In a proposed commonwealth budget that allocates over $3.4 billion for road projects, a small request of $3.5 million to fund the Kentucky AIDS Drug Assistance Program (KADAP) has been ignored, leaving hundreds living with HIV/AIDS facing difficult choices.

The cost for HIV/AIDS medication averages around $1,200/month--more than the entire monthly income of most families enrolled in KADAP.

"We've heard stories from people seeking out second mortgages to pay for their meds," say Kentucky Equality Federation President Jordan Palmer and Kentucky HIV/AIDS Advocacy Action Group (KHAAG) President Bobby Edelen. "One person who approached us said, 'with the uncertainty of receiving assistance I am thinking about selling off my life insurance policy' to afford life-sustaining medications. We're back to the 80s."

The nearly 1300 patients enrolled in KADAP, which is currently unfunded, receive medications through a hodge-podge of resources that are temporary and unsustainable. In the meantime, Kentucky has the longest waiting list in the nation for drug assistance--numbering over 160 men and women--with more being added every day.

"When do we come off the waiting list?" asked one HIV/AIDS patient, "When we die?"

People with HIV/AIDS who do not have access to medications are at increased risk for opportunistic infections, more frequent hospitalization (often under indigent status), and early death. In contrast, a person who is taking HIV medications as prescribed and taking care of their health can reasonably expect to live as long as someone without HIV.

"Not funding the Kentucky AIDS Drug Assistance Program is inhumane, shortsighted, and threatens individual and public health," states Palmer, who met with lawmakers six times during the legislative session trying to get KADAP restored.

Palmer held several meetings with Representative Tom Burch, Chairman of the House Health and Welfare Committee, DeeAnn Mansfield, Staff Administrator, House Health and Welfare Committee for the Legislative Research Commission, and Representative Jimmie Lee, Chairman of the House Budget Subcommittee on Human Resources.

On February 17, Edelen met with House Representatives to discuss the state of KADAP and other factors causing health care disparities in those living with HIV/AIDS.

"Chairman Tom Burch, a champion for the cause of health equity, asked some very astute questions," noted Edelen." In those questions, he demonstrated his support for re-funding KADAP and willingness to work on some measures to eradicate the waiting list. However, the House Appropriation and Revenue Committee did not seem willing."

As the commonwealth's budget makes its way through the Senate, time is running out for those who depend on KADAP for their medication.

The following is excerpted from a statement of opinion issued by the Board of Directors of AIDS Volunteers of Lexington (AVOL):

"Given the larger financial crisis facing the Commonwealth, this may seem a specific and 'special interest' concern. The impact, however, is far reaching. Individuals with HIV/AIDS are mothers and fathers, family providers, valued employees, consumers, and citizens. Lack of access to medication will result in more work missed, a greater strain on social service organizations as families are forced into poverty and homelessness, a burden on medical facilities who must write off astronomically expensive HIV/AIDS hospital care to indigent and low income people, plus further disenfranchisement of those Kentuckians already at highest risk. Inasmuch as the commonwealth is feeling the challenges of the current economic climate, low-income individuals and families living with HIV/AIDS are losing jobs, struggling to make ends meet, and deciding whether to use their meager incomes to buy life-sustaining drugs or to pay rent and buy food for their families.

AVOL sees an urgent need for action to restore KADAP. This effective program of preventative care is in the best long-term interest of the Commonwealth as well as those living with HIV/AIDS. Given the potential adverse effects and medical impact, time is of the essence."

HIV/AIDS has the most devastating impact on Kentucky's most at-risk communities, who already face significant barriers in accessing health care. KADAP is literally a lifeline for these men and women.

Minority populations are disproportionately at risk for HIV/AIDS. According to statistics from the HIV/AIDS Branch of the Kentucky Cabinet for Health and Family Services, African-Americans in Kentucky make 7.6% of the commonwealth's total population but account for 36% of all new HIV infections. Similarly, Latino Kentuckians make up 2.4% of the population but account for 7% of new HIV infections.

AIDS organizations across the Commonwealth are expressing alarm and dismay that the budget will be passed that does not include funding for the Kentucky AIDS Drug Assistance Program. Small non-profits do not have the resources to provide a safety net for the commonwealth's shortfall in funding.