Tag Archives: ADAP

Most HIV-Positive Americans Lack Regular Medical Care

by D Gregory Smith
English: Enterprise Performance Life Cycle

English: Enterprise Performance Life Cycle (Photo credit: Wikipedia)

From Betsy McKay of the Wall Street Journal comes this from the recently concluded International AIDS  Conference in Washington DC:

HIV Data (1990, 2000, 2010)

HIV Data (1990, 2000, 2010) (Photo credit: cmdelaserna)

More than half of the people diagnosed with the HIV virus in the U.S. aren’t getting treatment for their infection, the U.S government said (Friday).

African-Americans and younger people are least likely to be receiving regular treatment, meaning that programs to keep them under a doctor’s care aren’t working or aren’t plentiful enough, according to a report by the Centers for Disease Control and Prevention.

While 81% of those African Americans estimated to be infected are diagnosed, only 29% get ongoing care, and just 21% are “virally suppressed,” or have their virus controlled by a regular regimen of antiretroviral, or ARV, drugs. Among Americans ages 25 to 34, 72% of those infected are diagnosed, but 28% get care and a mere 15% are virally suppressed.

Overall, an estimated 1.1 million Americans are infected with HIV. Only 46% of those who are diagnosed with HIV get regular treatment, while a quarter of all those estimated to be infected are virally suppressed.

“We’ve got to do better,” says Jonathan Mermin, director of the CDC’s division of HIV/AIDS Prevention.

The data were released at the XIX International AIDS Conference in Washington, D.C.

The challenge is to find ways to make HIV testing more widespread, and then make it easier to link those who are diagnosed directly into care — and to make sure they stay there, says Mermin.  “I want to make the healthy choice the easy choice,” he says.

And therein lies the challenge. The easy choice is sometimes pretending the choices don’t even exist….

Read the rest here. 

English: IPSF HIV/AIDS Campaign Logo

English: IPSF HIV/AIDS Campaign Logo (Photo credit: Wikipedia)

 

 

Related articles

ADAP Watch 7.19.12

by D Gregory Smith

From NAPWA:

The Administration has pledged new money to end the waiting lists, but they will linger for some time. Making sure that everyone who needs ART drugs can get them is an obvious first step towards ending this country’s HIV/AIDS epidemic, but when the waiting lists are gone, we’ll have to move on to the hard work of changing attitudes towards people with HIV and ensuring access to health care for all Americans, not just those living with HIV.

It was grimly entertaining, explaining to Conference delegates from Canada and Germany what ADAP is and why we have waiting lists, when it’s so obviously better public health policy and so obviously more fiscally prudent to treat everyone with HIV who wants treatment. After she got past her initial disbelief, a German delegate gently suggested that there are better ways to handle this sort of thing. We wouldn’t need ADAPs, let alone have ADAP waiting lists, if we had a rationally designed national health care system.

Here are the latest numbers from our friends at NASTAD:

Related articles

ADAP Watch, May 31, 2012

by D Gregory Smith

From The National Association Of People With AIDS:

It’s just over two years now since we first reported the ADAP funding crisis. We thought it would be over quickly. Sad to say, we were wrong. The number of ADAP-qualifying lower-income Americans on waiting lists for the HIV drugs that would keep them healthy peaked last year at more than nine thousand before coming down to this May 31’s 2,357.

More than 90% of those now wait-listed are in five Southern states: Alabama, Florida, Georgia, Louisiana, and North Carolina. All five have legitimate state budget shortfalls. All five, however, also have increasingly serious rural HIV epidemics, and extending immediate ADAP drug assistance to everyone who qualifies would be a useful step towards slowing the spread of the virus. The additional cost to the states would be trivial in the context of their whole state budgets – eliminating state ADAP contributions altogether would not materially improve their fiscal situations, and doubling them would not make them materially worse.

 

Here are the latest numbers from our friends at NASTAD:

 

 

Related articles

ADAP Watch

by D Gregory Smith

From NAPWA: Recently released supplemental federal funding is slowly bringing state waiting lists down – 2,552 this week. Regional disparities are troubling, though. Ninety percent of Americans on ADAP waiting lists are in the South. The only non-Southern state with comparable numbers is Nebraska. The South is where HIV is spreading fastest, and providing HIV drugs to those who need them would help prevent new infections.

