Underutilization of the AIDS Drug Assistance Program: associated factors and policy implications.

摘要: The current paradigm of HIV/AIDS care calls for a lifetime uninterrupted antiretroviral therapy (ART) (Finzi et al. 1999; Panel on Antiretroviral Guidelines Adults and Adolescents 2009;). For many patients, the high cost medications represents significant barrier to continuous access ART (Kates 2004; Jing 2007;). In 1990, Ryan White Comprehensive AIDS Resources Emergency (CARE) Act (RWCA) was authorized provide funding low-income, uninsured, or underinsured individuals living with HIV/AIDS. To help address therapy, Drug Assistance Programs (ADAPs) were included in RWCA. Through these programs, federal government provides individual states block grants administer local ADAPs purchase life-saving other at no patients (Kaiser Family Foundation National Alliance State Territorial Directors 2009). 2009 reauthorization Treatment Modernization Act, legislative extension RWCA, allocated U.S.$1.28 billion Part B fiscal year 2009, receiving approximately 75 percent funds facilitate provision (Ryan Extension 2009). In addition receipt, high-level adherence another principal tenet blueprint HIV treatment success (Ulett By providing medication those without coverage from public private insurers, have succeeded critical service vulnerable populations One-third engaged United States receive reliable through programs While clear beneficial effect numbers HIV-infected ART, degree programmatic utilization by enrollees (i.e., consistent possession) is not well described. Evaluation ADAP important understanding barriers persistence among program enrollees. The primary goals this study following: (1) characterize University Alabama Birmingham 1917 Clinic (1917 Clinic) (2) determine patient factors associated underutilization Clinic.