Antiretroviral treatment that results in full viral load suppression is clinically beneficial (making it possible to manage HIV as a chronic condition) and significantly reduces the risk of HIV transmission. Federal expert panels now recommend early treatment for anyone living with HIV, and though there are relatively simple regimens available, patients must adhere to them for a lifetime. Monitoring and managing treatment success is a complex task for clinicians. Finally, despite the many advances in recent years, there is still much that is not understood about the long term impact of HIV and HIV medications.
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Best Practices
- Best Practices CompilationCollaborative Care Management (CoCM) integrates mental health and primary care, with a care team of a primary care provider, behavioral health care manager, and psychiatric consultant. Together they provide comprehensive and coordinated care to people with HIV who have co-occurring depression or other psychiatric disorders. Four sites implemented CoCM as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017–2021. CoCM led to statistically significant increases in antiretroviral therapy (ART) prescription and viral suppression.
- Best Practices CompilationTen organizations across the U.S. integrated Community Health Workers (CHWs) into their multidisciplinary care teams. Enrolled clients had statistically significant improvements in viral suppression, antiretroviral therapy prescription, and appointment attendance after six months in the program.
- Best Practices CompilationHealthy Divas focuses on empowering transgender women with HIV to achieve their personal health goals. Three sites implemented the intervention as part of the E2i initiative funded through the RWHAP Part F SPNS program from 2017 through 2021. Both engagement in HIV care and having an antiretroviral therapy prescription improved significantly for clients 12 months after enrollment in Healthy Divas.
- 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 CompilationJumpstART launched in 2016 as part of New York State’s Ending the Epidemic initiative, changing the service delivery model of eight sexual health clinics to include an initial prescription of ART after an HIV diagnosis and prior to linkage to the community provider. Between November 2016 and September 2018, 60% of JumpstART clients received ART on the same day as diagnosis. JumpstART clients were also more likely to reach viral suppression within three months compared to non-JumpstART clients.
- Center for Innovation and EngagementLink-Up Rx is a 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 (ART) interruption.
- Best Practices CompilationThe RWHAP Part F SPNS program funded the Building a Medical Home for Multiply Diagnosed HIV-Positive Homeless Populations initiative from 2012–2017, to provide coordinated housing supports and HIV, behavioral and mental health care to people experiencing homelessness. Nine funded demonstration sites created partnerships with housing providers, integrated behavioral health and HIV care, and provided intensive patient navigator services. A multi-demonstration site evaluation found that, compared to baseline, participants were more likely to be virally suppressed after 12 months in the intervention.
- Best Practices CompilationProject CONNECT uses linkage coordinators to effectively engage people in HIV medical care. It focuses on people with newly diagnosed HIV or people with HIV who are transferring their care or have been out of care. AIDS Taskforce of Greater Cleveland implemented Project CONNECT as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017–2021. Project CONNECT was successful in increasing the number of clients retained in HIV care and who reached viral suppression.
Resources
- AETC National Coordinating Resource Center (NCRC)
HIV clinical training resources for HRSA's AIDS Education and Training Centers Program.
- HRSA HIV/AIDS Bureau (HAB), NASTAD
CPAPA is no longer being updated by NASTAD and has been replaced by Pharmaceutical Company Patient Assistance Programs and Cost-Sharing Assistance Programs.
- National Clinician Consultation Center
Healthcare providers can receive no-cost expert clinical consultation in HIV prevention & care, HCV treatment, and substance use management.
- 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
U.S. HIV-related treatment guidelines, drug database, and glossary.
- U.S. Department of Health and Human Services
Federal guidelines for treatment, prevention and care of HIV disease, opportunistic infections, and common co-infections.
- HRSA Office of Pharmacy Affairs (OPA)
Information on HRSA's Office of Pharmacy Affairs, which administers the 340b program, which provides drug discounts to certain federal grantees,
- Technical Assistance Provider Innovation Network (TAP-in)Guide for EHE jurisdictions on what they can do to enhance implementation of long-acting injectable antiretroviral therapy.
- ACE TA CenterFact sheet on the different coverage and cost-sharing considerations for LAI ART across public and private payers.
- Technical Assistance Provider Innovation Network (TAP-in)What HIV care providers can do to create a rapid ART program to get HIV clients on treatment the same day as a diagnosis.
Webinars
- HRSA HIV/AIDS Bureau (HAB)
Pre-application webinars for Notice of Funding Opportunity (NOFO) announcements from HRSA's HIV/AIDS Bureau for the Ryan White HIV/AIDS Program (RWHAP).
- SPNS HIV/HCV Data-to-Care InitiativeReview of the data to care project and lessons learned on HCV micro-elimination activities from the Arizona Department of Health Services.
- Technical Assistance Provider Innovation Network (TAP-in)Role of health centers in increasing PrEP access and use among women.
- Technical Assistance Provider Innovation Network (TAP-in)Learn how to improve messaging about HIV prevention and care to improve acceptance of services among all Black women.
- Technical Assistance Provider Innovation Network (TAP-in)In 2021, the U.S. public was introduced to a bi-monthly injectable form of PrEP, which stands for Pre-Exposure Prophylaxis.
- Technical Assistance Provider Innovation Network (TAP-in)In this Microlearning segment, learn what types of injectable long lasting HIV prevention and treatment medications are available, and their similarities and differences.
- Technical Assistance Provider Innovation Network (TAP-in)Review of concept of status neutral (access to HIV services regardless of HIV status).
- Technical Assistance Provider Innovation Network (TAP-in)Recordings of the TAP-in webinars on topics critical to the Ending the HIV Epidemic Initiative.