340B Rebate Pilot Debuts [take two], Aligning Payments with Patient Needs

By: Marcus J. Hopkins, Health Policy Lead Consultant, ADAP Advocacy

On July 31st, 2026, 340B reform denialists opposing efforts to modernize the 340B Drug Pricing Program were served a reality check: reform is coming. Why? The Health Resources and Services Administration (HRSA) announced its revised 340B Rebate Model Pilot Program, providing qualifying pharmaceutical manufacturers with “…a voluntary pathway to provide the 340B ceiling price to covered entities through rebates, rather than upfront discounts” (HRSA, 2026). Proponents of reforming the decades-old program might say, HRSA dropped the proverbial mic.

This pilot model, which represents HRSA’s second attempt, is still significantly limited in scope, covering only the following drugs:

The drugs listed above were selected because they are part of the Medicare Drug Price Negotiation Program (MDPNP), and the rebate pilot requires manufacturers to allow 340B covered entities (CEs) to order the selected drugs under existing distribution mechanisms (e.g., 340B wholesaler accounts with Wholesale Acquisition Cost (WAC) prices loaded).

In the Federal Register notice published about this revised pilot, HRSA took great care to highlight the concerns submitted during the public comment period, of which they received 2,475 comments, including:

• Concerns across covered entity types (e.g., hospitals, Federally Qualified Health Centers, Community Health Centers, et cetera) that a rebate model could increase financial and administrative burdens, with rural providers highlighting cash flow and liquidity concerns, larger hospital systems highlighting operational complexity, and community-based and safety-net providers highlighting patient access concerns;
  
  
• General support for a rebate model among manufacturers, technology vendors, some employer and purchaser coalitions, several patient advocacy groups, and other stakeholders, emphasizing improved transparency, program integrity, and avoidance of duplicative discounts;

Photo Source: ADAP Advocacy

HRSA’s assessments determined that:

• HRSA does not agree that exclusive reliance on an upfront discount model is reasonable or that such reliance forecloses consideration of alternative statutory mechanisms. The 340B statute expressly recognizes the authority to provide the 340B ceiling price via “rebate or discount,” which provides the Secretary, through HRSA, discretion in how best to operationalize the statutory pricing requirement.

• HRSA recognizes the importance of ensuring program integrity and enabling manufacturers to prevent duplicate price concessions across all applicable pricing programs. HRSA believes that a rebate-based approach, authorized by the 340B statute and including the use of standardized claims-level data, will improve the identification and prevention of duplicate discounts.

• HRSA finds that many projections of administrative burden rest on assumptions that do not align with the Pilot's design or accurately reflect the administrative requirements of implementing a rebate approach. The Pilot is structured to enable covered entities, manufacturers, and vendors to operationalize processes and identify implementation challenges on a limited, manageable scale. Given the Pilot’s limited scope and reliance on existing data infrastructure and operational processes, HRSA anticipates that any staffing impacts will generally be modest.

• HRSA recognizes that implementation of a rebate model may require coordination with IT platforms to support the submission and validation of claims data. As an initial matter, the costs of the rebate IT platform must be paid by manufacturers. That is a requirement of participation in this Pilot. HRSA anticipates that these platforms will leverage existing data flows and automation capabilities, thereby minimizing the need for covered entities to develop new systems.

• With respect to other anticipated costs, including vendor fees and training, HRSA notes that participation in the 340B Program has always entailed some level of compliance and operational cost. Covered entities derive significant financial benefit from participation in the Program. Covered entities are expected to maintain compliance as program requirements evolve. As part of its ongoing oversight, HRSA conducts audits and compliance reviews, and provides education and guidance to covered entities based on those efforts. Covered entities routinely update policies, procedures, IT systems, and operational practices to align with program requirements and guidance, and there may be operational costs associated with program participation and ensuring compliance. Overall, HRSA concludes that while a rebate model may introduce incremental or transitional administrative and operational changes, HRSA believes the magnitude of the associated costs is likely to remain low.

