Louisiana: HIV/AIDS Patients' Health Care Options Thin

Since June 1, the state AIDS Drug Assistance Program (ADAP) for low-income patients has turned away 177 qualified applicants, canceled several provider contracts, and slashed funding to community clinics, all in a bid to plug an $11.7 million budget shortfall, according to DeAnn Gruber, interim administrative director of Louisiana's HIV/AIDS Program.

However, these reductions total only $4 million to $5 million. If officials cannot find additional funding for ADAP or manage further cuts to the program, which is estimated to cost $31.4 million through March 2011, they could be forced to eliminate it altogether by next spring, the state Office of Public Health said.

Louisiana's ADAP has been hard-hit in recent years by a confluence of factors, including a 15 percent increase in new HIV patients in the state since 2008. New Orleans ranks third behind Miami and Baton Rouge in new AIDS cases and eighth in the proportion of residents living with AIDS, advocates say.

Poverty is a key reason for the region's high HIV/AIDS rates, triggering other social problems such as lack of education, poor access to health care, and high prevalence of other STDs that can increase the risk of contracting HIV.

In 2009, more than 3,500 residents relied upon ADAP in Louisiana, where 56 percent of residents have incomes below 300 percent of the federal poverty level, and 19 percent are uninsured.

The state is encouraging would-be ADAP applicants to apply to pharmaceutical patient-assistance programs. Ryan White case managers and AIDS service organizations' staff have stepped in to help patients with the application process, which can take about two weeks. Alana Moore of the NO/AIDS Task Force said she has yet to see an eligible person turned away by a drug company.

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