Integration of testing for, prevention of, and access to treatment for HIV infection: state and local perspectives.

Individuals vary by socioeconomic status, race, geographic location, access to health care, risk for exposure to human immunodeficiency virus (HIV), and other co-occurring conditions, making it difficult to reach those who are at high risk for HIV infection. At the state and local levels, health departments often struggle to provide HIV prevention and care services, because of inadequate funding, fragmented systems, and a host of federal and state regulations. State and local health departments, however, have become adept at providing a patchwork of services despite these challenges. This report discusses public health efforts to improve testing for, prevention of, and access to treatment of HIV infection and the various challenges to their success at the state and local levels.