ArticlePloS one2023
AIDS Drug Assistance Program disenrollment is associated with loss of viral suppression beyond differences in homelessness, mental health, and substance use disorders: An evaluation in Washington state 2017-2019.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Free antiretrovirals as a key tool against the HIV pandemic: A systematic review.HIV medicine · 2025Pooled it
- What Tools Do We Have to End the US HIV Epidemic? A Review of Structural, Biomedical and Implementation Interventions and Their Potential Population Impact.Journal of the International AIDS Society · 2026Review
- State AIDS Drug Assistance Programs' Contribution to the US Viral Suppression, 2015-2022.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Projected Increase in HIV Incidence in 11 States if Ryan White Ends: A Simulation Study.American journal of public health · 2026Article
- Homelessness and HIV Treatment Among Men Who Have Sex With Men Across US Funding Contexts.JAMA network open · 2026Article
- Trends in AIDS Drug Assistance Program Support for People With HIV, by Age, Sex, Race, and US Region, 2008‒2021.American journal of public health · 2025Article
- Cost Analysis of Implementing a 12-Month Recertification Criterion for Ryan White HIV/AIDS Program's AIDS Drug Assistance Program in Washington State.Public health reports (Washington, D.C. : 1974)Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
AIDS Drug Assistance Programs (ADAPs) are state-administered programs that pay for medical care for people living with HIV in the US. Maintaining enrollment in the programs is challenging, and a large proportion of clients in Washington state (WA) fail to recertify and are disenrolled. In this study we sought to quantify the impact of disenrollment from ADAPs on viral suppression. We conducted a retrospective cohort study of the 5238 clients in WA ADAP from 2017 to 2019 and estimated the risk difference (RD) of viral suppression before and after disenrollment. We performed a quantitative bias analysis (QBA) to assess the effect of unmeasured confounders, as the factors that contribute to disenrollment and medication discontinuation may overlap. Of the 1336 ADAP clients who disenrolled ≥1 time, 83% were virally suppressed before disenrollment versus 69% after (RD 12%, 95%CI 9-15%). The RD was highest among clients with dual Medicaid-Medicare insurance (RD 22%, 95%CI 9-35%) and lowest among privately insured individuals (RD 8%, 95%CI 5-12%). The results of the QBA suggest that unmeasured confounders do not negate the overall RD. The ADAP recertification procedures negatively impact the care of clients who struggle to stay in the program; alternative procedures may reduce this impact.
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Registered trials
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