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This is bad, for sure, but not unforeseen. When I met with Sen. Durbin in 2004 and proposed the idea that Illinois be the first state to have everyone know their HIV-status, his response was that we could not do this because we did not have the funds to get everyone on treatment. He pretty much acknowledged back then that funding was short, but we continued to dither for the next 5 years. So what we are seeing now has been in the works for years. "AIDS, Inc." is as much a part of the problem as well. Wasteful needs assessments that tell us nothing new and are ignored anyway and a system dependent on people having HIV to be successful was going to catch up with us eventually. None of it was sustainable. The alarm has been ringing for years, but most of our "AIDS leaders" (governmental and private) kept hitting the snooze button. There are some of us who have been consistently speaking up and warning of this (as a client of services and as one who has been working in the field, I've seen it from many angles), but the big players simply had too much invested in the status quo. Perhaps this will be just the thing tthat gets people to see it's not just a dollars thing, but a systemic thing and AIDS organizations should not be funded but instead called to task for their oversight.
Henry
Most of those on ADAP lists are not poor but middle class. Many states have tightened eligibility requirements so that only the very poor actually still qualify. There are many lower and even upper middle class Americans who can't afford expensive HIV meds and don't have insurance or are under-insured. Sometimes it's easier to quit one's job and become poor in order to at least qualify for public assistance. The system in this country makes it hardest on the middle class, not on the poor or on the rich.
August 20, 2010