ADAP and the Numbers

We all live by the numbers.  Gas prices, mortgage rates, even votes on reality TV shows can influence our lives. People living with HIV live especially by the numbers. We learn to monitor our viral loads and the cost of HIV medications. Rarely, however, do we praise those who help adjust those numbers. Yet praise is exactly what President Obama deserves. Last month his administration announced it was transferring $35 Million to ADAP, the federal AIDS Drug Assistance Program. This transfer will help assure that 8,000 low-income people living with HIV who were at risk of losing their HIV medications will continue to get them. This is truly worthy of praise.

African Americans are at highest risk of not only of having HIV, but of having no insurance to pay for HIV medications to help keep us alive. The numbers are staggering. The often-cited HIV Treatment Cascade, an inverted triangle with the 1.2 million Americans living with HIV at the top, shows towards the bottom the shocking low proportion that only 36 percent of Americans with HIV are getting HIV treatment consistently.  At the very bottom is the even lower number that only 28 percent (yes, only 28 percent!) of Americans with HIV have successfully obtained an undetectable viral load --- that numeric medical indicator that the HIV virus is suppressed in your body. Need I suggest to you what proportion of those are African Americans? Not nearly enough. And, as I often remind audiences, below that number is the even lower number of Americans living with HIV who have their own private insurance to pay for HIV medications --- only 17 percent.  None of these numbers are acceptable; not for Black people, not for any of us living with HIV, and not for anyone who cares about someone living with HIV.

The 8000 Americans who will benefit from these new ADAP funds reside in states such as Georgia, Tennessee, and Alabama. Our brothers and sisters in those states -- Black and white and of all other races -- desperately need these resources to help them obtain and remain on the medications that can help them reach the most important number of all, that of longer life.   Living a long and healthy life with HIV is possible, but you will not reach that goal unless you have the necessary HIV medications to help you attain a suppressed viral load, and have the resources to consistently access and take those medications day after day, year after year to maintain that low level.

With sequestration casting a dark shadow over federal spending, moving millions of dollars to the ADAP program to help those at risk of losing their HIV medications may be politically risky.  However, our President has to worry no longer about counting electoral votes or watching poll numbers. Instead, he has done the right thing. By moving $35 million to ADAP, his administration is helping those most in need get to the numbers we who live with HIV want the most: a suppressed viral load and living to a very old age.

In this issue we introduce you to Chiquita Brooks LaSure, deputy director for policy and regulation at the Center for Consumer Information and Insurance Oversight, and one of the Black notables playing a critical role in implementing the Affordable Care Act. As we near National HIV Testing Day on June 27, our friends at AIDS.gov roll out a new HIV testing sites locator widget that you can add to your website or social-media template. NIH scientists have recently discovered how HIV kills immune cells – findings that have great implications for treatment. A review of 21 international studies found that both supervised and unsupervised HIV self-testing strategies had high preference, acceptance and partner self-testing rates. And our friends at Kaiser Health News share a story about how African Americans continue to be hit hard by medical bills in spite of all the progress we've made.

Jesse Milan, Jr., JD is Chair Emeritus of the Black and Institute and a Vice President and Fellow at the Altarum Institute.  He has been living with HIV for 31 years.