• HRSA believes the Pilot is unlikely to result in unstable cash flow for covered entities, contrary to certain commenters’ predictions. HRSA has incorporated several design elements intended to mitigate potential cash-flow impacts on covered entities. First, the Pilot requires prompt rebate payments, within 10 calendar days of submission of a complete claim. This accelerated payment timeline is intended to precede the payment deadlines associated with standard wholesaler payment terms, thereby reducing or eliminating the need for covered entities to “float” the WAC price or finance drug purchases for extended periods.

• In response to commenter concerns regarding rebate denials and dispute resolution, HRSA includes design features within the Pilot to promote transparency, consistency, and accountability in rebate determinations. Specifically, the Pilot requires manufacturers to document and report denied claims, including the basis for each denial and the status of any associated dispute. HRSA intends to use this information to monitor denial patterns and assess whether rebate determinations are applied consistently and appropriately across participating manufacturers and will remove manufacturers from the Pilot where appropriate. In addition, the Pilot will provide a defined pathway for covered entities to challenge denied claims, including specified timeframes for review and response, to facilitate timely resolution of disputes.

• HRSA intends to limit the data collection that manufacturers may impose on covered entities under the Pilot to the minimum necessary to effectuate rebate payments and to support 340B program integrity and nonduplication under the MDPNP. HRSA believes that limiting the required data collection to a narrowly defined set of standardized pharmacy and medical claims data elements substantially reduces the potential burden compared with broader reporting models considered during the development of the Pilot. In response to stakeholder feedback, HRSA declined at this juncture to require additional data elements proposed by manufacturers, including purchasing data, encounter data, invoice-level information, and patient-level clinical information, because HRSA determined that collecting and reconciling such information could create additional operational complexity and systems burden for covered entities acclimating to a new rebate environment.

• As an initial matter, HRSA notes that the data elements required under the Pilot, as set forth in Section VIII.D of this Notice, are limited to standardized pharmacy and medical claims fields such as date of service, NDC-11, quantity dispensed, prescriber ID, service provider ID, 340B ID, RX BIN, RX PCN, and health plan identification information. These data elements do not include direct patient identifiers such as patient names, addresses, dates of birth, Social Security numbers, medical record numbers, or other information that would directly identify individual patients.

• HRSA will require participating manufacturers to submit purchase data reports to the agency. HRSA will continue to assess reporting burden and implementation experience and may refine requirements as appropriate to balance program integrity objectives with administrative feasibility. HRSA agrees that collecting Pilot data is important for evaluating adherence to the rebate framework and the impact of the Pilot. HRSA also agrees that providing aggregate data, which will not contain confidential or proprietary information, to the public is important to provide further transparency into the 340B Program.

• Congress created the 340B Program so covered entities could “stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.” H.R. Rep. No. 102-384(II), at 12 (1992). The Pilot does not deviate from that statutory purpose. Nor does implementation of a rebate-based model modify the statutory 340B ceiling price, covered entity eligibility requirements, or the legal framework governing patient eligibility under the 340B Program. Rather, the Pilot changes the mechanism and timing by which the 340B price is effectuated, shifting from an upfront discount to a post-dispense rebate that is expressly authorized by the 340B statute. HRSA further notes that the Pilot is structured to mitigate any potential operational or financial disruption to covered entities. HRSA anticipates the Pilot will provide program integrity benefits that ultimately support patient care and stewardship of federal resources (Notice Regarding 340B, 2026).

Ryan White Clinics for 340B Access (RWC-340B), a lobbying organization representing clinics and other HIV/AIDS service providers represented by an inside-the-beltway special interest firm with deep ties to the American Hospital Association, alleges that support for the rebate pilot is overstated, highlighting that 1,170 of the 2,351 publicly posted comments “…were substantially identical submissions tied to an astroturfing campaign intended to mimic genuine grassroots engagement” (Muolo, 2026). HRSA, in its receipt and analysis of the public comments, specifically mentioned that 1,170 comments were “…identical comments as part of a letter campaign” (Notice Regarding 340B, 2026), and took that into account before releasing the revised pilot program.

