Although less than 1% of the country's HIV-positive population live in Colorado, the state has 280 people living with HIV/AIDS on its AIDS Drug Assistance Program waiting list, which represents about one-third of the total number of people on ADAP waiting lists nationwide, the Denver Post reports (Auge, Denver Post, 4/4). ADAPs -- which are supported with both state and federal funds -- provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals. As of January, 15 states had waiting lists or access restrictions for their ADAP programs, according to an "ADAP Watch" released by the National Alliance of State and Territorial AIDS Directors (Kaiser Daily HIV/AIDS Report, 4/2). In July 2003, state officials capped funding for Colorado's ADAP at a level that covers an average of 750 patients a month and limited the type of drugs covered by the program to antiretrovirals, effectively excluding treatments for opportunistic infections. In addition, the program does not cover Fuzeon, the "newest and most expensive" antiretroviral drug, the Post reports (Denver Post, 4/4). The reasons for the state's "disproportionately long" waiting list are not known, the Associated Press reports. AIDS advocates and health officials say that recent layoffs and longer life expectancies for people living with HIV/AIDS, among other factors, are contributing to the problem. Colorado AIDS Project Executive Director Deirdre Maloney said, "We're seeing a lot of increased need ... not just new infections but more poverty. More people are meeting the eligibility requirements (for ADAP) because they are out of work and financially strapped" (Associated Press, 4/4).

Picking Up Slack
Some HIV/AIDS advocates in Colorado say that insufficient funding for the state's ADAP is "fomenting a domestic crisis" in drug access, according to the Post. Some HIV/AIDS advocates say that the "makeshift system of charity and drug company" programs and "clandestine drug exchanges" that was "cobbled together to pick up where ADAP has left off is strained to a near-breaking point," according to the Post. "Clinics and [other facilities providing HIV/AIDS treatment] have been picking up the tab, but they can't sustain that," Maloney said, adding, "We're going to see that money run out, and the more the waiting list grows and the more different facilities lose their funding -- we're going to see that opportunity go away. And that's going to lead to more death and more need." Scott Barnette, head of the Colorado ADAP at the state Department of Public Health and Environment, said that most patients on the ADAP waiting list "are getting their medications through a variety of different sources," including pharmaceutical company patient assistance programs, the Colorado Indigent Care Program and other AIDS service organizations, as their funding will allow. However, he added, "All these are not long-term solutions" (Denver Post, 4/4).

MPR's "Marketplace Morning Report" on Tuesday reported an International Association of Physicians in AIDS Care summit on HIV/AIDS drug access and treatment issues. The segment includes comments from IAPAC President and CEO Jose Zuniga (Wicai, "Marketplace Morning Report," MPR, 4/6). The complete segment will be available online in RealPlayer after the broadcast.

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