Waiting Lists for HIV Drugs in the U.S.–Again

It's not just the economy. Treatment assistance programs for low-income and uninsured people living with HIV have been chronically underfunded, even in good times.

By Jamilah King Jul 02, 2010

In a dismal economy, it may seem easy to overlook continual government neglect. This week the *New York Times* reported that the country’s ailing economy is crippling government-funded programs that provide antiretroviral drugs to millions of people living with HIV and AIDS. Yet what *The Times* marks as another casualty of our tough economic times is actually a window into a much larger story about an overwhelmed–and historically underfunded–care and treatment system. At least this much is true: The AIDS epidemic in this country is increasingly [Black, southern, and poor](http://www.kaiwright.com/new_more.php?id=378_0_31_0_M). Although life-sustaining antiretroviral drugs are available, they cost an average of $12,000 a year. Certainly rising unemployment rates and cutbacks to public insurance have pushed more and more people living with HIV and AIDS into increasingly life-threatening situations. And as The Times reported, at the state level nearly 1,800 people have been forced onto long waiting lists for the [AIDS Drug Assistance Program](http://www.kff.org/hivaids/upload/1584_10.pdf), known as ADAP, a government-run program in every state that helps subsidize the costs of medications. Of the over 180,000 people enrolled in the program in 2007, 63 percent were people of color, 77 percent were men, and nearly 75 percent lived below the poverty line. While states like New Jersey and Illinois plan to dramatically shrink the numbers of people on their rolls, others, like Louisiana, are doing away with waiting lists altogether. "We don’t want to give anyone false hope," DeAnn Gruber, interim director for the state’s HIV/AIDS program,[ told ](http://www.nytimes.com/2010/07/01/us/01aidsdrugs.html?_r=1&adxnnl=1&hpw=&adxnnlx=1278000046-bSW5HYuDJbDxVpGRLHQxzw)The Times. Ten states, including [Florida](http://www.doh.state.fl.us/disease_ctrl/aids/care/ADAP_Waiting_List.html), plan to stop covering drugs that don’t directly combat HIV or AIDS, but often help stave off diseases like diabetes, high blood pressure and anxiety, which are often associated with infections. ColorLines editor Kai Wright [noted](http://www.kaiwright.com/new_more.php?id=378_0_31_0_M) two years ago that drug costs for people enrolled in ADAP nationally reached an estimated $1.2 billion in 2007. There are more than a million people living with HIV today, more than ever before. Southern states in particular have been unable or unwilling to maintain their share of the costs required to keep ADAPs running with that level of demand. Advocates and government officials in the South have complained that federal funding favors coastal regions with longer standing epidemics. Either way, there’s not enough money overall: Federal contributions to ADAP have never kept pace with demand, in good times or bad, and the Centers for Disease Control’s HIV prevention budget has never topped $800 million. *Photo: Getty Images/David McNew*