• DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
    Austin, Texas 78714

    Phone: 737-255-4300

    Email the HIV/STD Program

    Email HIV, STD, Hepatitis C, and TB data requests to the Program - This email can be used to request data and statistics on HIV, STDs, Hepatitis C, and TB in Texas. It cannot be used to get treatment or infection history for individuals, or to request information on programs and services. Please do not include any personal, identifying health information in your email such as HIV status, Date of Birth, Social Security Number, etc.

    For treatment/testing history, please contact your local health department.

    For information on HIV testing and services available to persons living with HIV, please contact your local HIV services organization.

Texas HIV Medication Program - Spend Down Discontinuation Delayed for ADAP


In the past, the Texas HIV Medication Program (THMP) applied a “spend down” equal to the cost of each participant’s yearly THMP medications. This income adjustment is for those who are over the 200% Federal Poverty Level (FPL) rule.

In December, THMP discontinued this spend down. This includes both new and renewed applications received December 1 or later.

We are delaying the elimination of the spend down for the AIDS Drug Assistance Program (ADAP) through at least June 30, 2021. THMP will review any denials based on income from December 1, 2020 forward.

If a prior applicant qualifies for the program after applying the spend down, THMP will send an approval letter. The applicant will be reinstated into the program.

THMP will process all applications for ADAP using the spend down criteria through June 30, 2021. THMP will communicate any changes between now and the end of June.

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Q.  What is the THMP spend down? 

A.  The THMP spend down is an income adjustment for determining program eligibility. THMP calculates the adjustment as the cost equal to each participant’s yearly THMP medications. The adjustment is for those who are over the program’s 200% Federal Poverty Level (FPL) requirement.


Q.  Why did THMP eliminate the spend down?

A.  THMP eliminated the spend down for two reasons:

  • The Health Resources Services Administration (HRSA) funds THMP. In December 2019, HRSA directed THMP to eliminate the spend down.
  • THMP identified a program deficit of $52 million for Texas’ 2021 fiscal year. Eliminating the spend down reduces program costs. This helps to continue to serve the most vulnerable.


Q.  What has changed with the elimination of the spend down?

A.  We have not changed the program. But the delay in the spend down elimination allows you and the agencies that support you more time to find other ways to get your medications.


Q.  THMP denied my application.  What happens now?

A.  THMP will review applications denied for being over the allowable income.  We will review applications we got between December 1, 2020 and February 10, 2021. For now, continue to seek help with your medications. Your local agency can help with this.


Q. What if I am in the State Pharmacy Assistance Program (SPAP) or the Texas Insurance Assistance Program (TIAP)?  How does this affect me?

A.  This change did not affect SPAP and TIAP enrollees. SPAP and TIAP have not started the spend down elimination.


Q. How will I find out if my eligibility is getting reinstated with the ADAP program?

A.  If you are now eligible for ADAP, THMP will send you an approval letter.



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Last updated February 23, 2021