The RWHAP Best Practices Compilation gathers and disseminates interventions that improve outcomes along the HIV care continuum. Explore the Compilation to find inspiration and new ideas for improving the care of people with HIV. Learn more about the Best Practices Compilation and submit your innovation today for possible inclusion.
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Displaying 1 - 10 of 16
CoRECT was a data to care project to identify and reengage people with HIV who were newly out of care. It included a clinic and health department data reconciliation process to identify missed laboratory results or appointments and create the out-of-care list, case discussions via telephone to review the combined list, and field epidemiologist outreach to assist clients with making appointments, securing transportation, and arranging referrals. The intervention employed strengths-based case management techniques and motivational interviewing to contact identified people within 30 days, reengage them in care, and reduce time to viral suppression.
Evidence-Based Intervention
People with HIV who are not in care
Linkage to HIV medical care; Retention in HIV medical care
Outreach and reengagement activities; Data utilization approach
MA
CT
Philadelphia, PA
Enlaces Por La Salud is an HIV linkage, navigation, and education program for Mexican men and transgender women. The intervention is grounded in a transnational framework for providing cultural context to support the delivery of one-on-one educational sessions to Latina(o/x) people with a new HIV diagnosis, as well as people with HIV who are not yet retained in care. After 12 months, the majority of people participating in Enlaces Por La Salud were retained in care and reached viral suppression.
Emerging Intervention
Hispanic/Latina(o/x) people; Gay, bisexual, and other men who have sex with men (MSM); Transgender women; People with a new diagnosis of HIV; People with HIV who are not in care
Retention in HIV medical care; Viral suppression
Support service delivery model; Outreach and reengagement activities
Wake County, NC
Mecklenburg County, NC
The New York City HIV Care Coordination Program is a structural intervention that combines multiple strategies, including multidisciplinary care coordination, patient navigation, and personalized health education to address client medical and social needs. Multiple evaluations of the program consistently show improvements in viral suppression and engagement in care, especially for people with a new diagnosis of HIV or who are out of care.
Evidence-Based Intervention
People with a new diagnosis of HIV; People with HIV who are not in care
Retention in HIV medical care; Viral suppression
Clinical service delivery model; Outreach and reengagement activities; Support service delivery model; Systems/structural interventions
New York, NY
The Bottom-Up Project is a multi-organizational initiative focused on leveraging health information exchange data and peer navigation. Using real-time clinical data, in combination with linkage to HIV care and social services, the Bottom-Up Project locates and reengages people with HIV who are not currently in medical care and are not virally suppressed. Through this collaboration, over half of patients on the lost-to-follow-up list were found and invited to enroll in the linkage to care/reengagement program.
Emerging Intervention
People with HIV who are not in care
Retention in HIV medical care
Data utilization approach; Outreach and reengagement activities
NY
Viviendo Valiente aims to reduce ethnic disparities in HIV care and outcomes by providing culturally responsive services to the Latino/a community, specifically to people of Mexican descent. It is a multi-level intervention, featuring individual-, group-, and community-level activities, that links people to HIV care, offers HIV education and health literacy in group sessions, and promotes community-level testing for HIV and other sexually transmitted infections (STIs). Viviendo Valiente had positive impacts on HIV testing, retention in care, viral suppression, and client satisfaction.
Emerging Intervention
Hispanic/Latina(o/x) people
HIV diagnosis; Retention in HIV medical care; Viral suppression
Outreach and reengagement activities
Dallas, TX
ERASE was developed to address the unique needs of Black MSM. Through an intensive case management intervention, peer case managers provide health education and wellness support, and connect clients to medical and behavioral healthcare. ERASE also offers a physical “safe space” for Black MSM to meet with a case manager, access medical services, or connect with peers. Enrollment in ERASE improved retention in HIV care for clients.
Emerging Intervention
Black gay and bisexual men; People with HIV who are not in care; People with a new diagnosis of HIV
Retention in HIV medical care
Outreach and reengagement activities
Oakland, CA
The Enhanced Patient Navigation for Women of Color with HIV intervention uses patient navigators, who are non-medical staff in clinical settings, to reduce barriers to health care and optimize care. The intervention was effective in improving linkage to and retention in care, as well as viral suppression.
Evidence-Informed Intervention
Women of color; Transgender women; Women
Linkage to HIV medical care; Retention in HIV medical care; Viral suppression
Outreach and reengagement activities; Support service delivery model
Atlanta, GA
Los Angeles, CA
Newark, NJ
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.
Emerging Intervention
People with HIV who are not in care
Retention in HIV medical care; Viral suppression
Data utilization approach; Outreach and reengagement activities
Detroit, MI
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.
Evidence-Informed Intervention
Gay, bisexual, and other men who have sex with men (MSM); Black gay and bisexual men
Retention in HIV medical care; Viral suppression
Clinical service delivery model; Outreach and reengagement activities
Durham, Orange, and Wake Counties, NC
Columbia, SC
Stay Connected for Your Health helps clients stay engaged in HIV medical care through clinic-wide messaging, enhanced personal contact, and behavioral skills training. Originally implemented by six academically affiliated HIV clinics nationwide more than 10 years ago, this 12-month intervention has become well-established and is incorporated in many provider trainings. Evaluations show that people with HIV receiving behavioral skills training and personalized and frequent positive messages about care engagement were more likely to be engaged in care.
Evidence-Based Intervention
All clients
Retention in HIV medical care
Outreach and reengagement activities
Birmingham, AL
Miami, FL
Baltimore, MD
Boston, MA
New York, NY
Houston, TX