The RWHAP Part F SPNS program funded the Building a Medical Home for Multiply Diagnosed HIV-Positive Homeless Populations initiative from 2012–2017, to provide coordinated housing supports and HIV, behavioral and mental health care to people experiencing homelessness. Nine funded demonstration sites created partnerships with housing providers, integrated behavioral health and HIV care, and provided intensive patient navigator services. A multi-demonstration site evaluation found that, compared to baseline, participants were more likely to be virally suppressed after 12 months in the intervention.
Evidence-Based Intervention
People who are unstably housed
Retention in HIV medical care; Prescription of antiretroviral therapy; Viral suppression; Beyond the care continuum
Support service delivery model
Pasadena, San Diego County, San Francisco, CA
New Haven, CT
Jacksonville, FL
Cumberland, Hoke, Harnett, Johnston, and Sampson Counties, NC
Multnomah County, OR
Dallas and Harris Counties, TX
Five clinics implemented Tailored Motivational Interviewing (TMI) to better serve young people with HIV as part of a RWHAP Part F SPNS initiative. Motivational interviewing is a well-documented approach to engage youth in care and facilitate behavior change in a variety of contexts. Clients participating in TMI received integrated HIV medical care and TMI, and demonstrated improved engagement in care and health outcomes.
Evidence-Based Intervention
Support service delivery model
Los Angeles, CA
Ft. Lauderdale, FL
Baltimore, MD
Detroit, MI
Philadelphia, PA
Seeking Safety helps people who have experienced trauma and/or substance use disorder gain safe coping skills through a flexible 12-session intervention. The University of California, San Diego Mother Child Adolescent HIV Program and the Multicultural AIDS Coalition implemented Seeking Safety as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017–2021. Participants had higher rates of retention in care and viral suppression after 12 months of the intervention.
Evidence-Based Intervention
People with a history of trauma; People with substance use disorder
Retention in HIV medical care; Viral suppression
Support service delivery model
Cognitive Processing Therapy (CPT) is an evidence-based, cognitive behavioral treatment for posttraumatic stress disorder. Through individual or group sessions of CPT, clients learn to recognize and challenge unhelpful thoughts and beliefs related to trauma. Positive Impact Health Centers and Western North Carolina Community Health Services implemented CPT as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017 to 2021. While not statistically significant, CPT participants had increased engagement in care and retention in care from enrollment to 12 months.
Evidence-Based Intervention
People with a history of trauma
Retention in HIV medical care
Support service delivery model
Decatur, GA
Duluth, GA
Marietta, GA
Asheville, NC
Collaborative Care Management (CoCM) integrates mental health and primary care, with a care team of a primary care provider, behavioral health care manager, and psychiatric consultant. Together they provide comprehensive and coordinated care to people with HIV who have co-occurring depression or other psychiatric disorders. Four sites implemented CoCM as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017–2021. CoCM led to statistically significant increases in antiretroviral therapy (ART) prescription and viral suppression.
Evidence-Based Intervention
People with diagnosed mental illness
Prescription of antiretroviral therapy; Retention in HIV medical care; Viral suppression
Clinical service delivery model
Washington, DC
Baton Rouge, LA
Detroit, MI
Tulsa, OK
Tailored Motivational Interviewing (TMI) delivers brief motivational interviewing counseling sessions customized to encourage people with HIV to engage in HIV care, take HIV medications as prescribed, and improve other health-related behaviors. Three sites implemented TMI as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017 to 2021. Clients who participated in TMI had significant improvement in engagement in care, prescription of antiretroviral therapy, retention in care, and viral suppression.
Evidence-Based Intervention
Black/African American people; Gay, bisexual, and other men who have sex with men (MSM); Youth ages 13 to 24; Young adults ages 25 to 34
Linkage to HIV medical care; Retention in HIV medical care; Prescription of antiretroviral therapy; Viral suppression
Support service delivery model
Fort Lauderdale, FL
Macon, GA
Jackson, MS
The CrescentCare Start Initiative is a program of CrescentCare, a Federally Qualified Health Center, and the New Orleans Office of Health Policy. The initiative connects people with newly diagnosed HIV to antiretroviral therapy (ART) through intensive patient navigation and a streamlined intake process. Time between HIV diagnosis and linkage to HIV medical care has decreased from 30 days to only 1.3 days.
Evidence-Based Intervention
People with a new diagnosis of HIV
Linkage to HIV medical care
Support service delivery model