3190.0: Monday, November 13, 2000 - Table 1

Abstract #7743

Evolution of HIV/AIDS "policy communities": 1984-2000

David Abramson, MPH, Division of Sociomedical Sciences, Columbia University, 600 West 168th STreet, Room 507, New York, NY 10032, 212-305-1929, dma3@columbia.edu

Background

There have been several sentinel federal policy "events" regarding HIV/AIDS – the initial implementation of the Ryan White CARE Act in 1990, its reauthorization in 1996, and the current 2000 reauthorization. During each of these policy events, policy communities form, strategize, and attempt to influence the ultimate policy outcome. This study analyzes how these policy communities form, and considers their composition and how they reshape over time.

Significance

The Ryan White CARE Act has provided a dramatic shift in health policy. Despite a history of federal policy which focused on shaping health care delivery through a market-based system of individual entitlements, categorical program initiatives, and organizational development, the Ryan White legislation authorized the development and funding of comprehensive systems of care in areas particularly hard hit by the HIV/AIDS epidemic. The emphases on comprehensive systems and local autonomy are both departures from conventional health policy. Several questions arise – why did HIV/AIDS policy develop as it did? How was the resultant policy related to the specific actors in the HIV/AIDS policy communities, and the policy communities from which they emerged?

Research Design and Methods

This study traces the structure and evolution of HIV policy communities using a network analysis of principals and agents in HIV policy communities, including ties to other policy communities (such as the disability movement, health system reform, patient rights, gay advocacy, social service providers) by analyzing archival data using congressional hearings testimony during the initial Ryan White legislation in 1990 and its reauthorization in 1996.

Learning Objectives: A participant at this sessions will learn about the relevance of policy communities in health policy, the roles of specific policy communities in shaping HIV/AIDS policy, and methodological approaches to studying such policy communities

Keywords: Policy/Policy Development, Ryan White

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA