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Overview of implementation science activities for the Ryan White HIV/AIDS Program (RWHAP) and feedback on future directions.News Article updated on 04/14/2023
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Telehealth Implementation at a Midwest HIV Clinic
The University of Nebraska Medical Center/Nebraska Medicine (UNMC/NM) Specialty Care Center (SCC) is the largest provider of comprehensive HIV care—including primary and HIV-focused medical services as well as multiple support services—in Nebraska. In March 2020, at the onset of the COVID-19 pandemic, the clinic integrated telehealth into its care delivery model to continue serving patients beyond the clinic structure, and developed algorithms that allowed any team member to quickly identify a patient's eligibility for a telehealth visit. The algorithms include the date of the most recent office visit, stability of HIV disease, most recent viral load and CD4 count, and antiretroviral therapy (ART) refill histories as a proxy for medication adherence. Overall, viral suppression rates remained high for all patients regardless of visit type, indicating that telehealth is a successful alternative to in-person visits for providing HIV care.Resource from the RWHAP Best Practices Compilation updated on 03/23/2024
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Medical Home for Multiply Diagnosed HIV-Positive Homeless Populations
The 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.Resource from the RWHAP Best Practices Compilation updated on 11/13/2023
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SPNS Initiative: Accelerating Implementation of Long-Acting Injectables (2022-2026)
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Accelerating Implementation of Long-Acting Injectables
The ALAI UP Project will support the implementation and delivery of LAI ART at eight demonstration sites in EHE jurisdictions across the US providing care to underserved populations and communities of color.RWHAP Technical Assistance Provider updated on 07/09/2024
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HIV Clinical Pharmacist Services
The 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.Resource from the RWHAP Best Practices Compilation updated on 11/01/2023
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LINK LA
LINK LA is a 12-session, 24-week peer navigation intervention for people with HIV who are scheduled to be released from incarceration. LINK LA peer navigators focus on behavioral changes that promote medication adherence and retention in care, while providing social support and facilitating communication with medical providers. LINK LA showed improvements in linkage to and retention in HIV care and viral suppression among people with HIV re-entering the community after incarceration.Resource from the RWHAP Best Practices Compilation updated on 01/03/2024
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Simplifying Salvage Antiretroviral Regimens in Treatment-Experienced PLWH
In a single-center restrospective cohort study, patients with extensive treatment experience and history of virologic failure and multi-drug resistance underwent simplification of ARV salvage regimens with a median pill burden reduction of six pills per day. This strategy led to high rates of virologic suppression.
Resource (Conference Presentation) updated 09/14/2023
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HIV Clinic Staff and Community Perspectives on Long-Acting Injectable ART in New York City
The first long-acting injectable antiretroviral therapy (LAI ART) formulation was FDA-approved January 2021. Drawing on the Consolidated Framework on Implementation Research, this mixed methods study assessed knowledge, attitudes, practices, and perceived barriers and facilitators related to implementation of LAI ART in NYC among HIV clinic staff and people with HIV.
Resource (Conference Presentation) updated 09/14/2023
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Telemedicine Implementation at a Midwestern HIV Clinic During COVID-19: One Year Outcomes
This HIV clinic evaluated effectiveness of telemedicine for selected patients during the first year of the COVID-19 pandemic, and found overall viral suppression and retention in care rates were not adversely impacted by switch to telemedicine. They also noted similar rates of telemedicine utilization across demographic criteria.
Resource (Conference Presentation) updated 09/14/2023
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Checklist for Evaluating HIV Telehealth Care
The rationale, methodology, and implementation of New York State's Checklist for Evaluating HIV Telehealth Care as used by HIV providers to assess the quality of their telehealth services.
Resource (Conference Presentation) updated 09/14/2023
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Adapting HIV Service Delivery During COVID-19: Lessons Learned
BPHC and HIV service agencies in the Boston EMA quickly adapted during the pandemic by shifting to telehealth, streamlining and enhancing processes, and expanding services to accommodate changing client needs. These changes have led to valuable lessons learned to reduce barriers to care, sustain adaptability and modernize service delivery.
Resource (Conference Presentation) updated 09/14/2023
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Telemedicine to Achieve HIV Viral Suppression in Incarcerated People in Tennessee – 9-year retrospective (2010 – 2018)
In collaboration with Tennessee Department of Corrections, we developed and implemented a stepwise HIV telemedicine program to optimize viral suppression in the state prisons during 2010-2018. Clinic attendance increased from 50 percent to 90 percent during full implementation. Viral suppression increased from 30 percent in 2010 to 90 percent in 2018.
Resource (Conference Presentation) updated 09/14/2023
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Implementation of a telePrEP program in partnership with state and local health departments in South Carolina
Review of a 12-month clinical telePrEP program for rural South Carolina residents, which evaluated the feasibility and acceptability of PrEP delivered through a telehealth model.
Resource (Conference Presentation) updated 09/14/2023
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Assessing Medication Access Barriers in Patients Living with HIV
Virginia quality improvement program that identifies access to medication barriers and provides emergency medication supplies to people with HIV if no timely access is secured.
Resource (Conference Presentation) updated 09/14/2023
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Corrections and community for continuity of HIV care upon re-entry
Development of a referral processes for persons re-entering the community from incarceration (in SOAR program), with referrals prior to release, resulting in higher rate of first appointments within 30-days; challenges for linkage to care through SOAR remain after release.
Resource (Conference Presentation) updated 09/14/2023
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Community Co-Creation: Engaging Traditional and Nontraditional Partners in a National Viral Suppression Campaign
HHS process for development of the “I Am a Work of ART” viral suppression campaign, in collaboration with community partners. of the National HIV/AIDS Strategy.
Resource (Conference Presentation) updated 09/14/2023
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Telehealth in the Ryan White HIV/AIDS Program
RWHAP recipients review their telehealth innovations developed during COVID-19 while HRSA reviews a new program identify and maximize the use of telehealth strategies in the RWHAP and other telehealth initiatives across HRSA.
Resource (Conference Presentation) updated 09/14/2023
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Correctional Health Linkage Interventions Toolkit
Training materials and a curriculum on implementing a project to enhance HIV health services between community and jail settings, based on insights from the SPNS initiative, Enhancing Linkages to HIV Primary Care & Services in Jail Settings.Informational updated 05/16/2024
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Long-Acting Injectables for HIV Antiretroviral Therapy
Guide for EHE jurisdictions on what they can do to enhance implementation of long-acting injectable antiretroviral therapy.Resource updated 04/12/2024