Bozeman-based therapist D. Gregory Smith says the HIV-positive clients he counsels across western Montana are afraid that they won't be able to afford the medications they need to stay alive. "It's a pretty desperate place to be," says Smith, who is also HIV positive. "That's quite a lot of stress."
Montanans who can't afford HIV drugs have recourse. The federally funded AIDS Drug Assistance Program provides medicine at no cost. What worries Smith and his clients is the fact that the program isn't meeting demand. In January, 4,200 people nationally were waiting for entry into ADAP. At the end of August, that number grew to 9,200. ADAP now provides drugs to 107 of Montana's 532 known HIV-positive patients, according to the state Department of Public Health and Human Services. In Montana, 28 people now await ADAP assistance. That's up from 21 last year.
Judy Nielsen, the state's HIV program coordinator, attributes the increasing demand to a "perfect storm" of more aggressive HIV testing and a tough economy in which more people are unable to pay for drugs that cost upward of $1,500 per month.
Nielsen says HIV-positive Montanans are not going without medicine, largely because state officials and health care workers solicit help from pharmaceutical companies. "Nobody's going to die on my watch," she says.
Despite Nielsen's pledge, Smith and his clients are worried. He warns that HIV-positive people could be forced to go off of their medications if the federal government doesn't increase program funding. And if they do, the virus becomes more infectious. "Treatment is prevention," Smith says.
Smith is working with Project Inform, a national HIV advocacy group, to lobby Congress to increase funding. Montanans are well equipped to ask for additional support, Smith says, because the state's congressman, Rep. Denny Rehberg, is the chairman of a congressional appropriations subcommittee that wields significant sway over ADAP funding. Project Inform is now circulating an online petition asking Rehberg to find an additional $106 million to pay for HIV drugs nationwide.
"We're just hoping that he will realize that people in Montana are affected by this issue," Smith says. "The disease is in every single county in the state of Montana."