Adherence to prescribed treatment plans is critical for their success, and adherence support is a key component of medical case management services.
Resources 29
Best Practices
- Center for Innovation and EngagementCollection of implementation guides on evidence-informed best practices in HIV care delivery.
- Dissemination of Evidence Informed-Interventions Project (DEII)
Evidence-informed HIV care interventions (jail transitional care, buprenorphine, patient navigation, peer support for women of color).
- AIDS Action Foundation
Workbooks describing ways to help connect people living with HIV/AIDS to medical care. Estos cuadernos describen la manera de asistir a conectar personas que viven con VIH/SIDA con el sistema médico.
- IHIPText Me, Girl! is a 90-day theory-based, transgender-specific, automated text-messaging intervention designed to improve engagement, retention, and health outcomes along the HIV care continuum.
- SPNS Latino Access Initiative, UCSF Center for AIDS Prevention Studies
Monographs describing interventions for the engagement and retention of Latinos in HIV care.
- IHIP
Implementation guide for HIV providers on addressing the unique needs of women of color living with HIV.
- Next Step and Mass CARE
Guidebook for multiple audiences that outlines steps for transitioning youth from pediatric care to adult services.
- Best Practices CompilationThe HIV Clinical Pharmacist Services intervention shortens the time between referral to and engagement in care by allowing newly referred clients to see pharmacists in addition to other clinical providers for their initial appointment. This intervention is supported by findings from a retrospective cohort study that took place from 2013 to 2017 at a RWHAP-funded clinic. In addition to significantly decreasing the time between referral and initial visit, clients who saw a pharmacist also experienced shortened time to antiretroviral therapy initiation and viral suppression compared to those who only saw non-pharmacist providers.
- Best Practices CompilationA broad population of men who have sex with men (MSM) reached viral suppression through intensive case management by applying tools and lessons learned in the Center for Quality Improvement Innovation end+disparities ECHO Collaborative.
- Best Practices CompilationThree participating clinics—MetroHealth, the University of Kentucky Bluegrass Care Clinic, and Centro Ararat—participated in a RWHAP Part F SPNS initiative from 2016 through 2019 to implement integrated buprenorphine treatment and HIV care. Research has shown that care integration improves HIV outcomes, engagement in substance use disorder treatment, and quality of life for people with HIV. Clients participating in this intervention received integrated opioid use disorder (OUD) and HIV care to improve retention in care, viral suppression, and engagement in OUD treatment.
- Best Practices CompilationThe University of California San Francisco, San Francisco General Hospital HIV Clinic developed a care model to enhance access to hepatitis C virus (HCV) treatment among people with HIV by co-locating care and creating a multidisciplinary team. Developed as part of the RWHAP Part F SPNS Hepatitis C Treatment Expansion Initiative, this model of care led to a considerable decrease in the number of people with HIV who were coinfected with HCV among the patients served by San Francisco General Hospital during the 2010 and 2011 demonstration years.
- Best Practices CompilationThe New York City HIV Care Coordination Program is a structural intervention that combines multiple strategies, including multidisciplinary care coordination, patient navigation, and personalized health education to address client medical and social needs. Multiple evaluations of the program consistently show improvements in viral suppression and engagement in care, especially for people with a new diagnosis of HIV or who are out of care.
- Best Practices CompilationThe Patient-Centered HIV Care Model (PCHCM) integrates the services of community-based HIV specialized pharmacists and HIV medical providers to deliver patient-centered care for people with HIV. PCHCM expands upon the medication therapy management model by including information sharing between partnered pharmacy and clinic teams; collaborative medication-related action planning between pharmacists, medical providers, and patients; and quarterly follow-up pharmacy visits. Patients participating in the intervention had improved retention in care and viral suppression rates.
- Best Practices CompilationPositiveLinks is a mobile platform deployed by clinics or community-based organizations to connect people with HIV to a digital support community. The client-facing app helps people with a new diagnosis of HIV become engaged in care and helps people at risk of being lost to care overcome barriers related to geographic or social isolation. From the app, people can access Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant patient dashboards, secure messaging, and patient lab records. People who used PositiveLinks had increased rates of retention in care and viral suppression.
- Best Practices CompilationProject ACCEPT is designed to improve engagement and retention in medical care for youth ages 16 to 24 years with newly diagnosed HIV. The educational and skill-building intervention was deployed at four demonstration sites and increased rates of medication use and appointment adherence in comparison to a control group. Although originally developed for cisgender youth, Project ACCEPT may be adapted for gender-diverse people.
- Best Practices CompilationProject nGage is a support intervention approach that offers participants an initial 90-minute session with a social work interventionist and a participant support confidant to develop a tailored care and support plan. The social work interventionist then offers four follow-up sessions to each participant to discuss progress on the care and support plan. Project nGage was evaluated in a randomized controlled trial from 2012 to 2015: participants in the intervention were more likely to have at least three HIV primary care visits in the last 12 months than those who received usual care.
- Best Practices CompilationSTYLE 2.0 is a multi-component intervention designed to help reduce stigma and social isolation for Black gay, bisexual, and other men who have sex with men. The intervention relies on health care navigators who facilitate linkage and engagement activities. They also connect clients to behavioral health providers who conduct motivational interviewing, as well as to a mobile application that supports all intervention activities. STYLE 2.0 participation has been associated with positive trends across HIV care continuum outcomes, including retention in care and increased viral suppression.
- Center for Innovation and EngagementDescription of a communication-centered approach to service delivery that provides a compassionate and supportive environment to promote intrinsic behavior change among youth 16 to 29 with newly diagnosed HIV.
- Evidence-Informed Interventions (E2i)Text Messaging Intervention to Improve Antiretroviral Adherence among HIV-Positive Youth (TXTXT) is an evidence-informed intervention that provides personalized text messages to remind and encourage young people with HIV to take their HIV medication as prescribed.
Resources
- AETC National Coordinating Resource Center (NCRC)
HIV clinical training resources for HRSA's AIDS Education and Training Centers Program.
- University of Washington
Online clinician training platform with evidence-based core competency training on HIV prevention, screening, diagnosis, care, and key populations.
- U.S. Department of Health and Human Services
Federal guidelines for treatment, prevention and care of HIV disease, opportunistic infections, and common co-infections.
Clinical care guides for various populations (based upon their racial, ethnic, and gender characteristics) and specific conditions.
- Dissemination of Evidence Informed-Interventions Project (DEII)Series of six brief, animated videos with HIV-specific patient education tailored for women of color with HIV.
- Dissemination of Evidence Informed-Interventions Project (DEII)Esta es una serie de seis videos animados breves que brinda educación específica sobre el VIH para pacientes y está destinada especialmente a mujeres de color que viven con el VIH.
- Massachusetts Department of Public Health
Medical case management acuity tool to assess severity of needs of clients living with HIV in various areas of functioning and categories of severity.
- HRSA HIV/AIDS Bureau (HAB)
Library of text messages for patients, developed by the UCARE4Life research study.
Webinars
- HRSA HIV/AIDS Bureau (HAB)
Tools to help health care providers adapt SPNS models within their existing operations in order to better engage hard-to-reach people with HIV into care.
- Boston University School of Social Work Center for Innovation in Social Work and Health
Cross-disciplinary training curriculum to increase knowledge and awareness of the relationship between HIV infection and substance use. Also available in Spanish (Version en español).