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ADAP Restrictions What Do I Do?
Sep 3, 2007

I am currently on Atripla and I will be taking a job in Georgia. I have researched their ADAP program and I have to have a <350 CD4 or a viral load >55,000 copies to qualify for access to their HIV medication progrm. The issue I am concerned about is my viral load is undetectable but my CD4 is less then 350. I have contacted their program in Georgia they said I would NOT qualify to receive medications. How dangerous is this to my overall HIV suppression if I was to move there? Also, would I not build a viral resistance to Atripla if I did qualify based on their guidelines, and then start and stop my meds due to their program restrictions.

Thank you.

Response from Dr. Wohl

I am pretty sure you have this wrong. No ADAP program forces people to come off their meds when they hit a certain CD4 cell count. The criteria for entry into a program are not the same as those required to be maintained on the program.

There are some rules about who can get into the ADAP program. According to their website, you need the following:

Comfirmed HIV status with CD4 and viral load restrictions. -CD4 < 350, OR Viral load > 55,000 -No insurance coverage for prescriptions. -Must be a resident of Georgia. -Must not be eligible for Medicaid. -Must not be eligible for third party funding.

Note, the "or" in the CD4 and viral load criterion. If you have a CD4 less than 350, you are in no matter what your viral load provided you meet the other requirements. Some states also give priority to those coming in on another ADAP program.

Once in the program, you do not need to keep meeting the CD4 or viral load restrictions but probably do need to continue to demonstrate financial need. Once you establish yourself with a goo HIV clinic, they can help. I recommend before moving you go to a reputable HIV clinic for an initial visit and to get everything in place before you officially move.

DW



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