Arkansas AIDS Drug Assistance Program


Contact Information
Division of AIDS/STD
Arkansas Department of Health
4815 West Markham, Slot #33
Little Rock, AR 72205-3867
1-(800) CDC-INFO (phone)
How to Apply:
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
  • Click here to visit the program's web site.
  • Eligibility:
    ATTENTION: YOU MUST BE HIV POSITIVE TO BE ELIGIBLE FOR THIS PROGRAM. Iincome must be at or below 300% of the current Federal Poverty Level, excluding Medical Expenses Clients who are chronically infected (duration of infection presumed to be > 6 months based on exposure history, clinical findings, CD4 count) with HIV, who are ineligible for Medicaid, must meet at least one of the following criteria: - Symptomatic AIDS or, - Baseline (pre-treatment) CD4+ T-cell count - Baseline (pre-treatment) HIV viral load > 55,000 (RT-PCR) or >30,000 (bDNA) Pregnant HIV-infected women are eligible regardless of CD4 count and viral load. Clients who are acutely infected (duration of infection presumed to be When situations occur where the clinician believes that antiretroviral therapy is indicated for a client who does not meet any of the above criteria. The Medical Director of the HIV/STD/TB Team will review the case and determine the appropriateness of eligibility. In the event that clients have to be triaged because they have just been released from the hospital, prison, or are moving into the state, every effort will be made to provide medications; particularly for those who are very ill and who, in the mind of the clinician, would die soon without medication support. These situations will be monitored and a determination made on a case by case basis. Clinicians may request emergency triage status for clients meeting the following criteria: - CD4 - Recent occurrence (within the preceding 2 months) of a major opportunistic infection or malignancy (category C in the CDC classification). - Drugs provided in an emergency situation will be supplied for a maximum of 60 days, allowing time for application to Medicaid, Patient Assistance Programs, or ADAP.
    Other Information:
    Call ADAP Pharmacy at (877) 288-8506 for the nearest location.
    Product(s) covered by program:
    • 3TC
    • Agenerase®
    • AZT
    • Bactrim
    • Biaxin® Filmtab
    • Biaxin® Granules
    • Biaxin® XL Filmtab
    • Cipro
    • Cleocin
    • Combivir®
    • Crixivan®
    • Cytovene
    • d4T
    • Daraprim®
    • ddC
    • ddI
    • DDS
    • Diflucan®
    • Emtriva
    • Epivir®
    • Famvir®
    • Fortovase
    • Fuzeon
    • HIVID
    • Humatin
    • Invirase
    • Kaletra®
    • Kaletra® Oral Solution
    • Lamprene
    • Lexiva®
    • Mepron®
    • Myambutol
    • Mycelex®
    • Mycobutin®
    • Mycostatin
    • Mykinac
    • NebuPent
    • Nilstat
    • Nizoral®
    • Norvir® Oral Solution
    • Norvir® Soft Gelatin Capsules
    • Nystex
    • O-V Statin
    • Pentam
    • Pravachol®
    • Rescriptor®
    • Retrovir®
    • Reyataz
    • Sporanox®
    • Sustiva
    • Trizivir®
    • Valcyte
    • Viracept®
    • Viramune
    • Viread
    • Zerit®
    • Ziagen®
    • Zithromax®
    • Zovirax®