In the early years of the HIV/AIDS pandemic, receiving an HIV diagnosis seemed like a death sentence. During the 1980s, with little scientific knowledge about the virus, doctors could not treat HIV/AIDS and AIDS deaths rose rapidly from year to year. The AIDS death rate peaked in the mid 1990s, finally slowing down when doctors began administering highly active antiretroviral therapy (HAART), drugs which substantially increased the lifespan of an HIV positive person.
Now, HIV positive people depend on HAART to live. Drug therapy for HIV/AIDS is incredibly expensive: one Florida man’s medications cost him over $4,500 monthly, ringing up at around $54,000 every year. Most HIV positive people simply can’t afford the skyrocketing costs of their prescriptions. Many of these people instead rely on the AIDS Drug Assistance Programs (ADAP), where they only have to pay $12,000 for their drugs. Currently, AIDS Drug Assistance Programs serve around 170,000 who are unable to buy these mind-numbingly expensive drugs.
However, because of the recession, AIDS Drug Assistance Programs have been hit hard. In order to balance strained budgets, many states have squeezed their ADAPs, forcing thousands of people nationwide onto waiting lists and off their prescriptions. Many states have either created more strict requirements for enrollments or trimmed their prescription drug formularies in order to keep the programs afloat. At the same time, more and more people are applying for assistance because of the high unemployment levels, squeezing the ADAP’s resources even more.
The effectiveness of HAART has also contributed to the ADAP crunch. Because of drug therapy, HIV positive people are living longer because the drugs more successfully slow the progression from HIV to AIDS. At the same time, the CDC’s HIV testing initiatives has resulted in more people knowing their status sooner, adding even more people to the ADAP pool.
Some people on the waiting list have been able to procure drugs from other resources: some pharmaceutical companies offer free or discounted drugs to qualifying patients on a temporary basis. Still, gaps in HAART can have deadly consequences for patients. HAART most effectively suppresses HIV when used consistently: when patients are off drugs, the HIV viral load increases and can even reduce the effectiveness of those drugs. When patients skip doses, the AIDS virus becomes resistant to that drug.
Ultimately, these programs need more funding. The government made a commitment to HIV/AIDS when it began promoting increased HIV testing and renewed the Ryan White Act, and it should thus help defray the costs of drug assistance. The states are not economically equipped to fund these programs. The National Alliance of State and Territorial AIDS Directors have requested $126 million dollars worth of funding to keep their programs afloat and patients alive, a number which dwarfs President Obama’s proposed $20 million in additional funding. Meanwhile, several Republican senators want the whole amount to be paid for from Department of Health and Human Service stimulus.
For people relying on state AIDS Drug Assistance Programs, enrollment in an ADAP can mean the difference between life and death. It is imperative that the United States continue its commitment in the war against HIV by increasing funding for such crucial programming and in turn, save lives.