An estimated 56,000 persons in the United States become infected with HIV every year. Of the 1.1 million persons living with HIV in the United States, approximately 250,000 are not aware of their infection and their risk for transmitting HIV to others. Of those who are unaware, many are diagnosed late in the course of their infection, after a prolonged asymptomatic period during which further transmission may have occurred. Persons who are diagnosed late in their infection miss a valuable opportunity to start HIV care and are at greater risk for AIDS-related complications (than those diagnosed earlier). Therefore, it should be a priority to identify HIV-infected persons and actively link the newly diagnosed to medical care, prevention and retention programs in the HIV care system. However, depending on the availability of publicly funded programs on a state by state basis, HIV medications are often not readily accessible to those who are uninsured.
Of the 1.1 million people living with HIV/AIDS in the United States, approximately 25% are uninsured and even more than that will experience a gap in health coverage at some point during a benefit year. Those who do not have health coverage or are experiencing a gap in coverage, rely on the pharmaceutical companies’ patient assistance programs as a safety net. It is estimated that there are 20,000 – 30,000 patients currently accessing HIV PAPs throughout the United States. While the manufacturers of HIV medications all offer patient assistance programs, industry and public health officials have long recognized the need for a common portal to access these programs. The HarborPath common portal eliminates burdensome paperwork and ensures that medications are dispensed and delivered to patients in a coordinated and efficient manner.
HarborPath is a not for profit 501(c)(3) corporation located in Columbia, South Carolina that was launched in July 2012. The organization is a cooperative effort supported by the Clinton Health Access Initiative (CHAI), the National Alliance of State and Territorial AIDS Directors (NASTAD) and pharmaceutical companies to improve access to HIV medications through patient assistance programs (PAP). HarborPath’s mission 
is to streamline the PAP application process for people living with HIV/AIDS who are uninsured and have no other access to HIV medications. HarborPath operates an electronic, on-line common portal where case managers and patient advocates can go to access HIV medications and process HIV patient assistance program applications. A common portal eliminates burdensome, duplicative paperwork normally required to submit individual PAP applications and ensures that medications are dispensed and delivered to patients in a coordinated and efficient manner.
The initial release of the HarborPath single electronic portal for access to HIV PAPs is the product of input from a variety of stakeholders including HIV case managers, public health department staff, pharmaceutical companies, NASTAD and CHAI. The system was developed in alignment with the business rules of the pharmaceutical companies’ programs to ensure that all of the necessary data is captured regardless of which drug is requested. The overall portal design provides case managers with access to all HIV PAP applications, allows for one time data entry for case managers and reduces the time spent processing PAP applications.
HarborPath currently receives donated HIV medications from Gilead, Merck and ViiV and is able to dispense their medications through the HarborPath contract pharmacy. Negotiations with additional pharmaceutical companies that manufacture antiretrovirals are in progress towards the HarborPath vision of a full complement of HIV medications available for dispensing through the HarborPath contract pharmacy. In addition to the full array of antiretrovirals, HarborPath is working with pharmaceutical companies to supply Hepatitis C medications for both mono-infected and co-infected patients.
The HarborPath portal has been launched as a pilot in multiple HIV clinics, AIDS Service Organizations (ASOs) and Community Based Organizations (CBOs) in multiple states that were identified as areas of high need including Alabama, Florida, Georgia, South Carolina, Texas, Washington and Washington, D.C. HarborPath continues to expand to additional sites in 2013.
Given the collaborative nature of the development of the HarborPath common HIV PAP portal and the long-standing need for streamlined access to donated antiretrovirals, HarborPath is poised to fill the needs of those who rely on HIV PAPs for their medications in 2013 and beyond.
Noreen O’Donnell, MSW
Noreen O’Donnell is the Director of Program Services for HarborPath, a new non-profit HIV medications assistance program that is currently piloting its program in Alabama, Florida, Georgia, South Carolina, Texas, Washington and Washington, D.C. As the Director of Program Services Noreen oversees program development and provides technical assistance to HarborPath portal sites.
Prior to coming to HarborPath in September 2012, Noreen was the Ryan White Program Manager for the STD/HIV Division of the South Carolina Department of Health and Environmental Control (DHEC) in Columbia, South Carolina. In that role Noreen oversaw the administration of all of the HIV care and support services for DHEC including Ryan White Part B, ADAP Direct Dispensing, ADAP Insurance Program, Ryan White Part D and the Housing Opportunities for Persons with AIDS program.
Noreen has been working in the field of HIV/AIDS since 2002. She has a Bachelors degree from The Ohio State University, a Masters degree from the University of South Carolina and served as a Peace Corps Volunteer in Togo, West Africa.
