•General State Demographics: According to July, 2021 United States (U.S.) Census Bureau estimates, California’s population is 39,237,836, accounting for approximately 12% of the U.S. population. At last estimate, California's population was 71.1% white (35.2% Non-Hispanic white), 40.2% Hispanic or Latino, 15.9% Asian, 6.5% Black/ African American, 1.7% American Indian/Alaskan Native, 0.5% Native Hawaiian/other Pacific Islander, and 4.2% from two or more races. Demographic breakdown by age is as follows: 5.7% persons under 5 years, 22.4% under 18 years, 56.7% between 18-64 years, and 15.2% 65 years and over. •Demographics of the populations with HIV in the State: In 2020, an estimated 159,000 Californians were living with HIV, with 139,703 of them aware of their diagnosis as reported to the California Office of AIDS (OA), a 2% increase from the previous year. Of the people living with HIV (PLWH) in California, approximately 38.5% are Latinx; 36.3% are white; 16.9% are Black/African American; 4.3% are Asian; 3.5% are multi-racial; 0.2% percent are American Indian/Alaskan Native; and 0.2% are Native Hawaiian/Pacific Islander. While Latinx and whites make up the largest percentage of PLWDH in California, the rate of HIV among Blacks/African Americans is substantially higher (984.5 per 100,000 population, versus 347.8 per 100,000 among whites and 334.9 per 100,000 among Latinx). The highest percentage of cases is among cisgender men (86.7%) followed by cisgender women (11.7%) and trans women (1.5%). •Brief description of the State ADAP and key environmental factors impacting the program: California ADAP was established in 1987 to ensure HIV-positive, low income individuals have access to life-saving medications. The program pays for medication co-pays and deductibles for clients who have health insurance, or the full cost of the medications for uninsured clients. Additionally, through its subprograms, California ADAP assists with paying clients’
health insurance premiums and costs related to HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). California ADAP is impacted in part by broad differences in ADAP-related needs, population levels, and resource availability within its 52 counties; according to the May 2022 California Department of Finance estimate, the State’s largest county is Los Angeles with 9,861,224 people, and the smallest is Alpine at 1,146. In 2020, ten local health jurisdictions reported at least 3,500 persons living with HIV: Los Angeles (53,077), San Diego (13,935), San Francisco (12,187), Riverside (10,199), Orange (7,457), Alameda (6,290), San Bernardino (5,056) Sacramento (4,668), Long Beach City (4,395), and Santa Clara (3,716). Eight of these counties are also identified in Ending the HIV Epidemic: A Plan for America as being among the 48 counties with the highest burden in the nation. •Description of the need for additional resources to prevent an ADAP waiting list: The number of PLWH in the state is expected to grow by two to three percent each year for the foreseeable future until more progress is made in preventing new HIV infections. This increase is attributed to stable incidence rates and longer survival rates, primarily due to the effectiveness and availability of treatment. Without medications provided by ADAP, thousands of HIV-positive Californians would face rapidly deteriorating health and higher rates of HIV transmission. •Description of planned use of ADAP ERF, if received: California ADAP plans to use the 2023 RWHAP ADAP ERF to prevent an ADAP waiting list by using the funds to support medication expenditures.