In Katrina's Aftermath

While Hurricane Katrina has proved devastating for hundreds of thousands of Gulf Coast residents, the lingering effects of the disaster could be particularly harmful to HIV-positive evacuees who suddenly find themselves without medical care, support services, and in some worst-case scenarios, even the medications they need to survive. Officials believe that about 8,000 HIVers have been evacuated from parts of Louisiana, Mississippi, and Alabama, particularly from the New Orleans area. Many have been relocated to Texas, but states throughout the country are welcoming the displaced. 'We suspect most of them are going to be poor and uninsured,' says Don Maison, president of AIDS Services of Dallas, of the evacuees. As such, these people will need immediate access to public treatment and care programs, and local government groups and policy makers have been quick to provide it, Maison adds. The Texas AIDS Drug Assistance Program, for example, is open to Katrina evacuees, says Katy Caldwell, executive director of the Houston's Montrose Clinic, which stationed one of its social workers at the Astrodome, where thousands of New Orleans residents had been relocated. Her agency also is providing emergency 10-day medication supplies to anyone who needs them. Alabama's ADAP is offering eight weeks of treatment to displaced HIVers, says Kathie Hiers, head of AIDS Alabama; other state-run ADAPs, including Illinois's program, are also offering emergency supplies of drugs. But this help is only the beginning of what's going to be needed, according to Terje Anderson, executive director of the National Association of People With AIDS. Through a statement from the National Minority AIDS Council, Anderson said, 'AIDS Drug Assistance Programs in affected states are starting to get HIV medications to evacuees, but even before this disaster, Alabama's ADAP had more than 500 people on a waiting list, and the rest of the affected and neighboring states were already filled to capacity. It's vital that ADAP and the other parts of the Ryan White Act receive immediate federal emergency supplemental funds for folks to remain in care.' Meanwhile, local agencies are doing their best to cope with the onslaught of new patients. Maison says Texas officials waived rules pertaining to filling out-of-state prescriptions. 'Any prescription from Louisiana is now recognized as legitimate,' he notes. 'If you have knowledge about what you were taking--even if it's an empty prescription bottle or just recognizing the pills--you can get your medication.' Caldwell adds that primary medical care for HIV-positive evacuees will be available at public clinics covered by state-run Medicare programs. A bipartisan bill introduced in the Senate in mid September aimed to provide Medicaid coverage for several months to low-income evacuees, no matter where they relocated. Local health departments throughout the Southeast also are providing HIV treatment and medical care. Regional AIDS organizations also are working overtime to meet other immediate needs of displaced HIVers, including offering case management, referrals, other supportive services, and even HIV antibody tests, since proof of positive serostatus is needed to access publicly funded AIDS programs. But the needs of evacuees are going to shift over time, and some--particularly demand for low-income housing--will persist for months or even years, warns Paul Scott, executive director of the Resource Center of Dallas. While this is daunting, Caldwell pledges that she and her colleagues are committed to rising to the challenge: 'We just have to play it day by day and see what happens.''