Bassett Ingrid V, Farel Claire, Szmuilowicz Emily D, Walensky Rochelle P
Division of Infectious Disease, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Clin Infect Dis. 2008 Sep 1;47(5):695-701. doi: 10.1086/590936.
AIDS [Acquired Immunodeficiency Syndrome] Drug Assistance Programs, operating within the larger Ryan White Program, are state-based, discretionary programs that provide a drug "safety net" for low-income and uninsured individuals infected with human immunodeficiency virus (HIV). Although the AIDS Drug Assistance Programs and the primary care system that provides care for patients with HIV infection are already financially stressed, the Centers for Disease Control and Prevention recently issued guidelines recommending universal HIV testing to help identify the estimated 300,000 individuals in the United States who are unaware that they are infected with HIV. As the number of people living with HIV/AIDS who are coinfected with hepatitis C virus has grown and the cost and complexity of care have increased, the sustainability of the current HIV care system requires a reevaluation in light of the new testing guidelines. We examine the current state of the AIDS Drug Assistance Programs, discuss the implications of the Centers for Disease Control and Prevention guidelines for the already overstretched Ryan White Program, and consider a federally supported national program to ensure high-quality, efficient HIV care for low-income HIV-infected Americans.
艾滋病[获得性免疫缺陷综合征]药物援助计划在规模更大的瑞安·怀特计划内运作，是基于州的酌处性计划，为感染人类免疫缺陷病毒（HIV）的低收入和未参保个人提供药物“安全网”。尽管艾滋病药物援助计划以及为HIV感染患者提供护理的初级保健系统已经面临财政压力，但疾病控制与预防中心最近发布了指南，建议进行普遍的HIV检测，以帮助识别美国估计30万不知道自己感染了HIV的人。随着同时感染丙型肝炎病毒的HIV/AIDS感染者人数增加，护理成本和复杂性上升，鉴于新的检测指南，当前HIV护理系统的可持续性需要重新评估。我们审视了艾滋病药物援助计划的现状，讨论了疾病控制与预防中心指南对已经不堪重负的瑞安·怀特计划的影响，并考虑一个由联邦支持的全国性计划，以确保为低收入HIV感染的美国人提供高质量、高效的HIV护理。
