AIDS Drug Assistance Program Transformation (ADAP-T)
Problem
As HIV care evolves, ADAPs must adapt operations to keep clients from losing consistent access to care.
AIDS Drug Assistance Programs (ADAPs) ensure that low‑income people with HIV can access essential, life-saving medications. As HIV care rapidly changes—with new insurance pathways, rapid‑start treatment expectations, long-acting therapies, and the Ryan White Program 2030 framework—ADAPs must refine their systems and operations to meet rising client needs. Jurisdictions face challenges in enrollment, insurance stability, medication distribution, and data-driven program management, especially as more people with HIV enter or re-enter care.
Although ADAP clients often experience improved health outcomes compared to national averages, maintaining consistent coverage is becoming more challenging amid these shifting policy and fiscal pressures. There is an increasingly urgent need for evidence-based insights and models that help ADAPs optimize resources, reduce barriers, and support improved client outcomes.
Solution
NORC is evaluating ADAP operations and developing tools to enhance efficiency and improve medication access.
NORC is supporting the Health Resources and Services Administration’s (HRSA’s) HIV/AIDS Bureau (HAB) to identify strategies that help ADAPs optimize resource utilization, streamline client enrollment, and strengthen continuity of HIV care. The project includes a national ADAP survey, in-depth qualitative interviews with selected jurisdictions, and the development of best-practice models and capacity‑building tools. Using a mixed-methods implementation science framework, NORC is assessing key areas such as insurance stability, medication access, enrollment processes, client engagement barriers, and program income management.
NORC is collaborating with the National Association of State and Territorial AIDS Directors (NASTAD) to ensure alignment with national priorities and to integrate findings into existing technical assistance systems.
Result
Results will equip ADAPs with evidence‑based tools to improve access and health outcomes.
This project will provide HRSA HAB and ADAPs across the country with a synthesis of best practices, challenges, and opportunities to strengthen program performance. NORC’s findings will inform the development of tools that support improved enrollment processes, more stable insurance coverage, better forecasting of client demand, and enhanced engagement for individuals entering or re‑entering HIV care. These tools aim to improve medication access, prevent treatment lapses, and support higher viral suppression rates nationally.
Deliverables from the project will include an ADAP Optimization Tool, an advanced tool mock-up to support scenario planning, easy-to-use fact sheets and case studies, and a national webinar. Insights will provide ADAPs with evidence-based resources that they can apply to improve health systems, close gaps in medication access across client populations, and prepare for emerging HIV treatment innovations.
Related Tags
Project Leads
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Rich Dunville
Principal Research ScientistProject Director -
Sabrina Avripas
Principal Research DirectorSurvel Lead -
Chandria Jones
Principal Research ScientistQualiitative Lead -
David Rein
Senior FellowTool Development Lead -
Alexis Marbach
Senior Research ScientistDissemination Lead
“ADAPs are a key part of this country’s approach to ending the HIV epidemic. We’re helping states modernize their programs so people with HIV do not experience gaps in lifesaving care.”
