California Gov. Arnold Schwarzenegger has proposed, and the California Legislature is considering, draconian cuts to all types of HIV-related funding in the near-bankrupt state.
In the worst-case scenario, which is still not off the table, slashes to the AIDS Drug Assistance Program could result in thousands of Californians who make less than $41,600 per year losing access to the state-provided drugs that suppress HIV and keep them alive.
In the apparent best-case scenario, not all HIV drugs would be available via ADAP and patients would have to pay part of the cost of the ones they could get. That is problematic because some HIV-positive people have developed resistance to some HIV drugs, and need access to the full arsenal of therapies to stay alive.
Further, the current plan apparently completely eliminates state funding for the tests that determine if a patient is responding to treatment—such tests as CD4 counts, viral-load measurement and drug-resistance monitoring.
These tests are essentially mandatory in HIV treatment. Doctors use them so they can change a nonresponsive patient's drug combination to another combo that works in that patient—before the patient's immune system breaks down further and the patient develops a life-threatening opportunistic infection.
The current plan apparently also dramatically slashes funding for education, prevention, counseling and testing programs.
Some 35,000 working- and middle-class Californians who don't make enough money to pay for their own treatment could be adversely or dangerously affected by the possible cuts to ADAP and elimination of monitoring testing.
Gay and HIV advocates have strongly denounced the budget proposals, and a large rally was held at the state Capitol in Sacramento on June 10.