Abstract
Objective.
The Centers for Disease Control and Prevention (CDC) provides funding for human immunodeficiency virus (HIV) surveillance in 65 areas (states, cities, and U.S. dependent areas). We determined the amount of CDC funding per reported case of HIV infection and examined factors associated with differences in funding per reported case across areas.
Methods.
We derived HIV data from the HIV/AIDS Reporting System (HARS) database. Budget numbers were based on award letters to health departments. We performed multivariate linear regression for all areas and for areas of low, moderate, and moderate-to-high morbidity.
Results.
Mean funding per case reported was $1,520, $441, and $411 in areas of low, moderate, and moderate-to-high morbidity, respectively. In low morbidity areas, funding per case decreased as log total cases increased (p<0.001). For moderate and moderate-to-high morbidity areas, funding per case fell as log total cases increased (p<0.001), but increased in accordance with an area's population (p<0.05) and the proportion of that population residing in an urban setting (p<0.05). The models for low, moderate, and moderate-to-high morbidity predicted funding per case as $1,490, $423, and $390, respectively.
Conclusions.
Economies of scale were evident. The amount of CDC core surveillance funding per case reported was significantly associated with the total number of cases in an area and, depending on morbidity, with total population and percentage of that population residing in an urban setting.