Photo Source: Realty Leadership

It is worth noting, RWC-340B’s executive committee is composed of representatives from some of the largest recipients of 340B revenues in the HIV/AIDS space, ironically enough, including some organizations whose executives are making $1,268,349…or $744,510…or $633,624…or $466,081, which represents compensation levels considered higher than most patients living with HIV believe are appropriate for an HIV service provider. For the sake of comparison, a majority of clients enrolled in the Ryan White HIV/AIDS Program (RWHAP) are low-income, with roughly 59% living at or below 100% of the Federal Poverty Level (FPL), according to a report by the Kaiser Family Foundation. For the layman reading this blog, it amounts to basically less than $16,000 annually.

Notably absent from this lobbying group's executive committee is any actual patient representation. ADAP Advocacy proudly boasts that over half of its board of directors are patients living with HIV, including 3:4 executive committee members. 

For its part, ADAP Advocacy fully supports the 340B Rebate Model Pilot because it promotes a robust 340B Program modeled after the gold standard among CE's: State AIDS Drug Assistance Programs. Many of these very programs have been actively and successfully implementing a rebate model since the practice was first authorized in 1998. And, by the way, they have been serving more clients since 2000. Arguments supporting this assertion have been clearly articulated in the first policy paper released earlier this year with Legacy Health Endowment, as well as the stand-alone policy paper subsequently released over the summer.

While the rebate model is an excellent first step, ADAP Advocacy contends that it is just that—a good first step. More reforms are desperately needed, including full transparency from every CE type regarding the total dollar amounts of 340B rebate revenues received, how those revenues are spent, and what percentage of annual revenues consists of 340B rebates. Carve-outs equate to transparency opt-outs.

Lately, Congress is awash in 340B-related legislation. Any attempt to stall implementation of holding healthcare organizations accountable for how 340B-related revenues are spent to help low-income patients under a new 340B rebate model, such as the SUSTAIN Act, should be met with caution by patients. At what point did accountability become a luxury? 

Photo Source: ADAP Advocacy

If the purpose of the 340B Program is to extend and expand access to affordable healthcare services for underserved and lower-income populations, then CEs need to be required to “show their work,” as many math teachers have demanded. Those who are opposed to such transparency rarely have patients' best interests in mind and are more than willing to threaten to limit or cease services altogether to avoid transparency requirements being imposed on them.

It’s time for that power to be broken and returned to the patients the 340B Program was intended to serve. ADAP Advocacy gladly can offer referrals! 

Disclaimer: All funders of the ADAP Advocacy Association are publicly listed on our website. 

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association; rather, they provide a neutral platform for the author to promote open, honest discussion of public health-related issues and updates.

References:

[1] Notice Regarding 340B Rebate Model Pilot Program, 91 F.R. 48883 (published August 03, 2026). https://www.federalregister.gov/documents/2026/08/03/2026-15633/notice-regarding-340b-rebate-model-pilot-program

[2] Health Resources and Services Administration. (2026, July 31). HRSA Announces Revised 340B Rebate Model Pilot Program to Strengthen Care in Rural and Medically Underserved Communities. Rockville, MD: United States Department of Health and Human Services: Health Resources and Services Administration: About HRSA: News & Events: Press Releases. https://www.hrsa.gov/about/news/press-releases/revised-340b-program-2026

[3] Muolo, D. (2026, July 31). Revised 340B Rebate Model Pilot Program moves forward, despite provider pushback. New York, NY: Fierce Healthcare: Providers. https://www.fiercehealthcare.com/providers/revised-340b-rebate-model-pilot-program-moves-forward-despite-provider-pushback

Paternalistic Ableism Voices Are A Growing Threat to Silence Patient Advocates

By:  Brandon M. Macsata, ADAP Advocacy CEO, Ranier Simons, ADAP Blog Guest Contributor, and Kalvin Pugh, ADAP Advocacy 340B Patient Advisory Committee Member

Healthcare policy is a complex issue, especially in the United States, with its fragmented system. Numerous stakeholders compete to influence the healthcare ecosystem — all with financial stakes in the game — including government agencies, pharmaceutical manufacturers, hospitals, practitioners, pharmacy benefits managers, insurance companies, pharmacies, and patients. Some of these stakeholders embrace the patient experience and encourage their involvement in the debate because they recognize that it is they, as patients, who are at the center of the healthcare ecosystem. Sadly, others have contempt for patient involvement. Their contempt leads to patients being attacked for their views, sometimes even to character assassinations, because their views align with pharmaceutical industry interests.

