The Ryan White HIV/AIDS Program provides HIV-related services in the United States for those who do not have sufficient health care coverage or financial resources for coping with HIV disease. The program fills gaps in care not met by other payers.

How to Apply

Please either download the application below (if available) or go to the program website for more information on how to apply. Once you fill out your application, send it to the address on the application. Remember not to send program applications to PPA.

Product(s) Covered by Program

  • 3

    • 3TC
  • A

    • ACTOS®
    • Agenerase®
    • Aldara
    • Ambien®
    • Anafranil™ (clomipramine hydrochloride)
    • Aptivus®
    • Atarax
    • Ativan
    • Atripla®
    • Augmentin®
    • Avosulfon®
    • AZT
  • B

    • Baraclude®
    • Biaxin® Filmtab
    • Biaxin® XL Filmtab
    • Biaxin® XL Pac
  • C

    • Celexa
    • Centrax
    • Cleocin®
    • Clozaril®
    • Combivir®
    • Compazine
    • Complera™
    • CRIXIVAN®
    • Cymbalta® (duloxetine) delayed release capsules
  • D

    • d4T
    • Dalmane
    • Dapsone
    • ddC
    • ddI
    • DDS
    • Depakote®*
    • Desyrel Dividose tablet
    • Detrol®
    • Dilantin®
  • E

    • EDURANT® (rilpivirne) Tablets
    • Elavil
    • Enablex®
    • Epivir®
    • Epzicom®
  • F

    • Famvir®
    • Fortovase
    • Fuzeon
  • G

    • Glucophage
  • H

    • Halcion®
    • HALDOL® (haloperidol) Immediate-Release Formulation Injection
    • HIVID
    • Hydrea
  • I

    • Inapsine®
    • INH
    • INTELENCE® (etravirine) Tablets
    • Invirase
    • ISENTRESS®
  • K

    • KALETRA®
    • KALETRA® Oral Solution
    • KEPPRA®
    • Klonopin
  • L

    • Lamictal®
    • Lamisil®
    • Lamprene
    • Lexapro®
    • Lexiva®
    • Librium
    • Lipitor®
    • Luvox
  • M

    • Megace Oral Suspension
    • Mepron®
    • Minocycline
    • Moban
    • Myambutol
    • Mycobutin®
    • Mycostatin
  • N

    • Navane®
    • Neurontin®
    • Nizoral®
    • Norpramin
    • Norvir® Oral Solution
  • O

    • Orap
  • P

    • Pamelor™ (nortriptyline HCI)
    • Paxil®
    • Paxipam®
    • Pravachol®
    • PREZISTA® (darunavir) Oral Suspension
    • PREZISTA® (darunavir) Tablets
    • Prolixin elixir
    • ProSom Tablets
    • Prozac® (fluoxetine)
    • PZA
  • R

    • Rescriptor®
    • Restoril™ (temazepam)
    • Retrovir®
    • Reyataz®
    • Rifadin
  • S

    • Selzentry®
    • Septra
    • Serax
    • Serentil
    • SEROQUEL® (quetiapine fumarate)
    • Serzone
    • Sinequan®
    • SPORANOX® (itraconazole) Capsules
    • Stelazine
    • Surmontil®
    • Sustiva®
  • T

    • Tegretol
    • Thorazine®
    • Tofranil™ (imipramine hydrochloride)
    • TriCor®
    • Trilafon
    • Trimox
    • Trizivir®
    • Truvada®
  • V

    • Valcyte
    • Valium
    • Valtrex®
    • Vasotec
    • Videx
    • Viramune® Oral Suspension
    • Viramune® Tablets
    • Vistaril®
  • X

    • Xanax®
  • Z

    • Zerit®
    • Ziagen®
    • Zithromax®
    • Zithromax® Suspension
    • Zithromax® Tri-Pak
    • Zithromax®Z-Pak
    • Zoloft®
    • Zovirax®