• 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 – Documents

THMP Application

Other Documentation

Medical Certification Form - Word (DOC) | Medical Certification Form - PDF (PDF) – allows physicians to request any and all medications currently available through the THMP. See Medical Certification Form Quick Facts to learn more. Please note that a separate form for the drug Fuzeon (enfuvirtide) is no longer required. (updated November 2021)

It is recommended that patients initiating Fuzeon treatment receive additional training and support through Nurse Connections. This service is provided free to new and existing patients. For information or to enroll a patient, please call 1-877-4Fuzeon (1-877-438-9366).

Trogarzo Medical Certification Form - Word (DOC) | Trogarzo Medical Certification Form - PDF (PDF) – allows physicians to request Trogarzo through the THMP. (updated June 2020)

THMP Acceptable Documentation - English (PDF) | THMP Acceptable Documentation - Spanish (PDF) (updated September 2021)

Guidelines (PDF) – program guidelines for THMP applicants. (updated February 2021)

THMP Medication Formulary and Maximum Quantities Table (PDF) – the list of drugs currently available through the THMP. (updated January 2021)

Out of State Texas Residents Medication Guidelines (PDF) (updated May 2019)

THMP Extra Medication Request Form (PDF) – complete to request extra refill or a 2-month supply of medication. (updated June 2020)

ADAP Enrollment Worker Training Manual (PDF) – manual from enrollment worker training.

Training Request Form [Survey Monkey]

Application Completeness Fact Sheet (PDF) – worksheet that explains the difference between an incomplete application and an application with verification issues.

THMP Eligibility Due Date Calendar (PDF) – monthly reminder of documentation due dates for THMP clients.

To view and download documents related to the HIV SPAP (State Pharmaceutical Assistance Program), please visit the TEXAS HIV SPAP page.

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Last updated November 5, 2021