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
The Navigator Case Management intervention helps people with HIV who are incarcerated and are leaving to return to the community. The intervention uses harm reduction, case management, and motivational interviewing techniques to promote healthy behaviors. Enhanced case management including peer support and connection to other needed services both immediately before and after release supports increased linkage to and retention in HIV care for people transitioning to the community from jail.
Evidence-Based Intervention
People who are justice involved
Linkage to HIV medical care; Retention in HIV medical care
Support service delivery model
MORE focuses on people who are not virally suppressed and/or who have not attended an HIV medical appointment in six months. Participants can choose from one of three MORE programs, depending on the intensity of services they want. Based on initial evaluation findings, participants who received more intensive MORE services were more likely to be virally suppressed and less likely to be lost to follow-up than those who received less intensive services.
Retention in HIV medical care; Viral suppression
Clinical service delivery model; Support service delivery model
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.
Evidence-Informed Intervention
Retention in HIV medical care; Prescription of antiretroviral therapy; Viral suppression
Support service delivery model
Birmingham, AL
Mobile, AL
Fort Myers, FL
Lake Charles, LA
New Orleans, LA
Baltimore, MD
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.
Evidence-Based Intervention
People with a new diagnosis of HIV; Youth ages 13 to 24
Retention in HIV medical care
Support service delivery model
Chicago, IL
Detroit, MI
Memphis, TN
Miami, FL
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.
People with HIV who are not in care; People with undiagnosed HIV
HIV diagnosis; Linkage to HIV medical care
Support service delivery model
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.
People experiencing food insecurity
Retention in HIV medical care; Viral suppression; Beyond the care continuum
Support service delivery model
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.
Retention in HIV medical care
Support service delivery model
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%.
People who are unstably housed
Retention in HIV medical care; Viral suppression; Beyond the care continuum
Support service delivery model