HRSA Ryan White HIV/AIDS Program and National Black HIV/AIDS Awareness Day

Remarkable Improvements in Viral Suppression

HRSA's Ryan White HIV/AIDS Program (RWHAP) provides services to low income individuals living with HIV who have no health care coverage (public or private), have insufficient health care coverage, or lack financial resources to get the care and treatment they need for their HIV disease. According to HRSA's RWHAP Annual Client-Level Data Report, 2017, nearly three-quarters of the 531,349 RWHAP clients were from racial/ethnic minority populations; almost half self-identified as Black/African American. 

Across the board, RWHAP clients have high rates of viral suppression. (Viral suppression is defined as more than one outpatient/ambulatory health services visit during the calendar year and one or more viral load reported, with the most recent viral load result less than 200 copies/mL.) These rates have improved steadily, from 69.5% in 2010 to 85.9% in 2017. 

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HRSA HIV/AIDS Bureau Infographic

Viral Suppression Rates Among RWHAP Clients, 2010-2017

The same improvement was seen for Black/African American individuals receiving RWHAP care, with rates jumping from 63.3% in 2010 to 82.6% in 2017. However, as the chart below depicts, viral suppression rates among Black/African American RWHAP clients fall below levels achieved by other RWHAP subpopulations. 

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HRSA HIV/AIDS Bureau RWHAP Annual Client-Level Data Report, 2017

Viral Suppression among Clients Served by the RWHAP, by Race/Ethnicity, 2017—United States and 3 Territories

HIV Outcomes by Gender

The RWHAP Annual Client-Level Data Report, 2017 also provides insights into RWHAP client HIV health outcomes by gender and other client characteristics. 

• The percentage of Black/African American men who achieved viral suppression was lower (81.9%) than the average of 86.3% for all male RWHAP clients.

• The percentage of Black/African American women who achieved viral suppression (84.1%) was comparable to the 85.2% for all women getting RWHAP care.

African American Ryan White HIV/AIDS Program Initiatives

In recognition of National Black HIV/AIDS Awareness Day on February 7, below is a recap of RWHAP Technical Assistance (TA), training, and other activities--from models of care to special initiatives. 

Engaging Black MSM in Care

HRSA has supported numerous initiatives over the decades to enhance care delivery for hard-hit populations and to close the gap in outcomes for clients receiving RWHAP care and services.

• His Health: Engaging Black MSM in HIV Care with a compendium of care models, training modules, and resources for enhanced linkage, retention, and engagement strategies targeting Black MSM. The site is designed for providers and offers continuing medical education (CME) and continuing nursing unit (CNU) credits for clinicians to increase their capacity to provide high-quality health care to Black MSM.
• Well Versed is a conversation-starting resource for health care providers and Black MSM. This consumer-oriented website provides information about how to get the most out of health care by being active and informed.
• In It Together, a National Health Literacy Project for Black MSM, is another recent HRSA-supported project designed to increase health professionals’ understanding and use of health literacy to improve engagement and retention in HIV care and treatment.

Improving Care for African Americans

HRSA has funded additional TA and training initiatives to improve services for African Americans and other minority populations, including efforts focused on health coverage enrollment assistance for underserved populations, health literacy, improved treatment for people of color co-infected with HIV and hepatitis C, care delivery approaches such as use of community health workers, and leadership training for people of color. 

The RWHAP Special Projects of National Significance (SPNS) program is part of the success with RWHAP client outcomes in its decades-long investigation of innovative models of HIV/AIDS care, including those focused on minority and underserved populations. One recent example is the Enhancing Access for Women of Color Initiative, 2009-2014. Another, the Transgender Women of Color Initiative, recently published a set of implementation manuals.

• The Integrating HIV Innovative Practices (IHIP) Project packages tools derived from multiple SPNS initiatives. 

• Dissemination of Evidence-Informed Interventions is evaluating implementation packages for several SPNS-derived projects that focused on racial and ethnic minority communities, including retention approaches for women of color.