A state advisory panel took a huge step May 21 in the financial battle for more than 4,000 low-income Illinois residents with HIV/AIDS.
The panel voted to urge Illinois to immediately close the AIDS Drug Assistance Program ( ADAP ) to new applicants and begin a waiting list. The recommendation is now under review by state officials.
"Because the program is deeply underfunded, Illinois must take immediate steps to preserve services for those who rely on ADAP for their lifesaving care," said David Ernesto Munar, vice president of the AIDS Foundation of Chicago ( AFC ) and a member of the ADAP Medical Issues Advisory Board, which made the recommendation. "The program faces total fiscal collapse unless immediate actions are taken."
The Medical Issues Advisory Board—composed of doctors, pharmacists, legal experts, advocates and people with HIV—advises the Illinois Department of Public Health on ADAP policy. Jointly funded by the state and federal governments, ADAP provides HIV medications to low-income, HIV-positive Illinoisans who have no other means to afford the costly HIV therapies they need.
"Denying urgent HIV care will only heighten Illinois's already acute HIV crisis and result in greater numbers of preventable HIV deaths and new infections," said AFC President/CEO Mark Ishaug. "We call on Illinois Gov. Pat Quinn, the Illinois General Assembly and the federal government to provide immediate assistance to maintain this and other core public health and HIV programs."
The Illinois General Assembly will convene this week in Springfield to finalize the fiscal year 2011 state budget. Quinn's proposed budget would underfund HIV-related services by more than $4 million, AFC reports.
"The General Assembly and Gov. Quinn must act [ immediately ] to avert ADAP waiting lists by allocating sufficient funding for the program," said John Peller, AFC's director of government relations. "For the past decade, Illinois ADAP has been one of the strongest ADAPs in the nation. We urge the state's leaders to uphold their promise that people with HIV in Illinois can get help from the state when they need it the most.
"Thirty years ago, at the beginning of the AIDS epidemic, there was no treatment for HIV. Today, it's a different story. Doctors know how to keep people with HIV healthy so they live and be productive members of society. Imagine hearing from your doctor, "Sorry, you could get these medications," but ..."
Peller estimated that one in five people with HIV don't know they're infected with the virus. However, he questioned what message does it send if someone learns they have HIV, but they cannot get the medications that will help them stay alive? Thus, why should anyone bother learning their status, if there's nothing they can do about it, he said.
And yes, it could have a major impact on the LGBT community.
"Gay men are the largest group impacted by HIV/AIDS in Illinois and around the country," Peller said. "According to the U.S. Centers for Disease Control & Prevention ( CDC ) , HIV rates among gay men are 44-86 times higher than among other groups. We know that people who are on HIV treatment are less likely to transmit HIV because they are less infectious. Without access to HIV medications, the HIV crisis will get even worse among gay men."
Advocates estimate that an additional $9.68 million in state funding in fiscal year 2011 is needed to avert a waiting list. In April, 2010, there were 4,391 Illinoisans with HIV who obtained HIV medications through ADAP, a new record. Each month, more than 100 people join the program, AFC reports.
Without ADAP or adequate insurance, HIV medications are simply too costly to afford for most people. An HIV medication regimen can cost as much as $20,000 per year.
"People of color will be most impacted by a closed program and waiting list," said Rev. Doris Green, director of correctional health and community affairs. "Two out of three people using Illinois ADAP are African American or Latino. People of color are disproportionately impacted by HIV and they tend to be diagnosed at later stages of disease than their white counterparts. An ADAP waiting list will only worsen existing health disparities."
ADAPs across the nation are facing financial crises. Illinois would become the 12th state to institute a waiting list if the advisory panel's recommendation moves forward. More than 1,000 individuals are currently on ADAP waiting lists across the United States.
"It's a national embarrassment that people with HIV can't get access to the medications that will allow them to work, thrive and contribute to society," said Munar, who is living with HIV. "The United States is failing to meet the most basic need of people with HIV—medications that will extend their lives."
Peller added, "The cost of care for someone with HIV who gets sick—for example, because they can't access medications—rises by almost $23,000 a year, almost completely due to hospitalizations. Providing medications through ADAP could prevent this and other unnecessary costs."