Here are the latest numbers from our friends at NASTAD:

Related articles

ADAP Watch 4/19/12

by D Gregory Smith

Last week (while I was on vacation)- NASTAD released the ADAP waiting list. From NAPWA (emphasis mine):

There’s some good news on the ADAP front: the FY 2011 emergency federal ADAP funding has brought waiting list numbers down in a number of states. South Carolina has eliminated its waiting list altogether, for the time being.

The bad news is that the numbers aren’t coming down very much. Georgia and Virginia – big states with big budgets – account for almost two-thirds of the nation’s total waiting list, and it looks like they are accepting their waiting lists as the “new normal.” Other states have disguised their real unmet need by setting income eligibility ceilings artificially low, and that looks set to become the “new normal,” too.

It’s hard to understand and hard to forgive. Over five years, it will cost the states with visible waiting lists or waiting lists whisked away by lowering income ceilings more to care for PLWHA who become sick enough for Medicaid than it would have cost to give them drugs to keep them healthy. It’s already a dollars-and-cents blunder before we even think about the human cost.

Here are the latest numbers from our friends at NASTAD:

Related articles

ADAP Waiting List 1/26/12

by D Gregory Smith

ADAP Watch 1/13/2012

by D Gregory Smith
ADAPs With Waiting Lists
(4,717 individuals in 12 states*, as of January 12, 2012)
State Number of Individuals on ADAP Waiting List Percent of the Total ADAP Waiting List Increase/Decrease From Previous Reporting Period Date Waiting List Began
Alabama 47 1% -44 October 2011
Florida 1,301 28% 135 June 2010
Georgia 1,275 27% -12 July 2010
Idaho 6 0.1% -3 February 2011
Louisiana** 628 13% 27 June 2010
Montana 11 0.2% -2 January 2008
Nebraska 17 0.4% 2 October 2011
North Carolina 126 3% 1 January 2010
Ohio 0 0% 0 July 2010
South Carolina 164 3% 0 March 2010
Utah 32 1% 0 May 2011
Virginia 1,110 24% 7 November 2010
* As a result of FY2011 ADAP emergency funding, Alabama, Florida, Georgia, Idaho, Louisiana, Montana, North Carolina, Ohio, South Carolina, Utah, and Virginia were able to reduce the overall number of individuals on their waiting lists.

** Louisiana has a capped enrollment on their program. This number represents their current unmet need.

 

ADAPs With Other Cost-Containment Strategies: Financial Eligibility
(445 Individuals in 6 States, as of November 9, 2011)
State Lowered Financial Eligibility Disenrolled Clients
Arkansas 500% to 200% FPL 99 clients (September 2009)
Illinois 500% to 300% FPL Grandfathered in current clients from 301-500% FPL
North Dakota 400% to 300% FPL Grandfathered in current clients from 301-400% FPL
Ohio 500% to 300% FPL 257 clients (July 2010)
South Carolina 550% to 300% FPL Grandfathered in current clients from 301-550% FPL
Utah 400% to 250% FPL 89 clients (September 2009)

ADAPs with Other Cost-containment Strategies (instituted since April 1, 2009, as of November 9, 2011)

Alabama: reduced formulary Arizona: reduced formulary Arkansas: reduced formulary Colorado: reduced formulary Florida: reduced formulary, transitioned 5,403 clients to Welvista from February 15 to March 31, 2011 Georgia: reduced formulary, implemented medical criteria, participating in the Alternative Method Demonstration Project Illinois: reduced formulary, instituted monthly expenditure cap ($2,000 per client per month), disenrolled clients not accessing ADAP for 90-days Kentucky: reduced formulary Louisiana: discontinued reimbursement of laboratory assays North Carolina: reduced formulary North Dakota: capped enrollment, instituted annual expenditure cap Ohio: reduced formulary Puerto Rico: reduced formulary Utah: reduced formulary Virginia: reduced formulary, restricted eligibility criteria, transitioned 204 clients onto waiting list Washington: instituted client cost sharing, reduced formulary, only paying insurance premiums for clients currently on antiretrovirals Wyoming: capped enrollment, reduced formulary, instituted client cost sharing

ADAPs Considering New/Additional Cost-containment Measures (before March 31, 2012***)

Alaska: reduce formulary Florida: lower financial eligibility Kentucky: reduce formulary Montana: reduce formulary Oregon: reduce formulary Puerto Rico: reduce formulary Tennessee: establish waiting list Wyoming: establish waiting list, lower financial eligibility, institute client cost sharing

Access to Medications (as of November 9, 2011)

Case management services are being provided to ADAP waiting list clients through ADAP (2 ADAP), Part B (9 ADAPs), contracted agencies (5 ADAPs), and other agencies, including other Parts of Ryan White (4 ADAPs).

