U.S. states struggling to provide AIDS medicines to poor patients have had to create waiting lists and limit the drugs they provide in order to cut costs, a report said on Wednesday.

Eleven states have closed enrollment in their AIDS Drug Assistance Programs, or ADAPs, which are the last resort for patients with no other funding for their medicines, the report said.

Many states had to impose limits despite a 9 percent increase in the overall ADAP budget between fiscal years 2002 and 2003.

Most states saw a jump in the number of people seeking care, and costs for AIDS medicines rose.

“The demand for medications still exceeds the resources available in many states,” the report said.

About 136,000 patients, or 30 percent of people receiving HIV and AIDS care in the United States, receive services from ADAPs each year.

Most funding comes from the federal government. States contribute as well but most have tight budgets and some have cut ADAP spending.

Last week, an expert committee recommended that the federal government pay to treat all low-income Americans infected with HIV. The committee at the Institute of Medicine, which advises the federal government on health issues, said the program would pay for itself by reducing future health costs.

Access to AIDS medicines varies across states, the new report found.

As of April 2004, 1,263 patients were on ADAP waiting lists in nine states. Three states limited monthly or yearly expenditures for each patient, and two states cut the number of drugs offered, the report said.

Sixteen states do not cover all of the FDA-approved antiretroviral medicines that can suppress the HIV virus that causes AIDS. One state, South Dakota, does not provide any protease inhibitors, key components of AIDS-fighting regimens.

Thirty-three states provide Fuzeon, a new type of AIDS drug that costs more than $20,000 per patient per year, but most limit access to certain patients. Fuzeon is marketed by Roche Holding AG and Trimeris Inc.

The report was compiled by the Kaiser Family Foundation, a nonprofit health research organization, the National Association of State and Territorial AIDS Directors, and the AIDS Treatment Data Network, an association of state health officials.