Eligible Metropolitan Areas (EMAs) range in size from one city/county to more than 26 different political entities, and some span more than one State. EMA geographic boundaries are based on the U.S. Census. Grants are awarded to the Chief Elected Official (CEO) of the city or county that provides health care services to the greatest number of people living with AIDS in the EMA.

To be eligible, an area must have reported at least 2,000 AIDS cases during the previous 5 years and have a population of at least 500,000. When the first Title I grants were awarded in FY 1991, there were 16 EMAs. Today, 51 EMAs receive funding in 21 States, Puerto Rico, and the District of Columbia. The reauthorized CARE Act of 2000 has capped the number of cities eligible for Title I funding.