Nearly 500 low-income, uninsured Georgians with HIV/AIDS have gained access to life-saving drugs with the help of federal emergency funding in recent months, though nearly 1,000 remain on a waiting list.
The improvement reflects a nationwide decline in the number of people waiting for drug assistance, which dropped by more than 3,700 since last fall, according to the National Alliance of State & Territorial AIDS Directors. Georgia’s AIDS Drug Assistance Program wait list of 957 remains the largest among eight states.
The state Department of Public Health has ramped up the search for alternative ways to eliminate the wait list. Meanwhile, health officials are also creating a comprehensive plan to combat the deadly virus and help meet national goals of reducing new HIV/AIDS cases and transmission rates by 2015.
“There are a lot of efforts in Georgia fighting this epidemic,” said Dr. Patrick O’Neal, director of health protection for the state agency. “I am very concerned we don’t have a single vision of what we hope to accomplish.”
On Thursday, national experts will gather to discuss America’s ongoing HIV/AIDS epidemic at the White House LGBT Conference on HIV/AIDS at Atlanta’s Morehouse School of Medicine.
More than 1.1 million Americans live with HIV. In Georgia – one of the top 10 states for new HIV diagnoses – more than 40,000 people have the virus.
The conference will focus on the lesbian, gay, bisexual and transgender population, which has been disproportionately affected by both the virus and its stigma, said Dr. David Satcher, a former U.S. surgeon general now at Morehouse.
“With early screening and early diagnosis, we can actually prevent the spread of this disease,” Satcher said. “Until we can get this group of people engaged in our efforts … we’re not going to be successful.”
Drug assistance program wait lists have declined, but the trend won't last unless Medicaid is expanded so more people can have insurance and qualify for screenings and treatment much earlier, he said. Demand for the programs has ballooned in recent years as people lost their jobs and insurance in the economic downturn -- prompting several rounds of emergency federal funding including a $40 million infusion to states last fall.
Georgia and the Southeast have been particularly hard hit because of the large number of minorities and poor people who can't get adequate care, O’Neal said.
The state's Medicaid program is also more restrictive than other states that cover some adults with HIV/AIDS, said Jeff Graham, executive director of Georgia Equality, a lesbian, gay, bisexual and transgender advocacy group. Georgia's Medicaid program generally doesn't cover low-income adults under 65 unless they are parents, have some form of disability or need nursing home care.
“This is a very serious, very real crisis going on,” he said.
But Graham said cooperation between the state, advocates and others is growing.
In addition to using federal funds, the state has whittled the wait list by enrolling people in a federal program under the health care law that's designed to help people with pre-existing conditions buy insurance. About 47 people with HIV have been added to the program and another 250 or so will hopefully move over within the next several months, O'Neal said.
Georgia and other states continue to face challenges, however.
New federal rules will require a HIV/AIDS patient to provide a denial letter from an insurance company, not just a certified letter from a doctor, to qualify for the pre-existing condition program, said Ann Lefert, director of policy and health care access for the national AIDS directors group.
“It’s a whole other hoop for them to go through now,” Lefert said.
The Supreme Court decision on the health law will be critical in states’ efforts, she said, adding that the 2014 Medicaid expansion under the law would mean fewer people would have to rely on drug assistance programs.
“If nothing occurs…we have to rethink how to make [those programs] sustainable,” she said.
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