Nearly 20 states are moving to restrict assistance programs that help people afford HIV medications, a shift that could cut off tens of thousands of people from treatment.
For people living with HIV, losing access to antiretroviral medications risks weakening their immune systems, increasing the risk of developing AIDS and transmitting the virus to others.
According to KFF, both Democratic-led and Republican-led states are considering restricting HIV drug access through the Ryan White HIV/AIDS Programs and AIDS Drug Assistance Programs, known as ADAPs, because of the costs.
ADAPs help people pay for HIV medications by providing them for free or at a discounted rate, and, in some cases, assist people with paying their insurance premiums. One significant component of ADAPs is they provide grants to states. The programs are funded through discretionary federal appropriations, state dollars, and other sources.But as KFF analysis found, the funding doesn’t always match the number of people who need support or the cost of services, pushing states toward cuts not seen in over a decade.
In the past, ADAPs used waiting lists when programs could not serve eligible individuals, especially in the early 2000s. In 2013, waiting lists were last cleared thanks to significant emergency federal funding.
But more states are facing budget constraints and considering cuts that go further than waitlists, such as restricting who qualifies and what services are covered. These are measures that haven’t been taken since waitlists were widely adopted, KFF analysts note.
These changes mean that tens of thousands of people can lose access to HIV care and treatment. The KFF analysis points to several factors driving those budget pressures.
According to KFF, a few factors are contributing to budget constraints for ADAPs. Since 1996, Congress has allocated some funding for ADAPs, but over the last 20 years, ADAP funding has not kept pace with inflation.
In addition, the number of ADAP clients has increased by 56% from 2007, the first year with full-year data, to 2024, the most recent year with available data. Clients increased from 165,382 in 2007 to 257,644 in 2024.
Another factor is the rising costs of HIV treatment. A recent analysis
from the National Institutes of Health found that the average wholesale price (AWP) of recommended initial antiretroviral regimens in 2012 ranged from $24,970 to $35,160, increasing to $36,080 to $48,000 in 2018.RELATED CONTENT: Snoop Dogg Partners With GLAAD To Bring HIV Awareness To HBCU Campus