Estimating Unmet Need for HIV Primary Medical Care

Update to the Unmet Need framework for Ryan White HIV/AIDS Program (RWHAP) Part A and Part B recipients, by HRSA's HIV/AIDS Bureau. RWHAP Part A and Part B recipients will be required to submit Unmet Need estimates using the updated methodology in FY 2022 as part of their applications. Resources are to assist recipients with the successful implementation of the new methodology.


As part of the Ryan White CARE Act Amendment of 2000, the Secretary of US Department of Health and Human Services (HHS) was required to “develop epidemiologic measures for establishing the number of individuals with HIV disease who are not receiving HIV-related health services.”(1) In the RWHAP Program, Unmet Need is defined as “The need for HIV-related health services by individuals with HIV who are aware of their HIV status, but are not receiving regular primary [HIV] health care.” (1)

RWHAP Parts A and Part B recipients began reporting estimates of unmet need in FY 2005 applications. In the years since the original Unmet Need methodology was put in place, the treatment of HIV disease has changed significantly due to the effectiveness of antiretroviral treatment (ART). Moreover, the availability and quality of data used to estimate unmet need has also improved. HRSA HAB explored ways to more effectively estimate unmet need to meet both the legislative requirements and provide a better tool for jurisdictions to use to identify needs and develop interventions in response.

(1) 106th Congress, H.R.4807 - Ryan White CARE Act Amendments of 2000. 2000.

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