ADAP Shortfall Relief - Description of Proposed Project: Wisconsin’s HIV Care Unit in the Bloodborne and Sexually Transmitted Infections Section (BSTI), Division of Public Health, Department of Health Services, will use $6,7500,000 in ADS Drug Assistance Program (ADAP) Emergency Relief Funds (ERF) to address a projected increase in treatment needs due to increases in medication costs and in numbers of clients using Wisconsin’s HIV Drug Assistance Program (HDAP) and to address a reduction in available resources to fund HDAP due to delayed pharmaceutical rebate payments. In September 2025, 1,447 people living with HIV received Wisconsin HDAP services. ADAP ERF funds will augment HDAP services by directly paying for medications for the record number of clients using Wisconsin’s HDAP for medication assistance and ensure continued access to HDAP without waiting lists, enrollment caps, or reductions in the HDAP formulary. Wisconsin anticipates using ADAP ERF to provide medications to 265 clients and health insurance coverage for 230 clients in program year 2026. As the number of clients enrolled in the HDAP is expected to increase to over 1,800 clients by the end of program year 2026, the ADAP ERF award will help ensure continued ADAP services without waitlists or enrollment caps. Demographics of Populations Living with HIV in Wisconsin: In calendar year 2024, 278 people in Wisconsin were diagnosed with HIV. In addition, 297 people previously diagnosed with HIV moved to Wisconsin. These numbers bring the total number of people known to be living with HIV in Wisconsin to 7,678 at the end of 2024, with an estimated additional 1,127 people who are living with HIV and have not yet been diagnosed. Wisconsin’s 2024 HIV diagnosis incidence rate was 4.7 per 100,000 people, an increase of 27% from the 2019 rate of 3.7 diagnoses. Description of State ADAP and Key Environmental Factors Impacting the Program: Wisconsin’s HDAP provides medication and insurance assistance for people living with HIV who reside in Wisconsin and have household income at or below 300% of the federal poverty level. For clients without health insurance, HDAP will pay the full cost of medications on the HDAP formulary, which includes antiretroviral (ARV) medications and limited categories of other medications. For clients with health insurance, HDAP will pay insurance premiums associated with group and individual health insurance plans that include prescription drug coverage as well as deductibles, co-insurance, and co-payments for HDAP formulary medications. In calendar year 2024, Wisconsin’s HDAP served 2,081 clients during at least part of the year. 89% of clients were virally suppressed. HDAP enrollment is currently increasing, with particularly high numbers of people without health insurance applying for the program. HDAP is also experiencing high medication costs for both insured and uninsured clients. Description of the Need for Additional Resources: By March 31, 2027, Wisconsin anticipates the number of clients using HDAP to increase by 300 clients to 1,800. In addition, medication costs for both insured and uninsured clients are expected to continue to increase. Due to these factors, Wisconsin estimates a $6.7 million shortfall for the HDAP program in program year 2026 if no additional funds are made available and will need to implement cost-cutting and cost-saving measures limiting access to the program to avoid a deficit. Description of the Planned Use of ADAP ERF: The HIV Care Unit plans to use $5,300,000 in ADAP Emergency Relief Funds to purchase 3,180 formulary prescription medications for 265 clients accessing ADAP services in program year 2026 and $1,450,000 to purchase 2,760 months of health insurance coverage for 230 clients.
