Funding
Testing

James Grissom
HIV Positive
Steve Sherman
Coordinator, NC AIDS Drug Assistance Program
Peter Leone, M.D.
Medical Director, HIV/STD Prevention & Care Branch
Fred Wiggins
HIV Positive
Milford Evans
Benefits Advocate
Bart Haynes, M.D.
Director, Center for HIV/AIDS Vaccine Immunology, part of the National Institutes of Health

Acute HIV Testing
AIDS Funding
AIDS Research
AIDS Volunteers

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HIV/AIDS Funding

Whether someone lives in a small town or in a big city, North Carolina leaders say it costs tens of thousands of dollars to treat HIV. And they say because the face of HIV is increasingly poor, public assistance is essential. So where does the money come from? And is it enough, especially when it comes to buying life-prolonging medications?

Doctors say for many patients, a combination of three medicines, the so-called drug cocktail, is their best bet for fighting HIV. But the drugs are expensive-at least 12 thousand dollars a year, which puts them out of reach of many of the people who need them the most.

"I put it this way, I have good days and bad days," says James Grissom , who has HIV.

Today is a good day, and James Grissom can enjoy tending the garden outside his apartment. He's lived with HIV for eight years. Grissom moved to Winston-Salem in 2002 with barely more than the clothes on his back.

"I didn't have anything," Grissom remembers. "All I had was one box about this size. It was raining the day I got here, and I was really scared to death."

He depended on the kindness of strangers and on help from government programs to get the medication and other support he needed.

"I came with a little supply of medications to keep me going, but they wasn't going to last long, so I actually started early and let somebody know that I needed help," he says.

John Peebles, deputy branch head of the state's HIV/STD Prevention and Care Branch, says thousands of North Carolinians with HIV need help. And he says it comes from a variety of sources, both state and federal.

"We get money from the Centers for Disease Control and Prevention, CDC, primarily aimed at prevention," says Peebles. "We get resources from HRSA, the Health Resources and Services Administration, and those resources are primarily geared towards care for people living with HIV and AIDS.

Much of the federal funding comes through the Ryan White CARE Act. For fiscal year 2005-2006, North Carolina got about $23 million. The money pays for things such as health care, dental care, and the AIDS Drug Assistance Program, or ADAP. The state also picks up part of the tab for ADAP, covering about 45% of the cost each year. North Carolina's AIDS Drug Assistance Program currently serves about 4,000 people. To qualify, program director Steve Sherman says you must make below 125% of the federal poverty level, or just under $12,000 per year. It's the toughest criteria of any state in the nation, and there has been a waiting list off and on since 1997.

"The last thing we want to do is enroll somebody in the program, bring them in and start serving them, and then somewhere down the road during the course of that year get into a situation where we find we don't have enough money to serve the people who we are serving," says Sherman.

James Grissom found himself on the ADAP waiting list.

"It was scary then because I was wondering, my God, it seemed like one time I was trying to kill myself, now I want to live and what's going to happen if I don't have the money to buy my medicines," Grissom says.

Grissom says case managers and AIDS organizations helped him navigate the system and get the medicine and other support he needed. He believes he's living proof ADAP saves lives. HIV and AIDS advocate Patrick Lee agrees. He also benefited from ADAP.

"When I was in law school, one of my big worries was that I wouldn't be able to get my medication because I didn't have insurance, I didn't have an income, and then I heard about this program," says Lee. “And I realized that was a big burden lifted off my shoulders because of the fact that I didn't have to worry about where I was going to get the money for my medication."

Lee helped to organize the North Carolina AIDS Action Network to lobby state lawmakers for more money and says the effort is working. In 2004, the General Assembly increased ADAP funding by $2.8 million. AIDS advocates say it will go a long way.

"For every million dollars that's there, we can serve somewhere between 80 and 100 people a year, so I think it will help a lot," says Steve Sherman.

But state leaders and grassroots advocates agree the state still needs to spend more money on HIV/AIDS overall.

"In the prevention arena, both for other STDs and for HIV/AIDS, our funding has remained level or been decreased slightly along with other areas given the budget cuts we've had in the last 4 years," says John Peebles. "So we've done no better than be levelly funded particularly in the prevention areas."

"The state dollars that we get in go a long way and they help a lot of people in terms of the ADAP program," says Patrick Lee. "I just, I don't think it's enough, and I don't know what the magic number would be to bring it up to where everyone who needs the help will get the help."

James Grissom says the people who do need the help have to have the courage both to give and receive it.