Original Air Date: Oct. 21, 2004

Why does North Carolina's program to provide lifesaving medications to poor people with HIV have the toughest qualification guideline in the country? Why have bills to change this and allow more people into the program stalled in the legislature?

Medications for people who are HIV-positive can cost $13,000 to $25,000 a year. The AIDS Drug Assistance Program (ADAP) provides those medications to people who cannot afford them.

While North Carolina contributes more money to ADAP than most states, its guideline to qualify is the toughest in the country, requiring that a person’s income not exceed 125 percent of the Federal Poverty Guideline, or $11,600. The national average is 300 percent or $28,000. Some people with HIV who work but have no health insurance quit their jobs in order to qualify for ADAP and get the medications they need to survive.

Bills to increase the cap to allow more people into the program have stalled in the legislature. Some say the extra cost is the reason. Others blame discrimination against homosexuals, drug users and even minorities. But is it price or prejudice?

WRAL News Anchor David Crabtree hosts this edition of Focal Point, which examines the controversy from all sides and profiles two people who are HIV-positive, one who is on the ADAP program and one who is fighting to improve it.

Watch the Documentary

The Faces of AIDS (Part 1): If you think being infected with HIV is tough, imagine not being able to pay for the medications needed to keep you alive. Public health officials say providing HIV medications to poor people not only keeps them healthy, but reduces the risk for the rest of us.

The Medications (Part 2): There is an interesting paradox in North Carolina. We have one of the highest HIV infection rates in the country. We are also home to many of the companies that make HIV medications -- medications that are the only hope for treatment. If you are poor, there is no guarantee you are going to get them.

The Legislature (Part 3): State health officials say almost 26,000 people are infected with HIV in North Carolina. Some are on the waiting list for the AIDS Drug Assistance Program. Many more do not qualify because they make more than $11,600 a year -- but still cannot afford the medications that cost more than twice that amount.

What's Next? (Part 4): More federal money is on the way that should eliminate the rest of North Carolina's waiting list for the AIDS Drug Assistance Program. However, the income cap to become eligible for the program will continue to be a roadblock for those people needing lifesaving medications. AIDS activists, healthcare workers and many lawmakers believe this is a public health problem that needs to be resolved. And they say the issue of lifestyle choice has nothing to do with this debate.

Online Resources:

• HIV/AIDS Timeline
• FDA Timeline/Chronology of Significant Events
• North Carolina HIV/STD Prevention and Care
• Alliance of AIDS Services -- North Carolina
• Know HIV/AIDS