Dear Colleague Letter on Monkeypox for RWHAP Recipients


Dear Ryan White HIV/AIDS Program Colleagues:

On August 4, 2022, the monkeypox outbreak was declared a public health emergency in the U.S. From the outset, the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB) engaged with federal partners across the Department of Health & Human Services (HHS), including the Centers for Disease Control & Prevention (CDC), to provide resources to combat the accelerating spread of monkeypox, help health care providers who are treating patients who have monkeypox, and ensure those most at risk are at the focus of our response efforts.

As of today, there are more than 7,500 confirmed cases of monkeypox in the U.S., and the outbreak continues to spread nationwide. Gay, bisexual, and other men who have sex with men (MSM) have been particularly affected by this outbreak. As trusted providers with a strong history of supporting the health and well-being of the MSM community, many HRSA Ryan White HIV/AIDS Program (RWHAP) recipients and subrecipients are responding to the monkeypox outbreak, while continuing to provide essential HIV care and support services. Therefore, HRSA HAB is providing clarification on the use of RWHAP funds for monkeypox testing, treatment, and vaccination.

Monkeypox testing is available through public health and commercial laboratories. Testing done through public health laboratories is free of charge, while there are costs associated with testing at commercial laboratories. If a provider caring for a RWHAP client does not have ready access to public health laboratory testing, RWHAP funds can be used to cover co-pays and deductibles for insured clients and the cost of testing for uninsured clients when a commercial laboratory is used for testing.

CDC-recommended post-exposure prophylaxis and antiviral treatments are available for people exposed to monkeypox or diagnosed with monkeypox virus infection. Please note, at this time, monkeypox vaccines and treatment are being provided by the U.S. federal government. RWHAP providers should work with their state/territorial health departments to access the orthopox antiviral TPOXX (tecovirimat) for the treatment of monkeypox and the monkeypox vaccines.

RWHAP funds may be used to pay for fees associated with vaccine administration and treatment of monkeypox for eligible clients, such as medical visit costs, including personal protective equipment for staff, vaccination supplies, including co-pays and deductibles for insured clients, in accordance with Policy Clarification Notice #16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds. RWHAP providers should continue to partner with health departments and work together to address monkeypox in their communities. 

HRSA also understands that since a national public health emergency for monkeypox has been declared, some RWHAP recipients, particularly state health departments, may have questions on the allowability of RWHAP staff being assigned to assist with the monkeypox outbreak while being paid with RWHAP funds. HRSA will share more information on the allowability of staff reassignment as it becomes available.

We encourage you to visit HRSA’s Monkeypox Information web page to stay up to date on the monkeypox outbreak and access monkeypox resources, including press releases, fact sheets, and webinars and informational videos. We will be updating this web page regularly as new resources and information are available.

Please also visit and bookmark these resources from the CDC on managing monkeypox for people with HIV: Clinical Considerations for Treatment and Prophylaxis of Monkeypox Virus Infection in People with HIV and Interim Guidance for Prevention and Treatment of Monkeypox in Persons with HIV Infection.

Thank you for your ongoing work to support the health and safety of more than half a million people with HIV served by the RWHAP during these unprecedented times. Please reach out to your RWHAP project officer if you have any questions or concerns.


/Laura W. Cheever/

Laura Cheever, MD, ScM
Associate Administrator

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