AIDS Drug Assistance Program

CLIENTS SERVED

In 2002, 52 State and U.S. Territory AIDS Drug Assistance Programs (ADAPs) served 136,345 enrolled clients. Twenty-four percent of the clients served by ADAP (n=32,221) were newly enrolled during the reporting period. The number of clients served by ADAP in 2002 cannot be compared to previous years because two programs failed to report ADAP data in 2002. However, in the following section on client characteristics, the proportion of clients served by gender, ethnicity, race, and age are compared to previous years.

CLIENT CHARACTERISTICS

GENDER

As seen in the Figure 5, the majority of clients served by ADAP were males (79 percent, n=107,185). In comparison, 78 percent of the clients served by ADAP in 2001 were males. In 2002, the 52 programs that reported ADAP data served 29,013 females. Less than one percent of the clients served by ADAP were transgender (Table 15).

Figure 5. Gender of Clients Served by ADAP, 2002 (n=136,198)

ETHNICITY

Persons of Hispanic/Latino(a) ethnicity comprised 21 percent of the clients served by ADAP in 2002. Seventy-one percent of ADAP clients were non-Hispanic/Latino(a) and ethnicity was unknown or unreported for eight percent of those served by ADAP (Table 15).

RACE

In 2002, African Americans/Blacks comprised 38 percent of the clients served by ADAP. In comparison, 37 percent of ADAP clients were African American/Blacks in 2001. Asian/Native Hawaiian/other Pacific Islander and American Indians/Alaska Natives combined accounted for less than two percent of ADAP clients in 2002, and clients reporting more than one race comprised one percent of ADAP clients served. Forty-three percent of the clients served by ADAP in 2002 were White. Race was unknown or unreported for 17 percent of ADAP clients. (Figure 6).

Figure 6. Race of Clients Served by ADAP, 2002 [footnote 22]

AGE

In 2002, 64 percent of the clients served by ADAP were 25 to 44 years of age. Persons age 45 to 64 years comprised 32 percent of the clients served by ADAP and an additional two percent were age 65 years or older. It is interesting to note that the proportion of clients served who were 45 years or older continues to increase. In 2002, 34 percent of ADAP clients were age 45 years or older compared to 29 percent in 2001. Three percent of ADAP clients in 2002 were 13 to 24 years old and less than one percent of clients were age 12 years or younger (Table 15).

ADAP FUNDING AND EXPENDITURES

ADAPs receive funding from multiple sources. In addition to the Title II ADAP earmark and ADAP supplemental funding, ADAPs may receive funding from Ryan White CARE Act Title I, Title II base, and other CARE Act funding. Total ADAP funding may include Medicaid; Medicare; other Federal, State and local government funding; other public payments, manufacturer rebates, private contributions, and client payments as well as CARE Act funding. In 2002, the Ryan White CARE Act Title II earmark was the primary source of funding for ADAP.

In FY 2002, a total of $639,000,000 was awarded to State and territories for AIDS Drug Assistance Programs; an 8.5 percent increase from FY2001. ADAPs reported receiving additional funding of $287,921,065 from other sources. This included State and local contributions of $154,265,290 in 2002.

In 2002, the 52 ADAPs submitting CADR data reported drug expenditures totaling $820,298,784. State ADAPs spent 87 percent or $710,113,962 of the total drug expenditures on antiretroviral medications (protease inhibitors (PI), nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and nucleotide reverse transcriptase (NtRT)).

Table 15. Demographic Characteristics of Clients Served by ADAP, 2002

 Figure 7. Total Drug Expenditures by Drug Class, 2002

As seen in Figure 7, nucleoside reverse transcriptase inhibitors accounted for 53 percent of all drug expenditures in 2002 followed by protease inhibitors (17 percent) and non-nucleoside reverse transcriptase inhibitors (14 percent). Nucleotide reverse transcriptase drugs comprised four percent of drug expenditures. Drugs used to prevent or treat opportunistic infections comprised five percent of ADAP drug expenditures in 2002.

Antiretroviral medications (PIs, NRTIs, NNRTIs, and NtRTs) were the most commonly prescribed HIV medications provided by State ADAPs in 2002 (Table 16). It is important to note that these drugs are prescribed in combination; therefore, a single client may have received multiple drugs. Stavudine, combivir, and lamivudine (NRTIs) were the most commonly prescribed drugs in 2002, as they were in 1999, 2000, and 2001.

In 2002, combivir and nelfinavir were the most frequently prescribed HIV medications by expenditures, as they were in 1999, 2000 and 2002. (Table 17). Together, these two drugs accounted for nearly a quarter of the total drug expenditures in 2002. It should again be noted that these drugs are prescribed in combination; therefore, a single client may have received multiple drugs.

Table 16. Top Ten HIV Medications Prescribed by Number of Clients, 2002

Table 17. Top Ten HIV Medications Prescribed by Expenditure, 2002