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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Through the Test & Treat Rapid Access (TTRA) Program, clients with a new HIV diagnosis in Miami-Dade County can access ART, receive other services and counseling, start enrolling in RWHAP, and connect to HIV primary care during the initial visit. At Borinquen Health Care Center, one of the clinical sites participating in TTRA, 76% of clients were virally suppressed within three months of receiving a rapid ART start, and 95% were retained in care for 12 months.
Evidence-Informed Intervention
People with a new diagnosis of HIV; People with HIV who are not in care
HIV diagnosis; Linkage to HIV medical care; Prescription of antiretroviral therapy; Viral suppression
Clinical service delivery model
Miami-Dade County, FL
The goals of the Emergency Department and Hospital-Based Data Exchange for Real-Time Data to Care (ED Alert) intervention are to reengage people with HIV in care and to improve viral suppression rates. This is achieved using a real-time data exchange system that connects clients presenting to the emergency department with health department linkage specialists. ED Alert increased viral load testing and viral suppression over six months following a provider visit in the post-intervention period.
Evidence-Informed Intervention
People with HIV who are not in care
Linkage to HIV medical care; Viral suppression
Clinical service delivery model; Data utilization approach
Seattle, WA
Clínica Bienestar (Spanish for “Wellness Clinic”) was developed to provide comprehensive, integrated HIV primary care services to Spanish-speaking and bilingual people of Puerto Rican ancestry, with HIV who inject drugs. Clínica Bienestar is a multilevel, multipronged intervention combining evidence-based practices in behavioral health and HIV medical care with a transnational approach to care. Clínica Bienestar positively impacted retention in HIV medical care and viral suppression.
Evidence-Informed Intervention
Hispanic/Latina(o/x) people
Retention in HIV medical care; Viral suppression
Clinical service delivery model; Support service delivery model
Philadelphia, PA
Positive Care Center implemented the Rapid Access program in 2018, providing clients with ART on the same day as HIV diagnosis. Pharmacists, embedded within Positive Care Center’s care team, help clients with their treatment plans and adherence strategies. Over 90% of clients served through Rapid Access in 2021 received ART on the same day as diagnosis, and 82% of clients were retained in care at six months.
Evidence-Informed Intervention
People with a new diagnosis of HIV; People with HIV who are not in care
Linkage to HIV medical care; Prescription of antiretroviral therapy; Viral suppression
Clinical service delivery model
Minneapolis, MN
Virginia Rapid Start launched with HIV care providers across the state with goals to initiate ART for clients within 14 days of HIV diagnosis and to improve access to, and retention in, high-quality HIV care and support services. Through Virginia Rapid Start, providers initiated ART medications within an average of four days of HIV diagnosis, as compared with the statewide average of 28 days. Virginia Rapid Start clients had higher rates of viral suppression compared to both the RWHAP Part B overall and Virginia overall. The success of Virginia Rapid Start led VDH to expand the program to the entire Virginia RWHAP Part B.
Evidence-Informed Intervention
People with a new diagnosis of HIV
Linkage to HIV medical care; Prescription of antiretroviral therapy; Viral suppression
Clinical service delivery model
VA
JumpstART launched in 2016 as part of New York State’s Ending the Epidemic initiative, changing the service delivery model of eight sexual health clinics to include an initial prescription of ART after an HIV diagnosis and prior to linkage to the community provider. Between November 2016 and September 2018, 60% of JumpstART clients received ART on the same day as diagnosis. JumpstART clients were also more likely to reach viral suppression within three months compared to non-JumpstART clients.
Evidence-Informed Intervention
People with a new diagnosis of HIV
HIV diagnosis; Linkage to HIV medical care; Prescription of antiretroviral therapy; Viral suppression
Clinical service delivery model
New York City, NY
HHOME offers mobile HIV primary care, behavioral health care, and connection to housing services to people with HIV experiencing homelessness. A centralized HHOME team acts as a hub to meet clients where they are, refer them to housing and support services, and provide ongoing case management and HIV primary care services. Clients participating in HHOME experienced increased retention in care, viral suppression, and connection to stable housing.
Evidence-Informed Intervention
People who are unstably housed; People with substance use disorder; People with diagnosed mental illness
Retention in HIV medical care; Viral suppression; Beyond the care continuum
Clinical service delivery model; Support service delivery model
San Francisco, CA
The University of Nebraska Medical Center/Nebraska Medicine (UNMC/NM) Specialty Care Center (SCC) is the largest provider of comprehensive HIV care—including primary and HIV-focused medical services as well as multiple support services—in Nebraska. In March 2020, at the onset of the COVID-19 pandemic, the clinic integrated telehealth into its care delivery model to continue serving patients beyond the clinic structure, and developed algorithms that allowed any team member to quickly identify a patient's eligibility for a telehealth visit. The algorithms include the date of the most recent office visit, stability of HIV disease, most recent viral load and CD4 count, and antiretroviral therapy (ART) refill histories as a proxy for medication adherence. Overall, viral suppression rates remained high for all patients regardless of visit type, indicating that telehealth is a successful alternative to in-person visits for providing HIV care.
Evidence-Informed Intervention
All clients
Viral suppression
Clinical service delivery model; Use of technology and mobile health
Omaha, NE
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
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