McManus Kathleen A, Killelea Amy, Horn Tim, Steen Amber, Sun Brian, Keim-Malpass Jessica, Hamp Auntré, Strumpf Andrew, McQuade Elizabeth T Rogawski
Kathleen A. McManus, Amy Killelea, and Jessica Keim-Malpass are with the University of Virginia School of Medicine, Charlottesville. Tim Horn and Auntré Hamp are with National Alliance of State and Territorial AIDS Directors (NASTAD), Washington, DC. Amber Steen is with the University of Virginia School of Nursing, Charlottesville. Brian Sun and Andrew Strumpf were with the University of Virginia School of Medicine at the time of the study. Elizabeth T. Rogawski McQuade is with the Rollins School of Public Health, Emory University, Atlanta, GA.
Am J Public Health. 2025 Aug;115(8):1288-1298. doi: 10.2105/AJPH.2025.308101. Epub 2025 Jun 5.
To evaluate trends in AIDS Drug Assistance Program (ADAP) utilization among demographic subpopulations. For 2008 to 2021, we collected US state-level data regarding ADAP client utilization and estimated HIV prevalence data. We used descriptive statistics to describe state ADAP utilization by geography, demographics (age, sex, race), and programmatic characteristics. ADAP utilization proportion increased from 14.0% of all people with HIV (PWH) in 2008 to 22.3% in 2021. The proportion of female PWH supported by ADAP was lower in both 2008 (12.2%) and 2021 (18.3%) compared with the proportion of male PWH supported (2008: 14.5%; 2021: 22.9%). In 2008, the utilization proportion was lower for Black PWH at 11.7% compared with 16.0% for White PWH. In 2021, the utilization proportion for Black PWH was 25.2% compared with 28.4% for White PWH. ADAP enrollment and utilization have increased substantially. Despite equity gains, Black PWH and women were served at lower proportions by ADAP. National and state partners of ADAPs should examine ways to ensure that ADAP utilization is equitable in terms of age, sex, race/ethnicity, and other sociodemographic factors. (. 2025;115(8):1288-1298. https://doi.org/10.2105/AJPH.2025.308101).
评估艾滋病药物援助计划(ADAP)在不同人口亚群体中的使用趋势。在2008年至2021年期间,我们收集了美国州级层面关于ADAP客户使用情况的数据以及估计的艾滋病毒流行率数据。我们使用描述性统计方法,按地理位置、人口统计学特征(年龄、性别、种族)和项目特征来描述各州的ADAP使用情况。ADAP的使用比例从2008年所有艾滋病毒感染者(PWH)的14.0%增至2021年的22.3%。与受ADAP支持的男性PWH比例(2008年:14.5%;2021年:22.9%)相比,2008年(12.2%)和2021年(18.3%)受ADAP支持的女性PWH比例均较低。2008年,黑人PWH的使用比例为11.7%,低于白人PWH的16.0%。2021年,黑人PWH的使用比例为25.2%,而白人PWH为28.4%。ADAP的登记和使用情况大幅增加。尽管在公平性方面有所改善,但ADAP为黑人PWH和女性提供服务的比例较低。ADAP的国家和州合作伙伴应研究如何确保ADAP在年龄、性别、种族/族裔和其他社会人口因素方面的使用是公平的。(.2025;115(8):1288 - 1298。https://doi.org/10.2105/AJPH.2025.308101)