HIV Treatment *IS* HIV Prevention

There's an interesting twist to the news that HIV+ people on anti-retroviral medication have surprisingly low chances of passing the virus on to their sexual partners in this weekend's New York Times column by Charles Blow.

Blow makes the point that the AIDS Drug Assistance Program (ADAP) has been a victim of both state and federal budget cutting and points out the long-term fiscal irresponsibility of such actions.

According to data from the ADAP Advocacy Association: as of last week, the number of people on ADAP waiting lists had risen to 7,873; between April 2009 and April 2011, 14 states reduced the number and types of drugs they would pay for. A number of states have stiffened financial eligibility requirements, capped enrollment or removed some people already enrolled. Other states are considering doing so.


This is particularly problematic since the National ADAP Monitoring Project’s annual report, released in March, showed that those most dependent on the program are some of society’s most vulnerable. About a third of all people diagnosed with AIDS are enrolled in ADAPs, three-quarters of them had incomes of less than 200 percent of the national poverty level, 61 percent were uninsured, and 55 percent were black or Hispanic.


But as the recession put more patients in need, federal and state aid didn’t keep track. From 2007 to 2010, the number of people using ADAPs jumped by a third, but federal and state funds specifically appropriated for it grew by just 3 percent and 18 percent, respectively.


Not only is it morally reprehensible to restrict or deny life-saving drugs to those who need them (talk about death panels), it is a colossal miscalculation of public health policy, not to mention fiscally irresponsible.


The new findings should help change a paradigm that’s badly in need of changing. Treatment benefits the healthy as well as the sick. It not only prolongs and improves the lives of those who are H.I.V.-positive, but also is a prophylactic for those who aren’t. Everyone wins.


It’s time to expand ADAPs, not diminish them.

It's just amazing how we spend health care dollars in this country. It simply is not rational to be cutting funds for  prevention of any disease, especially when prevention is always cheaper than treatment. In the case of HIV, treatment can also improve prevention of future infections so it should be a no-brainer to increase, not decrease such expenditures. Unless you live in Mississippi, of course.