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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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 HIV Clinical Pharmacist Services intervention shortens the time between referral to and engagement in care by allowing newly referred clients to see pharmacists in addition to other clinical providers for their initial appointment. This intervention is supported by findings from a retrospective cohort study that took place from 2013 to 2017 at a RWHAP-funded clinic. In addition to significantly decreasing the time between referral and initial visit, clients who saw a pharmacist also experienced shortened time to antiretroviral therapy initiation and viral suppression compared to those who only saw non-pharmacist providers.
Evidence-Informed Intervention
People with HIV; People with a new diagnosis of HIV
Linkage to HIV medical care; Prescription of antiretroviral therapy; Viral suppression
Clinical service delivery model; Systems/structural interventions
Oklahoma City, OK
The Undetectables is a client-centered model of integrated care that uses innovative, superhero-themed, anti-stigma social marketing, agency cultural change, and a toolkit of evidence-based antiretroviral therapy adherence strategies to support treatment adherence and viral suppression among people with HIV. A two-year demonstration project evaluation showed a significant increase in the proportion of clients who were virally suppressed from 39% to 62%.
Emerging Intervention
People with diagnosed mental illness; People who are unstably housed; People experiencing food insecurity; People who use drugs; People with a history of trauma
Viral suppression
Clinical service delivery model; Systems/structural interventions
New York City, NY
Trauma-Informed Approach & Coordinated HIV Assistance and Navigation for Growth and Empowerment (TIA/CHANGE) was developed by HIV experts in collaboration with community members to improve health outcomes among people with HIV. Using a strength-based approach to HIV service provision, TIA/CHANGE offers guidance and structure for an organization to become trauma-informed. TIA/CHANGE includes enrollment of clients in trauma-informed intensive case management services. The Alaska Native Tribal Health Consortium implemented TIA/CHANGE as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017–2021. Among clients participating in TIA/CHANGE there were improvements in prescription of ART and viral suppression.
Evidence-Informed Intervention
People with a history of trauma; American Indian/Alaska Native people
Prescription of antiretroviral therapy; Viral suppression
Support service delivery model; Systems/structural interventions
Anchorage, AK