Abstract
Objectives. To evaluate trends in AIDS Drug Assistance Program (ADAP) utilization among demographic subpopulations. Methods. For 2008 to 2021, we collected US state-level data regarding ADAP client utilization and estimated HIV prevalence data. We used descriptive statistics to describe state ADAP utilization by geography, demographics (age, sex, race), and programmatic characteristics. Results. ADAP utilization proportion increased from 14.0% of all people with HIV (PWH) in 2008 to 22.3% in 2021. The proportion of female PWH supported by ADAP was lower in both 2008 (12.2%) and 2021 (18.3%) compared with the proportion of male PWH supported (2008: 14.5%; 2021: 22.9%). In 2008, the utilization proportion was lower for Black PWH at 11.7% compared with 16.0% for White PWH. In 2021, the utilization proportion for Black PWH was 25.2% compared with 28.4% for White PWH. Conclusions. ADAP enrollment and utilization have increased substantially. Despite equity gains, Black PWH and women were served at lower proportions by ADAP. Public Health Implications. National and state partners of ADAPs should examine ways to ensure that ADAP utilization is equitable in terms of age, sex, race/ethnicity, and other sociodemographic factors. (Am J Public Health. 2025;115(8):1288-1298. https://doi.org/10.2105/AJPH.2025.308101).