HIV Care Innovations: Replication Resources

These resources include implementation tools developed under the Ryan White HIV/AIDS Program (RWHAP). Tools were developed under the RWHAP Special Projects of National Significance (SPNS) research and demonstration program as well as various HRSA technical assistance and training projects.

  • AETC National Coordinating Resource Center (NCRC)
    Central source of clinical training for the RWHAP. Resources by national centers and regional sites include curricula (e.g., National HIV Curriculum, HIV/HCV Curriculum), phone/online one-on-one support, and training webinars, toolkits, etc. (AETC NCRC)
  • Center for Quality Improvement and Innovation (CQII)
    Technical tools from CQII include, for example, the Quality Academy tutorial on CQM fundamentals, and the create+equality Collaborative to mitigate disparities associated with social determinants of health. Other trainings include the end+disparities ECHO Collaborative, the Learning Lab, and Advanced Trainings. (CQII)
  • Health Insurance Coverage
    Tools for consumers and providers on helping secure health plan insurance coverage for people with HIV. (ACE)
  • Active Referral Intervention
    This intervention uses Disease Intervention Specialists (DIS) to more actively and immediately link clients to HIV care services. Overview, replication tips, and case study. (IHIP)
  • Clinic-Based Surveillance-Informed
    Combines clinic and health department surveillance data to identify and re-engage people with HIV who are out of care. (CIE)
  • Emergency Department and Hospital-Based Data Exchange (ED Alert)
    A real-time data to care program to identify and re-engage people with HIV in care. (CIE)
  • Link-Up Rx
    Data to care (D2C) program that aims to increase retention in care and viral suppression among people with HIV by using prescription refill information to decrease the length of time between refills and reduce antiretroviral therapy interruption. (CIE)
  • Louisiana Public Health Information Exchange
    This intervention facilitates bidirectional information exchange between hospital system records and public health surveillance data to identify and link out-of-care HIV-positive clients back to care and treatment. Overview, replication tips, and case study. (IHIP)
  • My Health Profile Continuity of Care Record Intervention
    My Health Profile is a patient portal leveraged across a regional health network containing critical health information to improve continuity of care. Overview, replication tips, and case study. (IHIP)
  • SPNS Systems Linkages Project
    Manuals and tools from five demonstration sites on how to replicate linkages across public health systems via innovative strategies (e.g., referral systems, care engagement techniques, patient navigation, electronic medical records). (SPNS ETAC)
  • Enhanced Patient Navigation for Women of Color with HIV
    Tools for use of patient navigators to support women of color living with HIV to optimize their engagement in care via support and patient empowerment. Includes training curriculum for navigators and manual for program staff on implementing a program. (DEII)
  • Enhancing Access for Women of Color Initiative
  • Peer Linkage and Re-engagement of Women of Color with HIV
    Resources to prepare women of color living with HIV to provide peer support to link/re-engage clients in HIV primary care. Includes training curriculum for peers and a manual for staff on how to implement a peer program, with extensive tips and tools in both. (DEII)
  • Women of Color: Enhancing Access
    Guide for ways to expand/improve services for women of color living with HIV, with planning and implementation steps based on best practices from demonstration sites, from steps on getting started to lessons learned. (IHIP)
  • Expanding Care for People Living with HIV Toolkit
    Actions that health agencies can take to either add or increase HIV care to their service offerings. Four steps are outlined, and each presents an implementation tool to guide that step. Also presents lessons learned. (SPNS ETAC)
  • Optimizing the Care Team
    Insights on operating Care Teams: multidisciplinary collection of providers who work together to meet multiple patient needs to improve care delivery and outcomes. Best practices cover: preparation, staffing, buy-in, formalization, and adaptability. (SPNS ETAC)
  • Patient Engagement and Care Coordination in HIV Health (PEACCH) Tool
    Steps for setting up an HIV care coordination program (e.g., getting buy-in, staffing, health information systems). (SPNS ETAC)
  • Building Futures: Supporting Youth Living with HIV
    Activities agencies can undertake to enhance delivery of HIV care to youth living with HIV, presented under the themes: clinical service models, infrastructure development, information program development, and wraparound services. (HRSA HAB)
  • HisHealth: Models of Care for Young, Black, Men who Have Sex with Men
    Collection features 11 models of care (summary fact sheets and program tools) and online multidisciplinary training modules for providers, community agency staff, and leaders. (CEBACC)
  • Project ACCEPT
    A group-based intervention for cisgender youth, 16- to 24-years old, to improve engagement in HIV care. (CIE)
  • Project STYLE
    An innovative model that links youth to the care step of the HIV care continuum. (CIE)
  • SPNS Social Media Initiative Demonstration Site Monographs
    Intervention monographs from ten demonstration sites on technology-based projects to improve engagement, retention, and outcomes in youth.
  • Tailored Motivational Interviewing
    Motivational Interviewing reimagined for youth with new HIV diagnoses to ultimately improve retention in HIV care. (CIE)
  • Well Versed
    Resources for Black MSM living with HIV focused on finding and getting the most out of HIV care. (CEBACC)

Guide to Sources

  • ACE TA Center. Tools to build the capacity of the RWHAP community to navigate the health care landscape help consumers access and use their health coverage. 2019-2022.
  • AETC NCRC: AETC National Coordinating Resource Center. Ongoing.
  • Black MSM Initiative. Implementation of Evidence-Informed Behavioral Health Models to Improve HIV Health Outcomes for Black Men Who Have Sex With Men. 2018-2022.
  • CEBACC: Center for Engaging Black MSM Across the Care Continuum. Ended 2018.
  • CIE: Center for Innovation and Engagement. 2018-2021.
  • CQII: Center for Quality Improvement and Innovation. 2020-2024.
  • DEII: Dissemination of Evidence-Informed Interventions. SPNS project evaluating implementation packages for four interventions. TA project: 2015 - 2020.
  • HRSA HAB: Health Resources and Services Administration HIV/AIDS Bureau.
  • IHIP: Integrating HIV Innovative Practices - developed and disseminated replication tools derived from the SPNS program after projects were completed.
  • In it Together Health Literacy Project: Two projects to help health professionals incorporate health literacy approaches into their services. 2014-2019.
  • SPNS: Special Projects of National Significance: Program under RWHAP Part F responsible for HIV care model identification, evaluation, and dissemination.
  • SPNS ETAC: Each SPNS project has an Evaluation and TA Center (ETAC) with responsibility for compiling dissemination tools (manuals, training resources) developed under the initiative.