UPDATE: AIDS Funding Cuts Feared in South Carolina Counties

More on a story we've been following at Rod 2.0. The Republican dominated legislature in South Carolina has proposed to cut its entire HIV/AIDS budget, including funding to the AIDS Drug Assistance Program. ADAP helps low-income HIVers, many of whom are who are unemployed or uninsured, pay for their medications. Those in the program are disproportionately black, many of the men are gay or bisexual.

The agency that administers South Carolina's ADAP is concerned about the availability of life-saving medications in critical counties, reports The Times and Democrat.

The Edisto Health District, which serves Orangeburg, Calhoun and Bamberg counties, has one of the highest rates in the state of people infected with HIV/AIDS. With state appropriations to the AIDS Drug Assistance Program facing an estimated $4.1 million shortfall, many local health and community leaders are concerned about the availability of critical medications for those living with HIV/AIDS. S.C. HIV Care Crisis Task Force reports that the annual funding need based on current patient load is $25.2 million for medications, with the current ADAP budget standing at only $21.1 million. 

The South Carolina HIV/AIDS Care Crisis Task Force reports that there are 1,163 individuals living with HIV/AIDS in the District. Eighty-five percent of that population is black. ADAP serves 233 people in that district. "I received ADAP funding assistance back in 1991, but back then, it was easier to get into the program than it is now," one man said. "It was a good thing, because I really couldn't afford my medication. The job insurance wouldn't cover it because of the price tag, and my concern now is how the younger generation who are being diagnosed HIV-positive are going to survive if they can't get the medication that they need."

The good news: While the proposed budget provides no state-based funding, ADAP will continue to run on $2.2 million from the federal government via Medicaid. But that means it will serve only a fraction of its caseload.

Meanwhile: More than 700 people are newly diagnosed with HIV each year, and more than 100 new ADAP applications arrive each month. And in South Carolina, just like many states across the South, that means black gay and bi men  will be hardest hit.  According to the Department of Health and Environmental Control, black men account for about half of persons recently diagnosed with HIV/AIDS in South Carolina. The vast majority, some 70 percent of those cases, are "attributed to sexual contact among men who have sex with men (MSM)."

Our latest article for Black AIDS Weekly, "Recession Forces States to Slash AIDS Drug Assistance Programs", surveys then nationwide trend toward cutting ADAP funding. HIV positive black gay men discuss what their life would be like without ADAP. Read the full article HERE.

Comments

[Jim]

Are the Christians of South Carolina all that different from the Muslims of Senegal, who declare we should become “fish food”?

I mean, just because they coo “Bless his heart...” when they hear you have been let to die—does that really make it any better?

[jmb]

“my concern now is how the younger generation who are being diagnosed HIV-positive are going to survive if they can't get the medication that they need."

At what point does societies accountability to the individual end and the individual’s responsibility begin? We in the US have been aware of HIV/AIDS for more than 30 years. Methods for the prevention of contracting this disease are well known and publicized in this country. Thus, with minor exceptions, it is not unreasonable that society not be expected to pick up the cost of providing HIV medication to the newly infected. The arguments for society covering the cost are 1) a moral obligation to the overall welfare and 2) to prevent the even further spread of the disease.

Concerning the moral obligation to the overall welfare, it may be that much of the on going HIV infection in the gay community is in fact rooted in issues of low self esteem, self loathing, isolation and/or depression, and the risky behaviors can be characterized as acts of uncertain and slow motion suicide. However, if such is the case then wouldn’t it be more beneficial and economical for society to simply provide free metal health care to poor gay individuals to help them conquer and cope with their issues before they engage in risky self destructive behavior, than to provide a life time of HIV medication after infection? And if this is not the case, then how does it benefit the overall welfare for society to support and enable amoral individuals with wonton and callous disregard for their own life as well as the life of others?

Concerning the prevention of the even further spread of the disease there are risks that if society does not pick up the cost for the newly infected poor then they will in turn infect other individuals. However, 1) the fact is that picking up the cost for the poor hasn’t prevented new people from being infected; 2) except in the case of rape, the most likely others infected will be those who engaging in irresponsible risky activity and who are likely to become infected at some point in time regardless; 3) an individual is most contagious within the first few months of contracting HIV, which is often well before discovery and any medication regimen is begun and 4) without medication the desirability, thus opportunities, of many infected individuals could rapidly decrease.

Now the people who are already in the program and have come to depend on it are a different matter. However, in order to meet the medication needs of individuals with life threatening conditions who are currently in the program and have come to depend on it, why doesn’t ADAP at least eliminate the prevent HIV/AIDS education programs and councilors and then direct that portion of its budget to provide the needed medication to those in the program whose lives are in the balance? As mentioned above methods for the prevention of contracting HIV are already well known, though obviously not always well practiced.

[Randall]

The reasons HIV treatment gets funded as opposed to other disorders are the stigma attached - as demonstrated in the last post; and the expense of the drugs - which is outrageous! The retail cost of the drugs that keep me alive is $1500.00 / month. And I PAY for them.
Not everyone gets HIV thru irresponsible behaviour. But EVERYONE with HIV has to deal with that as an accusation!

And funny, I can guess that most everyone has done something irresponsible in their youth. But the people with HIV pay for this years and decades after they have grown up and become responsible.

I contracted it in 1988 as a young single guy and yes, I did like to chase the women. That was irresponsible. I did change my ways a long time ago. But I pay the price now.

I am thankful I had a good career, powerful lawyers to keep my boss from firing me when I was too sick to work, and a lucky break for a clinical trial that got me out of the full-blown point and up to full-functioning taxpayer status, where I could afford to keep myself alive. I kept myself alive and kept my company profitable - therefore I am NOT a drain, I help many people keep their jobs now thru my hard work. My work is in high demand. I pay my way.

I also support my wife, who without the Ryan White assistance, would never have made it out of her last marriage alive. Her irresponsibility was marrying a cheater. Her fault??? I would not say that. But she is treated like a prostitute or drug addict by those people like the one above that wants to declare this a disease of lifestyle.

Glad I don't live in Utah. I would want to choke that senator. I would hope that if I do come on hard times, I would get the chance again for someone to help me pull out and become useful again to society. But having a disease that elicits NO sympathy makes it hard for those down on their luck to find help.

[Tom]

The comment above left by "jmb" is so morally repugnant I barely know where to start. For openers, no one deserves to be left to die by a society that calls itself compassionate. And where exactly do we draw that line again once it's crossed? How soon until we withhold treatment for smokers and their cancers? How long will it take before we abandon the obese to the ravages of diabetes? Who decides which mistakes we are to be condemned to death for? And when will it be your turn?