Things are looking grim for ADAPs across the nation. The most recent ADAP Watch reports that as of mid-November, there were 346 people on ADAP waiting lists in nine different states -- almost 100 of whom were added in the last two months alone.
Tennessee was forced to establish a waiting list in November, which reached 95 people by the end of the month. But the worst-hit state is Kentucky, where 120 people eligible for ADAP are on the waiting list, and the state is considering additional cost-containing measures, such as reducing its formulary and requiring patients to share costs. Eleven other states, five of which already have waiting lists, either have instituted similar measures or are considering it.
All this comes at a time when experts are pushing for earlier HIV treatment. The most recent HIV treatment guidelines, released on World AIDS Day, recommend that people begin taking medications when they have between 350 and 500 T cells. Following these guidelines would put more people on medications, but ADAP restrictions make that difficult. Many people on waiting lists can't afford medications without assistance and have to go without treatment at all, while others may have to switch to less expensive medications even if their current regimen is working well.