For clients on ADAP waiting lists who are currently on or in need of medications, 11 ADAP waiting list states can confirm that ADAP waiting list clients are receiving medications through either pharmaceutical company patient assistance programs (PAPs), Welvista, or other mechanisms available within the state.

***March 31, 2012 is the end of ADAP FY2011. ADAP fiscal years begin April 1 and ends March 31. To receive The ADAP Watch, please e-mail Britten Pund at bpund@NASTAD.org.

Related articles

ADAP Watch 12/19/11

by D Gregory Smith

From NAPWA:

President Obama called for the end of AIDS on World AIDS Day. But achieving that in America requires more public sector funding than Congress has provided to date, and the political climate for more funding is brutal.

 

We could make a classic business Republican argument for more funds: the increases would be trivial in the context of a $3.5 trillion federal budget, and the rate of return on investment would be as high as it gets – reduced public sector health care costs in future years, and improved private sector productivity. It cost next to nothing (in context) this year, and it pays back big for years to come. 

 

With recent additional federal money, ADAP waiting list numbers have come down some over the past month, but more than 4,000 Americans are still on wait lists. Ninety percent of them are in four Southern states, Florida, Georgia, Louisiana, and Virginia. All four are having financial difficulties in this economy, but the millions of dollars they would have to spend to eliminate their waiting lists are insignificant in multibillion dollar budgets, and spending the millions or not will not make their difficult positions materially any worse or any better.

 

Here are the latest numbers from our friends at NASTAD:

Related articles

ADAP Waiting List for 12/15/11

by D Gregory Smith

The waiting list continues- up 59 persons in 2 weeks:

Related articles

New York Times: Expanding HIV Treatment Necessary And Overdue

by D Gregory Smith

This hasn’t taken that long.

I’m blaming Hillary Clinton and Barack Obama.

The news that HIV treatment is prevention has taken a remarkably short time to hit the mainstream media, and it’s due to Secretary Clinton’s address to the NIH last month, and the President of The United States.

The NYT:

President Barack Obama announces a new compreh...

Image via Wikipedia

Important new findings show that very early treatment of people infected with H.I.V. enhances their health and greatly lessens the likelihood that they will spread the virus that causes AIDS. We welcome the Obama administration’s announcement of a farsighted effort to treat millions more infected people abroad, especially in sub-Saharan Africa.

The administration expects that the expanded treatments can be paid for with existing resources, by pushing for greater efficiencies and more financing from recipient nations. But if that effort stalls, the administration should re-evaluate quickly whether to ask Congress for money.

… Mr. Obama also announced that he would commit an additional $50 million in this country in fiscal year 2012 to help pay for treatments at AIDS clinics and in-state programs that provide AIDS drugs to people who can’t afford them. The money may be drawn from $1 billion available through the health care reform law.

Working to get these changes made legislatively have proven impossible in a Republican-owned House and a Republican-bullied Senate- especially when it involves the health of gay and bisexual men- so policy and administrative action were required. And by beginning to make testing and immediate treatment for HIV routine, medical practices are established that will be hard to take back.

An estimated 1.2 million Americans were infected with the virus at latest count, of whom 240,000 people are unaware. The Centers for Disease Control and Prevention started a campaign last week to increase testing with special emphasis on warning black gay and bisexual men, whose infection rates have been soaring, to get tested and treated.

Meanwhile, the New York City Health Department became the second (after San Francisco’s) to recommend doctors offer drug therapy immediately to every person diagnosed as infected, instead of waiting for the virus to damage their immune systems. The city has made enormous strides in testing, treating and cutting the number of new infections. Some 110,000 infected residents are under treatment; aggressive testing might find another 2,500 immediately and perhaps 500 a year thereafter.

The investments here and abroad should pay off in the long run by reducing the number of people infected and easing the severity of illnesses.

Thanks to you both.

 

Related articles