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March 27, 2026Clinical Infectious Diseases2 citationsOpen Access

State AIDS Drug Assistance Programs’ Contribution to the US Viral Suppression, 2015–2022

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KMKathleen A McManusAKAmy KilleleaERErin Rogers

Key Points

  • To assess the contribution of State AIDS Drug Assistance Programs (ADAPs) to viral suppression among people with HIV from 2015 to 2022.
  • Analyzed viral load test results and viral suppression data from publicly available jurisdiction-level reports.
  • Calculated proportions of viral suppression for both ADAP clients and all individuals with HIV.
  • Performed descriptive statistics over the dataset from 2015 to 2022.
  • The average viral suppression rate for PWH ranged from 60% to 66.3% annually.
  • ADAP clients showed a higher viral suppression rate of 81.2% to 91.4%.
  • ADAP clients comprised only about 23.1% of PWH, yet accounted for roughly 30.8% of total viral suppression.

Abstract

Abstract Background State AIDS Drug Assistance Programs (ADAPs) provide human immunodeficiency virus (HIV) medication access for people with HIV (PWH) with low incomes in the United States. We quantified the proportion of viral suppression (VS) that is from ADAP clients for 2015–2022. Methods For 2015–2022, we obtained viral load (VL) test results and VS data from publicly available, jurisdiction-level data on ADAP clients and PWH. We report descriptive statistics including the proportion of PWH with a VL who had VS and were supported by ADAPs. Results After excluding jurisdictions with missing data, PWH who were included in the analysis for each year was 63.7%–96.4%. Viral suppression for PWH each year was 60%–66.3%. Viral suppression for ADAP clients was 81.2%–91.4%. In all years, compared to all PWH, a lower proportion of ADAP clients had a reported VL and a higher proportion had VS. Over 2015–2022, the average proportion of PWH who were ADAP clients was 23.1%, the proportion of PWH with VLs who were ADAP clients was 22.2%, and the proportion of PWH with VS who were ADAP clients was 30.8%. Conclusions Almost a third of the entire VS rate was from ADAP clients, despite ADAP serving less than 25% of PWH. A much higher proportion of ADAP clients achieved VS, compared to PWH. AIDS Drug Assistance Programs’ impact is not due to ADAP clients being over represented among PWH with reported VLs. AIDS Drug Assistance Program does not directly receive any federal Ending the HIV Epidemic (EHE) Initiative funding. Policymakers should examine how ADAPs can support the EHE Initiative.

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Cite This Study

McManus et al. (2026) studied this question.

synapsesocial.com/papers/69c61ff615a0a509bde184f9https://doi.org/10.1093/cid/ciag034
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