The waiting list for Georgia’s program providing HIV medication to low-income people now has the longest waiting list in the U.S., despite recent efforts to address it.

The waiting list for the state’s AIDS Drug Assistance Program is now 1,287 people, topping Florida (1,166) and Virginia (1,103) to become the largest in the nation, according to the National Alliance of State & Territorial AIDS Directors, which tracks the numbers through its ADAP Watch. Some 4,606 people in 12 states are on ADAP waiting lists.

The troubling development comes despite a big drop in Georgia’s ADAP waiting list thanks to a $3 million grant in emergency funds to the state Department of Public Health in October. That helped lower the ADAP waiting list from nearly 1,800 to 1,525 in November. Another 238 people have dropped from the list since then, yet Georgia now tops the list of states for the largest pool of people hoping to get ADAP assistance.

Georgia Equality, which worked with a coalition of HIV groups to call attention to the crisis last year, had made “full funding” for the state’s ADAP program one of its two legislative priorities for the recently-opened Georgia General Assembly session.

Last year, the state’s $18.3 billion budget included a $100,000 cut for ADAP, a far cry from calls by Georgia Equality and other groups to boost funding by $5 million. But the $100,000 cut could have been worse – the House version of the budget cut $600,000 from ADAP; $500,000 was restored in budget negotiations between the House and Senate.

Georgia leading the U.S. with its ADAP waiting list comes as the state health department continues to struggle with its HIV prevention efforts. A loss in federal funds has led to the firing of 20 people in state health districts that work on HIV prevention programs. And the HIV unit was already a mess before the cuts.

UPDATE: Jeff Graham, Georgia Equality’s executive director, offers some additional insight into Georgia’s ADAP trouble: A budget proposal from Gov. Nathan Deal, unveiled Wednesday, offers no additional funding for ADAP though activists say it will take at least $8 million to clear out the state’s waiting list. Also Wednesday, the Metro Atlanta HIV Health Services Planning Council said it will recommend that at least $700,000 of its funding be shifted to address the ADAP waiting list.