderbilt University Medical Center. Tennessee lawmakers have also proposed legislation that would prevent trans people from changing their gender on their driver's licenses. Over the past decade, the South has become the epicenter of HIV states in America with people from southern states accounting for more than half of new HIV cases every year even though they only make up 38 percent of the US population. Shelby County which includes Memphis has one of the highest rates of new HIV cases in America.
Without grant money and drug discounts, Friends for Life clinic will most likely have to close. Prevention experts across the state have been scrambling to find alternative sources of funding ever since Dr. Osman announced that the state no longer wanted grant money. Osman and other CARES staff members brought a mobile clinic to a homeless camp next to Cumberland River in downtown Nashville and offered free HIV testing as well as distributing test strips that detect fentanyl in illicit drugs and distributing Narcan which can quickly reverse an opioid overdose.
PrEP professionals are health care specialists who can help people interested in PrEP learn more about medication, find a medical provider, locate a pharmacy, apply for financial assistance, and incorporate daily regimen into their lives.