The Ryan White HIV/AIDS Program was borne of a movement that began with the onset of the AIDS epidemic in America. First by the tens, then by the hundreds, then by the thousands, brave and commit¬ted people from all walks of life made a decision to get involved. Some were public health officials; others were activists. Some were community leaders, and others—at least until that time—were citizens quietly living their lives. In this sixth edition of the U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) Progress Report, we celebrate the legacy of those first responders. We also celebrate the incredible journey we have taken since 1990, when the first Ryan White Comprehensive AIDS Resources Emergency (CARE) Act was passed into law. Who could have imagined in those early years that we would one day have treatments powerful enough to forestall the progression of HIV/AIDS? Who could have known that we would touch so many lives? This year alone, through scores of grantees and providers* in cities and towns across America, the Ryan White HIV/ AIDS Program will serve well over half a million people. We continue to face hurdles in our fight against the epidemic, but we have made enormous progress. Highlights from this year include the following: At $2.29 billion, FY 2010 appropriations for the Program were the largest in Program history; Our AIDS Education and Training Centers (AETCs) conducted more than 18,000 trainings; Under the AIDS Drug Assistance Program (ADAP), we distributed medications to more than 175,000 clients; We treated the people most disproportionately affected by HIV: 73 percent of our clients were racial and ethnic minorities, and 88 percent of our clients had no private health insurance; We conducted research on innovative, replicable models of HIV care to reduce health disparities in women of color, improve access to oral health care, establish linkages between jail settings and HIV primary care, and expand health information technology and electronic medical systems; We have been involved in the Healthy People 2010 broad-based national collaborative to meet the Nation's most pressing health needs; We continue to set the standard for HIV/AIDS care using well-respected performance measures. This response to HIV/AIDS constitutes nothing less than a modern public health miracle. . . and within it lie other miracles, too—like that of an HIV-positive person living into old age, or the promising future that unfolds before the eyes of an HIV-positive adolescent. In this publication, you will read about many of the milestones we have encountered in our 20-year journey and the many qualities that make our team successful. We embarked on a quest that many would not. We stepped up to the plate when others stepped away. And today we constitute a powerful and cohesive force seldom seen in combating a single disease. Our rewards lie in victory after victory over isolation and disease and in the improved lives of our clients. It has been an amazing and empowering journey, and it is not over. We are trained. We are committed. We are full of resolve. And we will not stop. In this Progress Report, we remember and we honor the determination of those first responders and of Ryan White himself. It was the determination to go the distance for people living with HIV/AIDS, what¬ever it took and whatever the cost. That determination has never been more alive than it is today.