The ADAP can help pay for all or part of your HIV medications if you meet the program requirements.

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®
    • Alinia
    • Amlodipine
    • Androderm
    • Androgel® 1.62% and 1.0%
    • Aptivus®
    • Aranesp® (darbepoetin alfa)
    • Atripla®
    • Avosulfon®
    • AZT
  • B

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

    • Cipro® Oral Suspension
    • Cipro® XR
    • Cleocin Pediatric®
    • Cleocin Phosphate
    • Cleocin Vaginal Cream/Ovules®
    • Cleocin®
    • Combivir®
    • Compazine
    • Complera™
    • Cozaar Tablets
    • CRIXIVAN®
    • Cytovene
  • D

    • d4T
    • Dapsone
    • Daraprim®
    • ddC
    • ddI
    • DDS
    • Depakote® Sprinkle Capsules*
    • Depakote®*
    • Desyrel Dividose tablet
    • Detrol®
    • DiaBeta®
    • Diflucan®
    • Dilantin®
    • Diprolene® AF Cream
    • Diprolene® lotion
    • Doxycycline
  • E

    • EDURANT®
    • Elavil
    • Enablex®
    • Epivir®
    • EPOGEN® (EPOETIN ALFA) for dialysis use only
    • Epzicom®
  • F

    • Fansidar
    • Fortovase
    • Fuzeon
  • G

    • G-CSF
    • Glucophage
    • Glucophage XR
    • Glynase®PresTab®
  • H

    • HIVID
    • Humatin
    • Hydrea
  • I

    • Ibuprofen
    • Imodium
    • INTELENCE®
    • Invirase
    • ISENTRESS®
  • K

    • KALETRA®
    • KALETRA® Oral Solution
  • L

    • Leucovorin
    • LEVAQUIN® (levofloxacin) Tablets/Oral Solution
    • Lexiva®
    • Lipitor®
    • Lomotil®
    • Lopid®
  • M

    • Marinol
    • Megace Oral Suspension
    • Mepron®
    • Methadose
    • Micronase®
    • Myambutol
    • Mycelex-G
    • Mycobutin®
    • Mykinac
  • N

    • Naproxen Sodium
    • Neupogen®
    • Neurontin®
    • Niacor®
    • Nilstat
    • Norvir® Oral Solution
    • NOXAFIL®
    • Nystex
    • Nystop
  • O

    • O-V Statin
    • Oxandrin
  • P

    • Prezista®
    • Primaquine Phosphate
    • Prinivil tablets
  • R

    • Rescriptor®
    • Retrovir®
    • Reyataz®
  • S

    • Selzentry®
    • Septra
    • SPORANOX® (itraconazole) Capsules
    • Sustiva®
  • T

    • Tenormin® Tablets
    • Transderm Scop®
    • TriCor®
    • Trizivir®
  • U

    • Ultrase®
  • V

    • Valcyte
    • Vantin®
    • Videx
    • Videx EC
    • Videx Pediatrics
    • Viramune® Oral Suspension
    • Viramune® Tablets
  • W

    • Wellcovorin
  • Z

    • Zerit®
    • Zestril® Tablets
    • Ziagen®
    • Zithromax®
    • Zithromax® Suspension
    • Zithromax® Tri-Pak
    • Zithromax®Z-Pak
    • Zofran ODT
    • Zofran®
    • Zovirax®