Bulletin of Experimental Treatments for AIDS, No. 30; September, 1996
Ronald Baker, PhD

Test Results Guide Decisions About Therapy and Clinical Research

Armed with this invaluable knowledge, patients and their physicians can make rational, informed decisions about starting, switching or adding therapy. It has become clear that decreases in HIV viral load due to drug treatment correlate with decreased disease progression. Conversely, increases in HIV viral load correlate with increased risk for disease progression and suggest drug failure. In AIDS clinical trials, researchers employ HIV viral load testing to evaluate the effectiveness of the drug regimen(s) under study. FDA approved the new protease inhibitor drugs based almost exclusively on their ability to significantly reduce HIV viral load in patients using the drugs!

Viral Load Testing Is Standard of Care

Almost everyone agrees that these tests are now an integral component of the standard of care for HIV disease. Individuals denied access to these tests are receiving substandard care. Most private insurers, Health Maintenance Organizations (HMO) and Medicaid will reimburse for or provide viral load testing. That's the good news. Unfortunately, thousands of HIV positive individuals are underinsured or uninsured, do not belong to an HMO or are not covered by Medicaid. These individuals urgently require access to HIV viral load testing through some sort of patient assistance program. In San Francisco and in New York City, such individuals may take advantage of established programs that provide them access to the tests. But in many other areas of the country, no such programs exist.

Who Is Responsible for Providing Access to the Tests?

The San Francisco AIDS Foundation believes that it is the joint responsibility of federal, state and city governments, the test manufacturers and the manufacturers of anti-HIV drugs to create mechanisms for uninsured and underinsured individuals to access HIV viral load testing. It is unacceptable that any of these parties should refuse to contribute financial and other resources to ensure access for disadvantaged patients.

A working group comprised of people with HIV/AIDS and representatives of community-based AIDS organizations is continuing to meet with representatives of 3 test manufacturers and 10 drug manufacturers to find an at least temporary solution to this pressing problem. The Foundation calls on all parties to continue to work in good faith to quickly establish compassionate access to HIV viral load testing to all HIV positive individuals who need it.

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Copyright © 1996 - San Francisco AIDS Foundation. Reproduced by permission. Reproduction of this article (other than one copy for personal reference) must be cleared through BETA: PO Box 426182, San Francisco, CA 94142-6182. Tel: 415 487 8060 Fax: 415 487 8069 URL: http://www.sfaf.org/beta E-mail: beta@sfaf.org

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