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
Nine sites implemented four evidence-based interventions, collectively known as Addressing STIs: Ask.Test.Treat.Repeat. The four intervention components are audio computer-assisted self-interview sexual history taking, patient self-collection of urogenital and extragenital site chlamydia/gonorrhea nucleic acid amplification test specimens, sexual and gender minority welcoming indicators, and provider training, with the overall goal to routinize STI screening, testing, and treatment in primary care. The interventions increased routine STI screening and testing of bacterial STIs based on reported behavioral risk.
Evidence-Informed Intervention
All clients
Beyond the care continuum
Clinical service delivery model
Washington, DC
FL
LA
The Adolescent Quality Learning Network (AQLN) identified barriers to sexual health care in four areas: sexual health assessment; receipt of sexual health counseling; three-site STI testing; and receipt of STI treatment. The AQLN then tested approaches to address the identified barriers including opt-out testing, self-rectal swabs, and creating a sex positive environment in the clinic. After one year, the AQLN found improvements in the percentage of clients assessed for sexual health risks, as well as improvements in testing and treatment of STIs.
Emerging Intervention
Youth ages 13 to 24
Beyond the care continuum
Clinical service delivery model; Quality improvement
NY
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
Through the Practice Transformation Project, the Native American Community Clinic and Midwest AIDS Education and Training Center developed strategies to increase testing and linkage to care within the American Indian/Alaska Native population, and for those who inject drugs and are experiencing homelessness. These ongoing efforts have increased HIV testing rates by 10 percentage points through harm reduction, community outreach, and culturally sensitive strategies.
Emerging Intervention
American Indian/Alaska Native people; People who inject drugs (PWID); People who are unstably housed
HIV diagnosis; Linkage to HIV medical care
Clinical service delivery model
Minneapolis, MN
Kern County Rapid ART links people with a new diagnosis of HIV to ART. The Kern County Health Officer’s Clinic identifies people with a new diagnosis of HIV through onsite testing, surveillance data, and referrals from local hospital emergency departments. Kern County Rapid ART provides support services and refers clients to other community clinics for ongoing care. A study of clients with a new diagnosis of HIV in 2021 found that on average, Kern County Rapid ART clients were linked to care and provided ART within two days of diagnosis.
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
Clinical service delivery model
Bakersfield, CA
Stronger Together uses counseling to increase engagement in and improve the quality of HIV care available for serodiscordant male couples. Through three in-person and additional “booster” sessions over an 18-month period, Stronger Together gave couples a space to work with an HIV professional to improve treatment adherence and keep both people healthy. Stronger Together participants were more likely to adhere to ART than those in a control group.
Evidence-Based Intervention
People with HIV; Gay, bisexual, and other men who have sex with men (MSM)
Prescription of antiretroviral therapy
Clinical service delivery model
Atlanta, GA
Boston, MA
Chicago, IL
The Virginia Commonwealth University implemented a clinical quality improvement project to increase linkage to HIV medical care within 30 days and initiation of antiretroviral therapy (ART) at the first visit by making “Rapid Access” appointments available each week for people with newly diagnosed HIV.
Emerging Intervention
People with a new diagnosis of HIV; Youth ages 13 to 24
Linkage to HIV medical care
Clinical service delivery model
Richmond, VA
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