Photo Source: Bioethics Today

The relationship between patient advocacy and industry has and continues to evolve. For example, decades ago, at the early stages of the HIV epidemic, the relationship was adversarial. People living with HIV/AIDS (PLWHA) felt targeted and attacked by the medical establishment. Fear and stigma generated from many unknowns left PLWHA marginalized and manipulated by science and society, effectuating institutional disempowerment.

As such, the Denver Principles came to fruition. In 1983, at the Fifth Annual National Lesbian and Gay Health Conference held in Denver, Colorado, a group of people came together and drafted a manifesto (Rodriguez, 2023). The Denver Principles manifesto was a declaration of dignity and a statement reclaiming the rights to be treated humanely and non-paternalistically regarding HIV related medical treatment. Most importantly, the Denver Principles established collective PLWHA advocacy, creating a voice that the general public and medical establishment would have to listen to. 

The Denver Principles manifesto consisted of four sections: recommendations for healthcare professionals, recommendations for people with AIDS, recommendations for all people, and the rights of people with AIDS (U.S. PLHIV Caucus, n.d.). One of the poignant recommendations for health care professionals was to “Treat People with AIDS as whole people and address psychosocial issues as well as biophysical ones” (U.S. PLHIV Caucus, n.d.). One of the principles for PLWHA was to “Be included in all AIDS forums with equal credibility as other participants, to share their own experiences and knowledge” (U.S. PLHIV Caucus, n.d.). A notable right of PLWHA stated was the right “To quality medical treatment and quality social service provision without discrimination of any form, including sexual orientation, gender, diagnosis, economic status or race” (U.S. PLHIV Caucus, n.d.).

Photo Source: i-base

Although the Denver Principles were birthed through an HIV lens, the conference where they were presented contained many varied panels, including holistic medicine and alcohol and substance abuse (Rodgriguez, 2023). Many advocacy populations have used the Denver Principles as a blueprint, which is evidence of the need for patient advocacy in multiple spaces. Advocating for beneficial healthcare policy, insurance reform, disease decriminalization laws, and even medication access requires discourse with and assistance from industry. Patients need industry to effectively comprehend and act upon their needs, just as industry needs patients to survive from a business perspective, as well as to engage positively as part of the overall social compact for a healthy, functioning dynamic. One example is that the pharmaceutical industry needs to create effective medications and help ensure patients have access to the drugs because dead patients don’t take medication.

Moreover, effective financial and other resource provision partnerships with industry allow advocacy groups to fight for patients in more direct ways than industry can. Industry wants patient populations to thrive just as patients desire the infrastructure to enable them to live their best lives. When a patient's needs align with industry wants, industry financial backing does not turn patients into marketing lobbying slaves. There is no patient benefit in advocating or pushing an agenda that is not in the best interests of patient health and overall well-being. Patients are independent thinkers and are not manipulated by corporate malfeasance. Many advocacy groups that receive financial backing forthrightly communicate to their sponsors that they will never advocate for something that contradicts their beliefs, even if it may be beneficial to the corporate bottom line. 

When critics of the drug manufacturers, or even fellow advocates, attempt to denigrate the contributions of individuals or organizations that align themselves with industry partners, it is not the insult one may think. It reflects the other party's lack of imagination for what valuable collaborative partnerships can be. Other thought-leaders express an enlightened view, evidenced by extensive research done on the patient experience with industry, thereby demonstrating the mutually beneficial relationship.

Photo Source: LinkedIn | Matt Toresco

Negatively characterizing patient advocacy for “having industry ties” also demonstrates a vile attitude that patients aren’t independent-minded, well-equipped with critical thinking skills. Instead, their “gotcha” attitudes are deeply rooted in paternalistic ableism. This line of thinking, recently on display by a reporter for a faux digital “news” outlet on all things 340B-related, often leads to character assassinations of patients living with severe chronic health conditions, sometimes even life-threatening ones, for expressing their opinions. It truly matters not if these patient advocates or patient advocacy organizations accept financial sponsorships from drug manufacturers; simply agreeing with industry, in their paternalistic ableism lens, disqualifies them from expressing those opinions.

