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News Article updated on 10/01/2021
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Peer Engagement to Improve Linkage to Care and Retention in Care for Women and Youth
University Health uses peers and patient navigators to provide support, reduce barriers, and improve linkage and retention to care for women and youth with HIV. Two peers with lived experience were hired as Outreach Specialists to spearhead the program, encourage medication adherence and use of services, and provide mentoring. The intervention was successful in moderately improving the numbers of clients linked to care, retained in care, and virally suppressed.Resource from the RWHAP Best Practices Compilation updated on 11/14/2023
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Initiative Products and Resources
Webinars and briefs on delivery of HIV care to persons with unstable housing.Resource updated 09/14/2023
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Innovative Intervention Strategies (2iS)
HRSA SPNS project applying the implementation science framework to identify innovative HIV interventions for three priority populations (people with substance use disorder, sexual minority youth, people involved in criminal justice system) and use of telehealth. Project period: 2021-2025.RWHAP Technical Assistance Provider updated on 04/02/2024
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Reflections on Black Women with HIV and Incarceration
Coming Home: Women, Race, Social Justice & HIV, a virtual learning experience that centered voices from the community of justice-involved Black women with HIV.Blog updated 11/29/2022
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Transgender Women Engagement and Entry to Care (T.W.E.E.T): E2i
T.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.Resource from the RWHAP Best Practices Compilation updated on 02/09/2024
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Bilingual and Bicultural Care Team
Hispanic and Latino clients served by the team received culturally responsive care and linkages to external community resources, with resulting greater retention in care and improved viral suppression rates.Resource from the RWHAP Best Practices Compilation updated on 01/03/2024
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Integration of Oral Health and Primary Care in Seattle-King County
This referral-based oral health model used dental navigators to connect clients to a large network of dentists, which facilitated scheduling of appointments.Resource from the RWHAP Best Practices Compilation updated on 11/02/2023
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Peer Linkage and Re-engagement of Women of Color with HIV
From 2016 through 2019, three clinics—AIDS Care Group, Howard Brown Health, and Meharry Medical College—participated in a RWHAP Part F SPNS DEII initiative to implement peer linkage and re-engagement interventions for women of color with HIV. Integrating peers into HIV primary care teams has been effective in better engaging women of color in care.Resource from the RWHAP Best Practices Compilation updated on 02/28/2024
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National Monitoring Standards and RWHAP Part B Manual Recipients
This HRSA technical assistance webinar provided a high level overview of updates made to both the National Monitoring Standards (NMS) and the Ryan White HIV/AIDS Program (RWHAP) Part B Manual. Release of the NMS is forthcoming.Resource updated 08/21/2023
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Compendium of Evidence-informed Approaches to Improving Health Outcomes for People Living with HIV
Collection of implementation guides on evidence-informed best practices in HIV care delivery.Resource updated 03/04/2024
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Proyecto Promover
The Ruth M. Rothstein CORE Center launched Proyecto Promover to decrease HIV testing-related stigma, increase awareness of HIV status, and increase early linkage to and retention in care among Mexicanos with HIV. The program operates at the community level through social marketing, educational talks, networking, and testing. On the individual level, Proyecto Promover uses one-on-one conversations to identify and overcome barriers related to care engagement and retention. Evaluation showed promising rates of HIV testing, retention in care, and viral suppression.Resource from the RWHAP Best Practices Compilation updated on 02/29/2024
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Pay it Forward Transitional Care Coordination
One Stop Career Center of Puerto Rico (OSCC-PR) implemented Pay it Forward to increase workforce capacity to connect Puerto Ricans with HIV to community-based HIV care and social supports following release from jail. Pay it Forward included training of OSCC-PR staff in the Transitional Care Coordination model. Eighty percent of clients who were supported by Pay it Forward in Puerto Rico were still in HIV care 12 months after release.Resource from the RWHAP Best Practices Compilation updated on 05/07/2024
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National Monitoring Standards for RWHAP Part A Recipients
This HRSA technical assistance webinar was to provide a high level overview of updates made to the National Monitoring Standards (NMS). Release of the NMS is forthcoming.Resource updated 08/21/2023
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Project ACCEPT
Project 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.Resource from the RWHAP Best Practices Compilation updated on 01/03/2024
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Beyond the Walls: Building Foundation for Jail Linkage Programs
Effective models and best practices for connection to care for justice-involved individuals.Resource updated 05/15/2024
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Resiliency of Black Women with HIV
Resilient, Black, and Graceful: A Night of a Thousand Words, brought together 30 Black women from greater Atlanta to celebrate and share stories about their lives after being diagnosed.Blog updated 11/15/2022
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Transitional Care Coordination: From Jail Intake to Community HIV Care Intervention
Transitional Care Coordination (TCC) connects people with HIV who are incarcerated with a transitional care coordinator to facilitate access to HIV primary care and other community-based services and supports, following their transition from jail back to the community. TCC aims to establish vital linkages between jail-based and community-based HIV care, and may be implemented by community-based organizations, clinics, health departments, or jails.Resource from the RWHAP Best Practices Compilation updated on 07/03/2024
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Community Health Workers: Improving Linkage and Retention in HIV Care
Ten 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.Resource from the RWHAP Best Practices Compilation updated on 01/03/2024
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Project CONNECT: E2i
Project 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.Resource from the RWHAP Best Practices Compilation updated on 01/03/2024