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 Test and Treat initiative, implemented by Oklahoma State University, connects people to antiretroviral therapy (ART) within 14 days of HIV diagnosis through streamlined intake and initial clinic visit protocols and 30-day medication starter packs. Participants in Test and Treat are linked to care and reach viral suppression sooner, and are more likely to be retained in care, as compared with people in standard care.
Emerging Intervention
People with a new diagnosis of HIV
Linkage to HIV medical care; Prescription of antiretroviral therapy; Viral suppression; Retention in HIV medical care
Clinical service delivery model
Tulsa, OK
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
Routine Universal Screening for HIV (RUSH) provides non-medical case management services, opt-out HIV testing, and linkage to care for emergency department patients. The intervention automatically screens patients for HIV if they are aged 16 years or older, are having an IV inserted, or are having blood drawn for other reasons, unless the patient opts out. RUSH provides access to testing earlier in disease progression, bridging disparities that primarily impact people of color. It also promotes linkage to and retention in care for those with a positive HIV test result. Clients with a positive HIV test in the emergency department who had a prior diagnosis of HIV were more likely to be retained in care and to reach viral suppression.
Evidence-Informed Intervention
All clients
Linkage to HIV medical care; Retention in HIV medical care; Viral suppression
Clinical service delivery model
Houston, TX
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
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
Rapid ART Program Initiative for New Diagnoses (RAPID) was designed to connect people with a new HIV diagnosis to ART within five days of diagnosis and within one day of their initial care visit. Linkage navigators counseled people on HIV care, identified an available clinician capable of immediately prescribing ART, scheduled the clinical appointment, and connected people to additional support services. RAPID led to a reduction in median time between initial diagnosis and both ART initiation and viral suppression.
Evidence-Based Intervention
People with a new diagnosis of HIV
Linkage to HIV medical care; Prescription of antiretroviral therapy; Viral suppression
Clinical service delivery model
San Francisco, CA
Howard Brown Health established a specialized drop-in clinic and support groups, and implemented organizational initiatives to provide culturally relevant and gender-affirming services for transgender and non-binary people, including transgender women of color. The goal of this intervention was to optimize engagement in HIV services and primary care. From 2012-2021, the number of transgender and non-binary people served in primary care at Howard Brown Health more than tripled. In addition, after 24 months, participants were more likely to have been prescribed ART and to be virally suppressed than at baseline.
Evidence-Informed Intervention
Transgender women
Prescription of antiretroviral therapy; Viral suppression
Clinical service delivery model
Chicago, IL
By integrating comprehensive HIV medical care with addiction services and medication protocols for substance use disorder (SUD), clients with HIV and SUD saw improvements in retention in care and viral suppression.
Emerging Intervention
People who use drugs
Retention in HIV medical care; Viral suppression
Clinical service delivery model
Camden, NJ
The Maricopa Jail Project was implemented by five jails to decrease the wait time between incarceration and/or diagnosis to the start of treatment, and to better support clients to reach viral suppression. Maricopa hired a nurse practitioner to manage access and case manage across the jail system. The initiative was successful in increasing the number of clients who were virally suppressed.
Emerging Intervention
People who are justice involved
Viral suppression
Clinical service delivery model
Maricopa County, AZ
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