In reality, patients are educated and savvy enough to come to their own conclusions about what is best for their healthcare. Equally valid, patients come to different conclusions without being told what to think or accepting a financial sponsorship.

It may be understandable from some in the HIV space who carry with them the trauma of what happened in the 1980s, or what appears to be slow responses and delayed medication options. But today is not 1985. It is 2025, where we all face uphill uncertainty, and it’s important to reframe our thinking when the truth is that patients and industry can, and do, share common goals.

Attacking patients is paternal at best, and demeaning at worst. When entities attack patient advocacy groups with malicious intent, it is evidence that the motivations of those entities are not patient-focused. It is deliberately irresponsible when individuals or entities slander the work of effective patient advocacy groups by using feeble allegations of insignificant operational characteristics to create a narrative of impropriety. Such actions raise questions about the motivations and funding of entities engaged in this behavior.

Photo Source: ABC News - Australia

The landscape of healthcare in the United States often leaves patients feeling like helpless pawns devoured by the cogs of the machinery of a complex system. The avenues for patients to fight for themselves continue to evolve. Patient advocacy encompasses a range of efforts, from individual initiatives to partnerships and community groups. Effective advocacy requires resources such as networking connections, access to subject matter experts, education, communications, data analysis, travel, and more. These endeavors often require financial resources as well. At times, health industry entities partner with patient advocacy groups, providing the necessary funding to enable patients to advocate for decisions that affect their lives, ensuring they are made with a patient-focused lens. 

Industry money does not render patient advocacy tainted or disingenuous. Often, patient goals align with industry goals in a manner like that of patient-provider alignment. Unfortunately, entities that do not have patient well-being at the forefront of their motivations often deliberately conflate industry funding with manipulation, portraying ‘patient advocacy as industry shill’ as a misguided narrative. Simply put, they’re wrong!

[1] Rodriguez, M. (2023, July 5). Remembering the Denver Principles, 40 years later. Retrieved from https://www.thebody.com/article/hiv-denver-principles-40-years-later

[2] U.S. PLHIV Caucus. (n.d.). The Denver Principles (1983). Retrieved from https://www.hivcaucus.org/resource-links/the-denver-principles-1983

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.   

A Call to Serve: Patient Advocates Must Step-Up During T2

By: Brandon M. Macsata, CEO, ADAP Advocacy

In December 2024, ADAP Advocacy hosted its final Health Fireside Chat of the year as part of a broader Health Policy Retreat held in collaboration with the Community Access National Network. Despite hopes that the country's better angels would be reflected at the ballot box, both organizations had been preparing for what once seemed impossible: Trump Two (T2). POSITIVELY AWARE captured the sentiments shared by members of several national and state-level HIV advocacy and policy organizations from across the country prior to the Election. But now the rubber meets the road...

ADAP Advocacy CEO Brandon M. Macsata on The Morning Meeting, 12/09/24

At the Health Fireside Chat, political commentator Mark Halperin, editor-in-chief of 2WAY Interactive and host of The Morning Meeting podcast, pointedly dished out some straight talk about how patient advocates need to view the election as a call to serve. During the 2024 presidential election, Halperin scooped that President Joe Biden was dropping out of the presidential race days before the news broke, as well as three weeks prior to the election sounding the alarm that the Harris-Walz campaign was in big trouble in the swing states' suburbs. Agreeing to disagree in a few areas, most attendees in the room understood the merits of the advice being given by a political insider.

In fact, Halperin's message echoed the words of the late Bill Arnold (former President & CEO of the Community Access National Network and former founder and board co-chair of the ADAP Advocacy Association): leave your personal politics at the door! Halperin challenged the patient advocates and other stakeholders in the room to fight for a seat at the preverbal table. Ironically, it sounds awfully similar to The Denver Principles and the "Nothing About Us Without Us" principle!

