2025 Annual Report

Introduction

NASTAD’s National Ryan White HIV/AIDS Program (RWHAP) Part B AIDS Drug Assistance Program (ADAP) Monitoring Project, including its Annual Report, documents key trends, challenges, and successes faced by public health programs ensuring access to life-saving treatment and services for people living with HIV/AIDS (PLWHA) nationally. In the 28^th year of its history, this 2025 edition of the Annual Report features comprehensive, longitudinal data spanning several domains of state and territorial ADAPs, including budget, expenditures, utilization, and client demographics. 

As in the iteration published in 2024, the National RWHAP Part B ADAP Monitoring Survey and the resulting Annual Report reflect a relatively abbreviated snapshot of fiscal year 2023 (FY2023) and calendar year 2023 (CY2023), highlighting those data points that are most dynamic year-to-year, including budgets and expenditures, as well as client utilization and HIV virologic suppression.  

State and territorial ADAPs provide an important safety net for PLWHA who are under- or uninsured and are critical players in achieving the goals of the ending-the-HIV-epidemic (ETE) and National HIV/AIDS Strategy (NHAS) initiatives. Changes to the broader health care and payer landscape could significantly affect ADAPs and their contributions to ETE efforts, including the federal Ending the HIV Epidemic: A Plan for America.  

Unless otherwise noted, findings highlighted in this report are based on FY2023 and CY2023 data received from 47 states, the District of Columbia, and one U.S. territory (Puerto Rico). No fiscal or programmatic data were received from Alabama, Montana, West Virginia, the U.S. Virgin Islands, or the Pacific Island Jurisdictions. Limited programmatic data were received from Alaska and South Dakota.