Each year it is estimated that approximately 40,000 people in the U.S. are newly infected with HIV. In the late 1990s, the number of deaths from AIDS dropped 43% as a result of highly active antiretroviral therapy. Unfortunately, the complex system currently in place for financing and delivering publicly financed HIV care undermines the significant advances that have been made in the development of new technologies to treat it. Many HIV patients experience delays in access to other services that would support adhering to treatment. As a result, each year opportunities are missed that could reduce the mortality, morbidity, and disability suffered by individuals with HIV infections.


Public Financing and Delivery of HIV/AIDS Care examines the current standard of care for HIV patients and assesses the extent the system currently used for financing and delivering care allows individuals with HIV to actually receive it. The book recommends an expanded federal program for the treatment of individuals with HIV, administered at the state level. This program would provide timely access and consistent benefits with a strong focus on comprehensive and continuous care and access to antiretroviral therapy. It could help improve the quality of life of HIV/AIDS patients, as well as reduce the number of deaths among those infected.


Table of Contents


Front Matter
Prologue and Executive Summary
1 Introduction: Securing the Legacy of Ryan White
2 HIV/AIDS Care in the Third Decade: Opportunities and Challenges
in the Changing Epidemic
3 Current Financing and Delivery of HIV Care
4 Barriers to HIV Care
5 Options for Financing and Delivering HIV Care
6 Recommendations
Appendix A: Technical Appendix Estimating the Impact and Cost of
Expanded HIV Care Programs
Appendix B: Overview of Care Act Allocation Formulas
Appendix C: Mental Illness and HIV Comorbidity: A Large and
Vulnerable HIV Subpopulation
Appendix D: Financing HIV/AIDS Care: A Quilt With Many Holes
Appendix E: Towards an Understanding of Meeting HIV-Infected
Substance Users
Appendix F: Committee on the Public Financing and Delivery of HIV
Care
Index