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Curriculum updated on 06/09/2020
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Housing First to Treat and Prevent HIV
Caracole, an AIDS Service Organization, uses three interconnected approaches to improve retention in HIV care: housing first, harm reduction, and motivational interviewing. Clients in permanent supportive housing had high rates of viral suppression, exceeding Caracole's goal of 75%.
Resource from the RWHAP Best Practices Compilation updated on 05/13/2024
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Ridesharing to Transport Clients to Medical Visits
San Joaquin County Public Health Services Department partnered with the California Department of Public Health, Office of AIDS to help clients get to medical appointments via ridesharing. Representing the first partnership between a jurisdiction and a ridesharing company, this program addresses transportation barriers, promotes engagement in medical care, and leads to cost savings.Resource from the RWHAP Best Practices Compilation updated on 04/15/2024
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Test and Treat
The Test and Treat initiative, implemented by Oklahoma State University, connects people to antiretroviral therapy (ART) within 14 days of HIV diagnosis through streamlined intake and initial clinic visit protocols and 30-day medication starter packs. Participants in Test and Treat are linked to care and reach viral suppression sooner, and are more likely to be retained in care, as compared with people in standard care.Resource from the RWHAP Best Practices Compilation updated on 04/12/2024
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Expanding Oral Health Care Services for People with HIV
Extramural dental clinics implemented the medical home model, with integrated trauma-informed care, to expand oral health care services for people with HIV, and saw increases in referrals from partner organizations and the number of new clients.Resource from the RWHAP Best Practices Compilation updated on 11/22/2023
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Increasing Viral Suppression for MSM of Color
A broad population of men who have sex with men (MSM) reached viral suppression through intensive case management by applying tools and lessons learned in the Center for Quality Improvement Innovation end+disparities ECHO Collaborative.Resource from the RWHAP Best Practices Compilation updated on 11/24/2023
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Improving Access to Mental Health Care
The AIDS Institute is committed to promoting, monitoring, and supporting the quality of clinical services for people with HIV in New York State. The Adolescent Quality Learning Network (AQLN) is a collaborative of 16 HIV Adolescent/Young Adult Specialized Care Center (SCC) programs. In collaboration with the AIDS Institute, SCC providers selected a quality improvement project aimed to raise viral suppression rates by improving access to mental health services.Resource from the RWHAP Best Practices Compilation updated on 11/01/2023
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PACT Food Assistance Program
The University of Pittsburgh Medical Center, Center for Care of Infectious Diseases, Pittsburgh Area Center for Treatment (PACT) began implementing the Food Assistance Program in August 2017 to serve as a supplemental resource for people with HIV receiving care who experience food insecurity. The program helps bridge gaps in Supplemental Nutrition Assistance Program (SNAP) benefits and monthly food costs while promoting access to healthy foods and retention in HIV care.Resource from the RWHAP Best Practices Compilation updated on 11/14/2023
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Early Intervention Services and Outreach
The Oregon Health Authority awarded contracts to local public health authorities across the state to work with community partners to integrate early intervention services and outreach services, link people to HIV care, and provide support to help clients reach viral suppression. Quick linkage to care resulted in a median of 57 days to viral suppression for Early Intervention Services and Outreach clients in 2019.Resource from the RWHAP Best Practices Compilation updated on 05/14/2024
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Integration of HCV Treatment within an HIV Clinic
The University of California San Francisco, San Francisco General Hospital HIV Clinic developed a care model to enhance access to hepatitis C virus (HCV) treatment among people with HIV by co-locating care and creating a multidisciplinary team. Developed as part of the RWHAP Part F SPNS Hepatitis C Treatment Expansion Initiative, this model of care led to a considerable decrease in the number of people with HIV who were coinfected with HCV among the patients served by San Francisco General Hospital during the 2010 and 2011 demonstration years.Resource from the RWHAP Best Practices Compilation updated on 05/15/2024
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PositiveLinks
PositiveLinks is a mobile platform deployed by clinics or community-based organizations to connect people with HIV to a digital support community. The client-facing app helps people with a new diagnosis of HIV become engaged in care and helps people at risk of being lost to care overcome barriers related to geographic or social isolation. From the app, people can access Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant patient dashboards, secure messaging, and patient lab records. People who used PositiveLinks had increased rates of retention in care and viral suppression.Resource from the RWHAP Best Practices Compilation updated on 02/02/2024
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Project ACCEPT