To that end, ADAP Advocacy is returning some of its targeted advocacy efforts back to the very roots of the organization's founding some seventeen years ago...GRASSROOTS, that is. Back in 2010 during the height of the ADAP Crisis that landed over 1,300 people living with HIV/AIDS in thirteen states on waiting lists under the State AIDS Drug Assistance Program (ADAP), including a couple reported deaths, ADAP Advocacy helped to galvanize state grassroots networks to raise awareness and demand action by lawmakers. It is time to re-activate these state grassroots networks to push back against those dark forces seeking to gut the social safety-net, spread misinformation about science and vaccine efficacy, and perpetuate hate and stigma against marginalized communities...many of whom are disproportionately impacted by HIV.

ADAP Advocacy CEO Brandon M. Macsata at Florida town hall in 2010

Patient advocates are encouraged to contact ADAP Advocacy at info@adapadvocacy and indicate which state they're residing in, and how they might help with advocacy efforts. Aside from targeting federal lawmakers with constituent visits to better educate them, there will be plenty of opportunity for patient advocates to influence their state legislatures on many HIV-related issues.

Additionally, ADAP Advocacy leverages patient advocates and other public health stakeholders to serve on numerous patient advisory committees. This is a call to serve!

• ADAP State Drug Formulary Patient Advisory Committee

RE: Drug Formularies

Committee Chair: Rev. Alexander Garbera (Connecticut)

ADAP Advocacy works to improve access to timely, appropriate care and treatment for people living with HIV/AIDS being served by the State AIDS Drug Assistance Programs (ADAPs) under the Ryan White HIV/AIDS Program, including promoting robust drug formularies to best serve the needs of clients. Whenever feasible, ADAP Advocacy strongly supports "open" drug formularies. Approximately 20 seats need to be filled for this committee.

Learn more about the ADAP State Drug Formulary Patient Advisory Committee.

• ADAP Long-Acting Injectables Patient Advisory Committee

RE: Long-Acting Injectables

Committee Chair: Joey Wynn (Florida)

ADAP Advocacy strives to identify best practices on how to improve patient access to long-acting injectable therapies for the treatment of (and prevention of) HIV/AIDS. As general guidelines, they would be designed to help State AIDS Drug Assistance Programs (ADAPs), and other relevant payers, remove the barriers to accessing injectable HIV-related therapies, as well as other non-ARV, health-related injectable therapies. Three seats need to be filled for this committee.

Learn more about the ADAP Long-Acting Injectables Patient Advisory Committee.

• Ryan White Grantee 340B Patient Advisory Committee

RE: 340B Drug Pricing Program

Committee Chair: Guy Anthony

ADAP Advocacy ensures the voice of people living with HIV/AIDS shall always be at the table and the center of the discussion, including on how supports and services are financed under the Ryan White HIV/AIDS Program. To that end, reforming the 340B Drug Pricing Program is of paramount concern by returning the program to its original legislative intent: putting the patient first. Two seats need to be filled for this committee.

Learn more about the Ryan White Grantee 340B Patient Advisory Committee.

ADAP Advocacy has long prided itself on using its Values Statements to define its advocacy work. Among these values, that the voice of persons living with HIV/AIDS shall always be at the table and the center of the discussion. Patient advocates must step-up during T2, so join the fight!

Photo Source: shutterstock.com

"And We Will be Ignored No Longer" - The San Francisco Principles 2020

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

It was 1983 amid rising anger and fear over the federal government's failure to address the AIDS epidemic in the United States that people living with HIV/AIDS assembled to demand, “Nothing about us without us.” The Denver Principles were the first self-empowerment statement issued by people living with HIV/AIDS, yet nearly forty years later it still serves as the foundational platform for HIV advocacy. Now a chronic disease, HIV is turning gray. Although the face of the HIV epidemic has changed over time, our demands remain much the same: inclusion, resources, and treatment!

Authored by five long-term survivors — Paul Aguilar, Harry Breaux, Vince Crisostomo, Michael Rouppet, and Hank Trout — The San Francisco Principles seek more equitable care and services for long-term HIV survivors in the United States. These Principles address the unique concerns and needs among long-term survivors, among them ageism, isolation, and their shared history (Wilder, 2021).

