Ryan White HIV Care and Gay/Bisexual Men

TargetHIV

Of the more than half a million clients served by HRSA's Ryan White HIV/AIDS Program (RWHAP), 41.9% are MSM (67.9 percent of male RWHAP clients).

MSM RWHAP clients receiving RWHAP medical care have a slightly higher viral suppression percentage (90.2% in 2022) than the national RWHAP average of 89.6%. By race/ethnicity, viral suppression among MSM was lowest among young Blacks/African Americans. (HRSA, Gay, Bisexual, and Other Men Who Have Sex with Men (MSM) Clients: HRSA’s Ryan White HIV/AIDS Program, 2022, April 2024)

Since the beginning of the HIV/AIDS epidemic, the majority of HIV cases in the United States have been among gay and bisexual men (men who have sex with men, MSM). In 2019, 69% of HIV diagnoses were among MSM, with 37% of those cases being African American MSM, 32% Hispanic/Latino MSM, and 25% White MSM.

Best Practices

HRSA's Ryan White HIV/AIDS Program's Best Practices Compilation contains HIV care interventions with evidence of their efficacy in improving HIV care. As cited below, many of these interventions were developed under HRSA initiatives. 

Following are highlights of projects with a focus on MSM populations or their inclusion within a broader array of audiences. 

  • Behavioral Health. Multiple projects developed under the SPNS Black MSM Behavioral Health Initiative (2018-2022) are included in the Best Practices collection. Building Brothers Up, a peer case management project, improved retention in care and, more notably, enhance viral suppression rates among the 40 Black MSM who took part in the 12-month evaluation. Project Strength Through Youth Livin' Empowered (STYLE) 2.0 used social marketing and health care navigators, with resulting improvements in care engagement and viral suppression. +LOVE realized improved retention in care among those receiving case management and behavioral health services, when compared to those getting case management only.
  • Social Media. The weCare Social Media Intervention used a cyber health educator to promote care engagement with MSM, and transgender women. Missed appointments declined (from 68% to 53%) and viral suppression increased (from 61% to 89%). E-VOLUTION used a two-way text messaging intervention and realized significant improvement's in participant viral suppression. See additional SPNS Social Media Initiative Demonstration Site Resources (2015-2019), which utilize social and digital media methods to engage hard-to-reach youth and young adults in HIV care.
  • Linkage to Care Support. Project nGage is a Chicago-based project's social network interventions, coordinated by social workers and participant support confidants. Participants who took part in sessions involving motivational interviewing and other behavioral health techniques had higher rates of receipt of primary care and self-reported optimal adherence to ART regimens. Project CONNECT, which used linkage coordinators to effectively engage people in HIV medical care, is one of multiple Black MSM projects under HRSA's E2i, Evidence-Informed Interventions (2017-2022)
  • Rapid ART. The CrescentCare Start Initiative was an early adopter of the rapid ART intervention (starting people on HIV treatment shortly after an HIV diagnosis). Ninety-two percent of their clients started treatment within 72 hours of diagnosis. "In comparison to a historical cohort of 29 patients, the time from diagnosis to treatment dropped from 30 days to 1.3 days." CrescentCare is one of the projects examined under HRSA's Center for Innovation and Engagement.
  • Quality Improvement. Increasing Viral Suppression for MSM of Color, a quality improvement project under the end+disparities ECHO Collaborative (2018-2019), saw notable improvements in participant viral suppression: "of the 16 individuals who were not virally suppressed at the start of the initiative, 14 reached viral suppression and two were lost to follow-up after 18 months." See more ECHO HIV Disparity Interventions.

Additional Resources

HRSA’s HIV/AIDS Bureau has a number of additional resources to enhance access to HIV care for MSM in HIV care: social media, outreach, health literacy, and more.