HIV TREATMENT IN USA – HIV infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells. HIV infection leads to low levels of CD4+ T cells through a number of mechanisms, including pyroptosis of abortively infected T cells, apoptosis of uninfected bystander cells, direct viral killing of infected cells, and killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections.

HIV TREATMENT IN USA : Fortunately, access to HIV treatment in the US is generally very good, through a patchwork of private and public insurance programs as well as government and pharmaceutical industry assistance programs.

HIV TREATMENT IN USA :Most HIV pharmaceutical companies offer quite large patient assistance programs (upwards of several thousand USD per year) that cover copayment or coinsurance out of pocket costs, or for uninsured individuals, free medications. While helpful for individuals, it’s my opinion that such patient assistance programs blunts recognition and opposition of the high retail cost of medications.

For low income individuals, the Ryan White Care Act and the AIDS Drug Assistance Program (ADAP) covers many individuals at little or no cost.

HIV TREATMENT IN USA :As for insurance programs, the cost of the insurance premium, copayment (or as this unfortunate reader might have) and coinsurance costs can vary tremendously. It’s my opinion that it’s critical that people living with HIV and their caregivers understand what the details of medication costs are with any insurance plan. Often plans with low premiums come at the expense of high copayment or coinsurance (where the individual pays a percent of the total cost of medications)- these plans should be avoided if possible.

HIV TREATMENT IN USA : Ultimately, it’s critical that all people living with HIV have access to affordable and non-stigmatizing care environments for testing, care and medications. If we can ensure that this happens, we can end the epidemic of AIDS and make new cases of HIV a rare thing. Aspirational perhaps, but many jurisdictions are accelerating their community responses to HIV testing, linkage to care, treatment access- leading to dramatic improvements in community viral suppression. There’s much work to do in the US; despite obvious differences in income and wealth, several countries, including Malawi and Botswana have higher levels of HIV treatment and viral suppression than the US. This will be the challenge for all of us in HIV care for the next years.


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