Said Hank Trout, MA, of the collective work put into the statement: "For our purposes with the Principles, we chose to define long-term survivors as those of us who were diagnosed during the fifteen-year period between 1981 and 1996, before the advent of HAART. It is we who bore the brunt of the AIDS pandemic from the very first. It is we who suffered the first diagnoses and the unmitigated fear of catching or spreading the disease; we who buried our friends and lovers and family members after watching them slowly disintegrate; we who were ignored by public health officials, laughed at by politicians, condemned by religious leaders, and shunned by our own communities; we who put our bodies on the line as unpaid guinea pigs for pharmaceutical companies who have made billions in profits off us; we who submitted to the first toxic trials and research programs; we who are still living with PTSD from all the losses and chaos of the early, horrendous days of this pandemic. And finally, we are the ones who set the standard for compassionate caring for our own community" (Trout, 2020).

The ADAP Advocacy Association has long espoused the tenets of the self-empowerment message spelled out in The Denver Principles. The following value statements are the foundational ideals under which our organization operates:

• That the organization consistently strives to achieve them, while encouraging its supporters to do the same.
• That the voice of persons living with HIV/AIDS shall always be at the table and the center of the discussion.
• That HIV/AIDS advocates should welcome the opportunity to join the skills, experience and voices with others on issues of disability and access to adequate healthcare for all Americans.
• That advocacy efforts targeted to our federal government shall always carry the needed messages applicable at the state and local level.
• That messages and information shall be in accessible formats understandable to - and also deliverable by - grassroots advocates in any setting.

The ADAP Advocacy Association also has embraced the need for improving supports and services for the long-term survivors among us. We called attention to older adults with HIV as the Forgotten Majority. We raised awareness about AIDS Survivor Syndrome and understanding the linkages between mental health and HIV/AIDS. We highlighted Covid-19's disproportionate impact on older adults living with HIV & long-term Ssurvivors. And now, we wholeheartedly support The San Francisco Principles!

As we turn the page on an Administration that has ignored much of the needs facing the HIV community, as well as fueling stigma in this country, it is important that our advocacy efforts take a look back on The Denver Principles, while also look forward to The San Francisco Principles. Both serve to empower our efforts! 

Read the San Francisco Principles 2020.

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates. 

The 'Magic City' Embodies the Denver Principles

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

Birmingham is largest metropolitan city in Alabama, and its deep rooted history earned it the nickname, "The Magic City." Once a bustling manufacturing hub in the South, it is now recognized nationally for some of its leading medical research. Unfortunately, Alabama -- like most states in the Deep South -- has been disproportionately impacted by HIV/AIDS. Yet, thanks to organizations such as AIDS Alabama, there is a vibrant grassroots advocacy community fighting to raise awareness, advance linkages to care, and promote the ideals embodied in the "Denver Principles."

Photo Source: POZ.com

The ADAP Advocacy Association (aaa+^®) is committed to keeping the patient perspective at the center of its advocacy and educational activities, especially at the local level. After all, all HIV/AIDS organizations -- whether it is a advocacy organization, think tank, or service provider -- exist to promote greater patient health and wellness. Isn't that what the Denver Principles were all about, even as a movement that is still evolving?

(Editor's Note: Please read Larry Bryant's 2013 blog, Will The Denver Principles Ever Be Relevant To Black People Living With HIV & AIDS?)

To that end, aaa+^® again this year will host regional summits designed to gather community input on the AIDS Drug Assistance Programs (ADAPs). Community input at the local level is essential to improving access to care and treatment for people living with HIV/AIDS as the Affordable Care Act (ACA) continues to be implemented across the nation. With some of the ongoing challenges facing people living with HIV/AIDS under the ACA, it is important for the advocacy community to share their insight and perspective.

There will be a regional summit held in Birmingham, Alabama on April 15th. It is being held in collaboration with AIDS Alabama, AIDS Healthcare Foundation (AHF) and the Community Access National Network (CANN). To learn more about the ADAP Regional Summit in Birmingham, or to register for this important community event, go to http://adapadvocacyassociation.org/events.html.