A qualitative study of underutilization of the aids drug assistance program

Kristin M. Olson, Noah C. Godwin, Sara Anne Wilkins, Michael J. Mugavero, Linda D. Moneyham, Larry Z. Slater, James L. Raper

Research output: Contribution to journalArticlepeer-review


In our previous work, we demonstrated underutilization of the AIDS Drug Assistance Program (ADAP) at an HIV clinic in Alabama. In order to understand barriers and facilitators to utilization of ADAP, we conducted focus groups of ADAP enrollees. Focus groups were stratified by sex, race, and historical medication possession ratio as a measure of program utilization. We grouped factors according to the social-ecological model. We found that multiple levels of influence, including patient and clinic-related factors, influenced utilization of antiretroviral medications. Patients introduced issues that illustrated high-priority needs for ADAP policy and implementation, suggesting that in order to improve ADAP utilization, the following issues must be addressed: patient transportation, ADAP medication refill schedules and procedures, mailing of medications, and the ADAP recertification process. These findings can inform a strategy of approaches to improve ADAP utilization, which may have widespread implications for ADAP programs across the United States.

Original languageEnglish (US)
Pages (from-to)392-404
Number of pages13
JournalJournal of the Association of Nurses in AIDS Care
Issue number5
StatePublished - Sep 2014


  • AIDS Drug Assistance Program
  • Policy
  • Qualitative
  • Social-ecological model
  • Utilization

ASJC Scopus subject areas

  • Advanced and Specialized Nursing


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