TY - JOUR
T1 - AIDS Drug Assistance Programs in the era of routine HIV testing
AU - Bassett, Ingrid V.
AU - Farel, Claire
AU - Szmuilowicz, Emily D.
AU - Walensky, Rochelle P.
N1 - Funding Information:
AIDS Drug Assistance Programs, funded through Part B/ Title II of the program, were created to help states provide prescription drug access to HIV-infected people who lack adequate drug coverage from Medicaid or other forms of private insurance [12]; the program provides medications, but program funding can also be used by patients to purchase private insurance that includes drug coverage. More than 500,000 people with HIV/AIDS benefit each year from services funded by the Ryan White Program [13], with 1141,000 AIDS Drug Assistance Program enrollees [14]. Most AIDS Drug Assistance Program clients are male, are uninsured, are from racial or ethnic minority groups, have incomes at or below the federal poverty level [14], and are representative of recent new diagnoses of HIV cases in the United States [15] (figure 1). Since 1996, spending for drugs by AIDS Drug Assistance Programs has increased 16-fold, more than twice the rate of client growth [14]. By fiscal year 2007, federal funding for Title II programs had reached 1$1 billion, with 1$750 million going to AIDS Drug Assistance Programs, paralleling the increasingly wide- spread use of potent antiretroviral therapy [13] (table 1). Yet, despite the growing number of HIV-infected people and the increases in costs of care for those living with HIV/AIDS, federal funding for the Ryan White Program has stayed the same since 2003 [11]. The impact of this plateau has been felt particularly among public and nonprofit organizations that provide community-based comprehensive primary care services for HIV-infected patients. Although patient volume has increased 30%– 70%, these programs, which often provide case management and risk-reduction counseling, have seen no increase in support through Title III/Part C funding for 7 years [17, 18].
PY - 2008/9/1
Y1 - 2008/9/1
N2 - AIDS [Acquired Immunodeficiency Syndrome] Drug Assistance Programs, operating within the larger Ryan White Program, are state-based, discretionary programs that provide a drug "safety net" for low-income and uninsured individuals infected with human immunodeficiency virus (HIV). Although the AIDS Drug Assistance Programs and the primary care system that provides care for patients with HIV infection are already financially stressed, the Centers for Disease Control and Prevention recently issued guidelines recommending universal HIV testing to help identify the estimated 300,000 individuals in the United States who are unaware that they are infected with HIV. As the number of people living with HIV/AIDS who are coinfected with hepatitis C virus has grown and the cost and complexity of care have increased, the sustainability of the current HIV care system requires a reevaluation in light of the new testing guidelines. We examine the current state of the AIDS Drug Assistance Programs, discuss the implications of the Centers for Disease Control and Prevention guidelines for the already overstretched Ryan White Program, and consider a federally supported national program to ensure high-quality, efficient HIV care for low-income HIV-infected Americans.
AB - AIDS [Acquired Immunodeficiency Syndrome] Drug Assistance Programs, operating within the larger Ryan White Program, are state-based, discretionary programs that provide a drug "safety net" for low-income and uninsured individuals infected with human immunodeficiency virus (HIV). Although the AIDS Drug Assistance Programs and the primary care system that provides care for patients with HIV infection are already financially stressed, the Centers for Disease Control and Prevention recently issued guidelines recommending universal HIV testing to help identify the estimated 300,000 individuals in the United States who are unaware that they are infected with HIV. As the number of people living with HIV/AIDS who are coinfected with hepatitis C virus has grown and the cost and complexity of care have increased, the sustainability of the current HIV care system requires a reevaluation in light of the new testing guidelines. We examine the current state of the AIDS Drug Assistance Programs, discuss the implications of the Centers for Disease Control and Prevention guidelines for the already overstretched Ryan White Program, and consider a federally supported national program to ensure high-quality, efficient HIV care for low-income HIV-infected Americans.
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U2 - 10.1086/590936
DO - 10.1086/590936
M3 - Article
C2 - 18643759
AN - SCOPUS:49449085660
SN - 1058-4838
VL - 47
SP - 695
EP - 701
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 5
ER -