When Governor Gavin Newsom signed the state budget June 29, he expanded California's AIDS Drug Assistance Program and associated programs in a big win for the state's End the Epidemics Coalition and people living with HIV/AIDS.
The coalition touted the expansion, stating in a news release that it's "a highly significant win, especially in a year where the state had to fill a $44.9 billion budget deficit with difficult budget solutions, including a $500 million loan from the ADAP Rebate Fund, a state special fund that covers medications, health care premiums, copays and coinsurance, and related services for treatment and prevention for uninsured and underinsured Californians living with and vulnerable to HIV."
End the Epidemics' budget proposal maintained core ADAP services and increased investments in programs supporting people aging with HIV; transgender, gender-nonconforming and intersex people; and people who use drugs, according to the release.
Sebastian Perez, co-chair of End the Epidemics policy committee, stated the expansions "certainly reflect EtE's syndemic approach to care, and we must focus on reducing racial disparities in HIV acquisition, in particular."
Specifically, on July 1, five appropriations from the rebate fund began. These are $10 million each year for three years for the harm reduction clearinghouse, which provides supplies to syringe services programs in the state, and $5 million each year for three years for HIV services offered by trans, gender-nonconforming, and intersex-led organizations.
Additionally, appropriations include $200,000 to assess and analyze the pre-exposure prophylaxis (PrEP Assistance Program) navigation and retention services; $200,000 to assess and analyze the delivery of ADAP health care navigation and retention services; and $5 million for access to internal and external condoms available to public school pupils in grades nine to 12.
"PrEP and PEP uptake among young Black and Latinx gay, bisexual, and men who have sex with men is lower than uptake among white men, and transgender women of color are still disproportionately vulnerable to HIV," stated Perez.
PrEP, or pre-exposure prophylaxis, refers to the use of antiviral drugs to prevent people exposed to HIV from becoming infected. The pill Truvada was first approved for PrEP use in 2012 by the U.S. Food and Drug Administration; since then the FDA has also approved the pill Descovy for some groups and the drug Apretude as an injectable treatment.
PEP, or post-exposure prophylaxis, involves taking medication after exposure to HIV.
End the Epidemics seeks to treat the HIV, sexually transmitted infection, viral hepatitis and overdose epidemics as one related syndemic and has advocated for $160 billion from the Legislature for programs and services since its start in 2018, the release noted.
On January 1, three ADAP modernizations will begin. These are increasing the income eligibility from 500% to 600% of the federal poverty level; increasing the monthly cap on health care premium payment assistance from $1,938 to $2,996 for clients with commercial, employer-based, and Medicare plans; and the creation of an open formulary.
Tyler TerMeer, a gay man who is HIV-positive and CEO of the San Francisco AIDS Foundation, touted a "statutory commitment that loaned ADAP funds will be returned to the special fund when or if they are needed to maintain or expand services."
"This critical funding will ensure that individuals living with and at risk for HIV will continue to have access to life-saving medications and essential treatments, particularly those in our communities who may face the greatest barriers to care," he continued.
Laura Thomas, senior director of HIV and harm reduction policy at the foundation, thanked lawmakers.
"EtE is grateful to both the California State Legislature and the California Legislative LGBTQ+ Caucus for championing the EtE budget proposals in a very difficult fiscal environment," Thomas stated in the release. "We are also incredibly proud of our coalition for uplifting our stories throughout the budget process to convey to the legislature that the spread of HIV, STI, viral hepatitis, and overdose syndemic will only slow when the state adequately funds critical services focused on people facing the most barriers to quality prevention, care, and treatment."
Gay state Senator Scott Wiener (D-San Francisco) told the Bay Area Reporter that "it's a great result for the community."
"We worked hard in the budget to protect and bolster funding for people living with HIV and people at risk," stated Wiener, who chaired his chamber's budget committee this session.
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