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Background: The Southeast region of the United States contains nine out of the 10 states with the most severe syndemic of poverty and HIV infection.1 The Florida AIDS Drug Assistance Program (FL-ADAP) and Ryan White network are crucial for linkage to care services. Data from FL-ADAP are available but seldom published; thus this study quantifies this program’s impact on Florida PLWH access and linkage to care.

Methods: Data were obtained from the Florida Cohort, an ongoing cross-sectional survey among health clinics across the State of Florida from 2015 to 2018. Chi-square and binomial multivariate logistic regression analyses correlated anti-retroviral therapy (ART) access and linkage to care stratified by insurance status (ADAP vs. non-ADAP), demographics, and sexual orientation

Results: Of the total 934 PLWH, n = 418 (44.8%) self-reported ADAP participation. Of these, 68.4% were male, 79.7% were non-Hispanic, and 55.5% were African American. FL ADAP participants did not significantly differ by race, ethnicity, marital or education status, transportation barriers, nor the actual number of missed appointments. However, ADAP participants were slightly more likely to have same-sex relationships [OR 1.41 (CI 1.02 to 1.96)] or to be bisexual [OR 2.05 (1.21 to 3.47)]. ADAP enrollees reported greater adherence to antiretroviral therapy (ART) (94.2% vs. 87.1%; P < 0.001) and to have a case manager (83.8% vs. 75.4%; P = 0.008). Likewise, PLWH with a case manager were more likely to have ADAP [OR 2.04; (CI 1.32 to 3.17)]. However, ADAP enrollees were more likely to report barriers to care for a missed appointment (28.9% vs. 22.2%; P = 0.02).

Conclusion: The Florida ADAP program is successful in providing ART access, facilitating linkage to care, and improving adherence through embedded case management services. However, more resources are needed to improve ART and medical appointment adherence as well as to decrease socioeconomic barriers to care.

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Open Forum Infectious Diseases, v. 6, issue Supplement_2, p. S475-S476