Only four AIDS Drug Assistance Programs (ADAPs) are providing medications to help manage four major cardiovascular disease (CVD) risk factors common among people living with HIV: type 2 diabetes, high blood pressure, elevated cholesterol and triglyceride levels and smoking. This is the finding of a survey published in the Journal of General Internal Medicine (JGIM) and reported by aidsmap.

While many ADAPs do provide access to many, if not all, of the available antiretrovirals (ARVs) for people living with HIV who qualify for assistance—about one third of HIV-positive people in the United States—coverage for medications needed to prevent or treat health complications related to, or exacerbated by, HIV infection is limited.

According to the JGIM analysis, only four state ADAPs—Massachusetts, New Jersey, New York and Pennsylvania—provided prescription drug coverage consistent with guidelines for all four cardiovascular risk factors. However, 68 percent of states and territories provided therapy that was at least partially consistent with guidance for one risk factor. No coverage was provided by 25 percent of ADAPs.

“In our systematic survey of ADAP formularies, we identified only four states that provided prescription drug coverage consistent with clinical practice guidelines for all four modifiable cardiovascular risk factors,” write the investigators.

According to aidsmap, the study authors believe that financial pressures and cost cutting could lead to some ADAPs restricting their access to non-HIV medications.

The researchers conclude that policymakers should address the “root causes” for the variations in coverage and “provide a comprehensive ADAP formulary informed by clinical guidelines.”