AIDS Drug Assistance Program

CLIENTS SERVED

In 2004, 53 State and U.S. Territory AIDS Drug Assistance Programs (ADAPs) served 142,653 enrolled clients (Table 17). Twenty percent (n=28,305) of the clients served by ADAP in 2004 were newly enrolled during the reporting period, a decrease in the proportion of newly enrolled clients from 24 percent (n=136,345) of clients in 2002 and 21 percent (n=143,711) of clients in 2003.

Table 17. Demographic Characteristics of Clients Served by ADAP: 2002, 2003, and 2004

-- Unknown or unreported responses are not included in percentage calculations.
Percentages may not sum to 100 percent due to rounding error.
Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2002, 2003, and 2004 CARE Act Data Reports.

CLIENT CHARACTERISTICS

GENDER

ADAP served about four times more male clients than female clients in 2004: 112,127 males (79 percent) compared to 30,274 females (21 percent). Less than one percent of clients were transgender (Figure 6).

Figure 6. Gender of Clients Served by ADAP, 2004 (n = 142,599)

Data on gender were unknown or unreported for 54 clients.
Percentages may not sum to 100% due to rounding error.

AGE

Over half (58 percent) of ADAP clients served in 2004 were 25 to 44 years of age, down from 64 percent of ADAP clients served in 2002 in that age group. More than a third (38 percent) of ADAP clients in 2004 were adults age 45 to 66 years and 2 percent were adults age 65 or older.

ETHNICITY

In 2004, 27 percent of ADAP clients were Hispanic/Latino(a) and 73 percent were not Hispanic/Latino(a), compared to 2002, when 23 percent of ADAP clients were Hispanic/Latino(a) and 77 percent were not Hispanic/Latino(a) (Figure 7).

Figure 7. Ethnicity of Clients Served by ADAP, 2004 (n = 125,627)

Data on ethnicity were unknown or unreported for 17,026 clients.

RACE

The distribution of ADAP clients by race was the same from 2002 to 2004. In 2004, Whites comprised 52 percent of clients, Blacks comprised 45 percent of clients, 2 percent of clients were Asian, Native Hawaiian, or Pacific Islander, 1 percent of clients were Native American or Alaska Natives, and 1 percent reported being of more than one race (Figure 8).

Figure 8. Race of Clients Served by ADAP, 2004 (n = 111,410)

Data on race were unknown or unreported for 31,243 clients.
"Other" includes Asian, Pacific Islander, and American Indian or Alaska Native.

ADAP FUNDS AND EXPENDITURES

ADAP is funded through multiple sources, including CARE Act appropriations and non- CARE Act sources. In addition to Title II ADAP “earmark” funds (the largest component of CARE Act appropriations) and ADAP supplemental funds, State ADAPs may receive funds from Title I, Title II base, and other sources. Total ADAP funds may also include non-CARE Act sources such as Medicaid, Medicare, other Federal, State, or local government funding, other public payments, manufacturer rebates, private contributions, and client payments.

In FY2004, a total of $748,872,000 was awarded to States and territories for AIDS Drug Assistance Programs; a 5 percent increase from FY2003. ADAPs reported receiving additional funding of $402,435,389 from other sources, including State and local contributions of $226,295,184 in 2004.

ADAP drug expenditures increased by 6 percent in 2004, from $893,436,673 in 2003 to $945,739,383. State ADAPs spent $807,942,328, or 85 percent of 2004 total drug expenditures on antiretroviral medications: protease inhibitors (PI), nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and nucleotide reverse transcriptase (NtRTI). NRTIs accounted for 47 percent of all drug expenditures in 2004, followed by PIs (18 percent), NNRTIs (11 percent), and NtRTIs (10 percent). Drugs used to prevent or treat opportunistic infections (OI) comprised 5 percent of ADAP drug expenditures in 2004 (Figure 9).

Figure 9. Drug Expenditures by Drug Class, 2004

Percentages may not sum to 100 percent due to rounding error.

Antiretroviral medications (PIs, NRTIs, NNRTIs, and NtRTIs) were the most commonly prescribed medications provided by State ADAPs in 2004 (Table 18). Because these drugs are prescribed in combination, a single client may have received multiple drugs. Tenofovir DF, Efavirenz, Lamivudine, and Zidovudine/Lamivudine were the four most commonly prescribed drugs in 2004. Zidovudine/Lamivudine was the most frequently prescribed HIV medication by expenditure in 2004 (Table 19), accounting for 12 percent of the total drug expenditures in 2004.

Table 18. Top Ten HIV Medications Prescribed by Number of Clients, 2004

Generic Drug Name	Drug Class	Number of clients	Expenditures
Tenofovir DF	NRTI	46,202	$94,760,088
Efavirenz	NNRTI	38,761	$75,135,344
Lamivudine	NRTI	38,667	$54,451,095
Zidovudine/Lamivudine	NRTI	36,835	$114,788,389
Trimethoprim/Sulfamethoxazone	OI	32,071	$1,225,393
Lopinavir/Ritonovir	PI	27,957	$83,469,110
Ritonavir	PI	23,539	$37,032,258
Stavudine	NRTI	22,724	$30,566,208
Didanosine	NRTI	21,334	$23,701,139
Atazanavir	PI	18,142	$55,972,757

Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2004 CARE Act Data Report.

Table 19. Top Ten HIV Medications Prescribed by Expenditure, 2004

Generic Drug Name	Drug Class	Number of clients	Expenditures
Zidovudine/Lamivudine	NRTI	36,835	$114,788,389
Tenofovir DF	NRTI	46,202	$94,760,088
Lopinavir/Ritonovir	PI	27,957	$83,469,110
Efavirenz	NNRTI	38,761	$75,135,344
Abacavir/Zidovudine/Lamivudine	NRTI	14,490	$72,498,749
Atazanavir	PI	18,142	$55,972,757
Lamivudine	NRTI	38,667	$54,451,095
Nelfinavir	PI	14,987	$47,404,547
Ritonavir	PI	23,539	$37,032,258
Abacavir	NRTI	17,141	$33,419,259

Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2004 CARE Act Data Report.