HRSA HIV/AIDS Bureau Fact Sheets, March 2023.
Collection of implementation guides on evidence-informed best practices in HIV care delivery.
Transgender people, particularly, transgender women of color, have higher rates of HIV infection. Rates are especially high among African American transgender women. Transgender people face significant barriers to accessing HIV and other medical care and social support services.
Best Practices
- Center for Innovation and Engagement
- 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.
- IHIPProject to enhance the provision of HIV care for Latina transgender women in Los Angeles County.
- IHIPNinetyday theory-based, transgender-specific, automated text-messaging intervention designed to improve engagement, retention, and health outcomes along the HIV care continuum.
- SPNS Social Media Initiative
Social media tools developed by demonstration sites (e.g., text messaging, apps).
- SPNS Transgender Women of Color Initiative
Innovative models for linking and retaining transgender women of color in HIV care.
- Best Practices CompilationHoward Brown Health established a specialized drop-in clinic and support groups, and implemented organizational initiatives to provide culturally relevant and gender-affirming services for transgender and non-binary people, including transgender women of color. The goal of this intervention was to optimize engagement in HIV services and primary care. From 2012-2021, the number of transgender and non-binary people served in primary care at Howard Brown Health more than tripled. In addition, after 24 months, participants were more likely to have been prescribed ART and to be virally suppressed than at baseline.
- Best Practices CompilationThe Enhanced Patient Navigation for Women of Color with HIV intervention uses patient navigators, who are non-medical staff in clinical settings, to reduce barriers to health care and optimize care. The intervention was effective in improving linkage to and retention in care, as well as viral suppression.
- Dissemination of Evidence Informed-Interventions Project (DEII)Patient navigation intervention informed and adapted from the best practice findings of a past SPNS initiative that yielded successful HIV care continuum outcomes among client participants.
- Best Practices CompilationEnlaces Por La Salud is an HIV linkage, navigation, and education program for Mexican men and transgender women. The intervention is grounded in a transnational framework for providing cultural context to support the delivery of one-on-one educational sessions to Latina(o/x) people with a new HIV diagnosis, as well as people with HIV who are not yet retained in care. After 12 months, the majority of people participating in Enlaces Por La Salud were retained in care and reached viral suppression.
- 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.
- Evidence-Informed Interventions (E2i)Healthy Divas is an evidence-informed intervention that empowers transgender women with HIV to accomplish personalized gender affirmation and HIV health goals through peer-facilitated counseling sessions.
- Dissemination of Evidence Informed-Interventions Project (DEII)Peer linkage and re-engagement intervention, informed and adapted from the best practice findings of a past SPNS initiative.
- Best Practices CompilationThe PC4H initiative employs a mobile app and a digital literacy workshop to improve engagement, retention in care, and medication adherence for young people with HIV. These strategies aim to reach young people who are disproportionately affected by HIV, including young men who have sex with men, young transgender women, and youth of color, with a focus on serving people who know their status but are inconsistently engaged in care. Developed by Children’s Hospital of Philadelphia and Philadelphia FIGHT, PC4H was evaluated through the RWHAP Part F SPNS Social Media Initiative. The evaluation found that PC4H had positive impacts on retention in care and viral suppression.
- Evidence-Informed Interventions (E2i)T.W.E.E.T. is an evidence-informed intervention that engages transgender women into HIV care through peer-led health education groups, leadership opportunities, supportive services, and community building.
- Best Practices CompilationText Me, Girl! is a text messaging intervention that aims to improve linkage to and retention in HIV care, increase adherence to HIV medications, and improve viral suppression and other health outcomes among transgender women ages 18–34 years. The intervention supports young transgender women with HIV, particularly those experiencing barriers to care such as periods of homelessness and/or incarceration, substance misuse, or engaging in sex work. Text Me, Girl! participation was associated with statistically significant improvements in antiretroviral therapy uptake and adherence, and self-reported viral suppression.
- Best Practices CompilationThe Alexis Project used social network recruiting and engagement, peer navigation, and contingency management to reach and engage transgender women of color with HIV who were not engaged in HIV care. Participation in the 18-month intervention improved linkage to care and viral suppression.
- Best Practices CompilationBienestar developed TransActivate to improve timely engagement and retention in HIV care among Latina transgender women. Linkage coordinators/peer navigators use a strengths-based approach to help clients reach their goals of entering and staying in medical care to ultimately reach viral suppression.
- Best Practices CompilationThe Rutgers New Jersey Medical School created a transgender health program and integrated it into their Infectious Disease Practice. The program conducted community outreach to engage transgender men and women in care, trained all staff on gender affirming care, hired transgender staff, provided gender affirming care and hormone treatments onsite, and offered mental health support to patients.
- Best Practices CompilationT.W.E.E.T. aims to engage transgender women in HIV care by combining weekly peer-based education and discussion groups, leadership training, community building, and the provision of supportive services. Three sites implemented T.W.E.E.T. as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017–2021. Clients had improved outcomes across the HIV care continuum 12 months after enrollment in T.W.E.E.T.
- Best Practices CompilationIn weCare, a cyber health educator sent personalized messages through text, web-based apps, and Facebook to enrolled youth who identified as gay, bisexual, or other men who have sex with men (MSM), or transgender women, and who either had a new diagnosis of HIV or were not in care at the time of enrollment. Messages were personalized to each participant’s needs and were designed to support them as they navigated complicated health care systems as well as other challenges that affect care engagement (e.g., transportation, disclosure). The cyber health educator also moderated and posted information about health and well-being on an optional secret Facebook page that some participants chose to join. Participants were less likely to miss medical appointments and more likely to be virally suppressed after 12 months of the intervention.
Resources
- University of Washington
Online clinician training platform with evidence-based core competency training on HIV prevention, screening, diagnosis, care, and key populations.
Clinical care guides for various populations (based upon their racial, ethnic, and gender characteristics) and specific conditions.
- University of California, San Francisco
Resources on transgender health (e.g., guidelines, training).
- NASTAD
Document highlights programming options for ADAPs to better serve transgender communities.
- Howard Brown Health Center
Curriculum for nurses teaching cultural competency in the care of LGBT older adults.
Training Modules
- IHIP
Manual to help health care providers adapt SPNS models addressing how to engage hard-to-reach people with HIV (PWH) into care within their current operations.
Webinars
- IHIPWebinar series featuring HIV care innovations developed under HRSA SPNS projects.
- 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.
Conference Presentations
HRSA
Presenters:
Heather Hauck, Alex Keuroghlian, Jill York, Larry Zayas Rivera, Harold Phillips
2022 National Ryan White Conference on HIV Care & Treatment
HRSA
Presenters:
Alex Keuroghlian, Nicole Chavis, Beth Bourdeau, Demetrios Psihopaidas
2022 National Ryan White Conference on HIV Care & Treatment
HRSA
Presenters:
Alex Keuroghlian, Dana Hines, Paul Sacamano, Jamie Weinand
2022 National Ryan White Conference on HIV Care & Treatment
AIDS Alliance for Women, Infants, Children, Youth & Families
Presenters:
Ivy Turnbull, Michele Scavnicky
2022 National Ryan White Conference on HIV Care & Treatment
University of California San Diego
Presenters:
Blumenthal
2022 Ryan White HIV/AIDS Program Clinical Conference