Trends in AIDS Drug Assistance Program Support for People With HIV, by Age, Sex, Race, and US Region, 2008‒2021.

Abstract

<b>Objectives.</b> To evaluate trends in AIDS Drug Assistance Program (ADAP) utilization among demographic subpopulations. <b>Methods.</b> 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. <b>Results.</b> 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. <b>Conclusions.</b> ADAP enrollment and utilization have increased substantially. Despite equity gains, Black PWH and women were served at lower proportions by ADAP. <b>Public Health Implications.</b> 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. (<i>Am J Public Health</i>. 2025;115(8):1288-1298. https://doi.org/10.2105/AJPH.2025.308101).