Project ACCEPT is designed to improve engagement and retention in medical care for youth ages 16 to 24 years with newly diagnosed HIV. The educational and skill-building intervention was deployed at four demonstration sites and increased rates of medication use and appointment adherence in comparison to a control group. Although originally developed for cisgender youth, Project ACCEPT may be adapted for gender-diverse people.Resource from the RWHAP Best Practices Compilation updated on 01/03/2024
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Community Health Workers: Improving Linkage and Retention in HIV Care
Ten organizations across the U.S. integrated Community Health Workers (CHWs) into their multidisciplinary care teams. Enrolled clients had statistically significant improvements in viral suppression, antiretroviral therapy prescription, and appointment attendance after six months in the program.Resource from the RWHAP Best Practices Compilation updated on 01/03/2024
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Patient-Centered HIV Care Model
The Patient-Centered HIV Care Model (PCHCM) integrates the services of community-based HIV specialized pharmacists and HIV medical providers to deliver patient-centered care for people with HIV. PCHCM expands upon the medication therapy management model by including information sharing between partnered pharmacy and clinic teams; collaborative medication-related action planning between pharmacists, medical providers, and patients; and quarterly follow-up pharmacy visits. Patients participating in the intervention had improved retention in care and viral suppression rates.Resource from the RWHAP Best Practices Compilation updated on 11/26/2023
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Integrating Buprenorphine Treatment for Opioid Use Disorder in HIV Primary Care
Three participating clinics—MetroHealth, the University of Kentucky Bluegrass Care Clinic, and Centro Ararat—participated in a RWHAP Part F SPNS initiative from 2016 through 2019 to implement integrated buprenorphine treatment and HIV care. Research has shown that care integration improves HIV outcomes, engagement in substance use disorder treatment, and quality of life for people with HIV. Clients participating in this intervention received integrated opioid use disorder (OUD) and HIV care to improve retention in care, viral suppression, and engagement in OUD treatment.Resource from the RWHAP Best Practices Compilation updated on 01/07/2024
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Project nGage
Project nGage is a support intervention approach that offers participants an initial 90-minute session with a social work interventionist and a participant support confidant to develop a tailored care and support plan. The social work interventionist then offers four follow-up sessions to each participant to discuss progress on the care and support plan. Project nGage was evaluated in a randomized controlled trial from 2012 to 2015: participants in the intervention were more likely to have at least three HIV primary care visits in the last 12 months than those who received usual care.Resource from the RWHAP Best Practices Compilation updated on 11/30/2023
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Minimize to Maximize: A Cadence of Accountability
The Utah Department of Health and Human Services collaborated with RWHAP Part B-funded medical case managers to improve care and outcomes for clients following Franklin Covey’s 4 Disciplines of Execution: 1) focus on the wildly important goal; 2) act on the lead measures; 3) keep a compelling scoreboard; and 4) create a cadence of accountability. Through intensive case management, regular monitoring, and feedback sessions, the state's RWHAP Part B program's overall viral suppression rate increased from 88.9% in 2020 to 90.4% by December 2021.Resource from the RWHAP Best Practices Compilation updated on 11/13/2023
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Louisiana Public Health Information Exchange
The Louisiana Public Health Information Exchange is a bidirectional exchange that connects hospital system electronic health records with state surveillance data. Providers use the exchange to identify and relink people with HIV who are out of care to clinical and supportive services. Since LaPHIE was implemented in 2009, thousands of people with HIV who were out of care have been identified, with a significant number being successfully linked to care.Resource from the RWHAP Best Practices Compilation updated on 05/20/2024
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Project Strength Through Youth Livin' Empowered (STYLE) 2.0
STYLE 2.0 is a multi-component intervention designed to help reduce stigma and social isolation for Black gay, bisexual, and other men who have sex with men. The intervention relies on health care navigators who facilitate linkage and engagement activities. They also connect clients to behavioral health providers who conduct motivational interviewing, as well as to a mobile application that supports all intervention activities. STYLE 2.0 participation has been associated with positive trends across HIV care continuum outcomes, including retention in care and increased viral suppression.Resource from the RWHAP Best Practices Compilation updated on 11/30/2023
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Link-Up Rx
Link-Up Rx is a pharmacy-data-based Data to Care program implemented by the Detroit Health Department in partnership with the Michigan Department of Health and Human Services and a specialty pharmacy. Using pharmacy data to identify clients in need of follow-up greatly reduced the amount of time for clients to appear on “not in care” lists compared to traditional D2C approaches. Protocols for a three-tiered outreach and reengagement approach were developed to connect clients back to antiretroviral therapy and HIV care following a missed pharmacy pick-up. Nearly half of identified clients were linked back to their pharmacy or other HIV medical services.Resource from the RWHAP Best Practices Compilation updated on 01/03/2024