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Project CORE: Coordination of Resources and Employment
Avenue 360 Health and Wellness, a Federally Qualified Health Center, and AIDS Foundation Houston, a community-based AIDS Service Organization, implemented Project CORE. This intervention aimed to improve health outcomes for people with HIV through the coordination of supportive employment and housing services. Through Project CORE, 39% of participants were placed in housing and 39% gained employment.Resource from the RWHAP Best Practices Compilation updated on 01/03/2024
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No Wrong Door for High-Acuity Care
Fenway Health, Fenway AIDS Action Committee, and MassHire Downtown Boston provided housing and employment supports to clients who were unstably housed and were un- or under-employed, in order to improve health outcomes as part of the RWHAP Part F SPNS initiative Improving HIV Health Outcomes through the Coordination of Supportive Employment and Housing Services. Almost 70 percent of clients who participated in this intervention and received medical care at Fenway Health were virally suppressed, despite facing considerable barriers to care.Resource from the RWHAP Best Practices Compilation updated on 11/14/2023
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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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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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Preparing People with HIV (PWH) for Involvement in HIV Community Planning
Review of HIV community planning groups.Resource updated 10/24/2023
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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 02/02/2024
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Maricopa County: Expanding Jail Services & Improving Health for Incarcerated People with HIV
The Maricopa County Jail Project was implemented by five jails and uses a nurse practitioner to manage service access and case management across the jail system.Resource updated 10/13/2023
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RWHAP Part A Guidance for Planning Bodies on Supporting People with Lived Experience
From the HRSA HIV/AIDS Bureau Listserv, 12/16/22
News Article updated on 12/19/2022 -
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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Maricopa County Jail Project: Providing HIV Service to People Who Are Incarcerated
Partnership between jail staff and public health prevention staff created new data communication systems and bundled services for clients upon release.Resource updated 05/15/2024
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PATH to Jobs: Expanding Employment Opportunities for People with HIV as Peer Navigators and Community Health Workers
Workforce development initiative that creates opportunities for low-income New Yorkers with shared lived experiences to reenter the workforce.
Resource (Conference Presentation) updated 09/14/2023
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Joy in Workplace
Review of leadership and workplace changes on creating an improved work environment.Resource updated 11/01/2023
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Key Stakeholder Engagement Matters! Syndemics, Health Disparities, and Coordinating Systems of Care
Discussion of key stakeholder engagement in your Planning Council/Planning Body (PC/PB).Resource updated 05/09/2024
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Navigator Case Management for People Leaving Jail
The Navigator Case Management intervention helps people with HIV who are incarcerated and are leaving to return to the community. The intervention uses harm reduction, case management, and motivational interviewing techniques to promote healthy behaviors. Enhanced case management including peer support and connection to other needed services both immediately before and after release supports increased linkage to and retention in HIV care for people transitioning to the community from jail.Resource from the RWHAP Best Practices Compilation updated on 01/19/2024
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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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I am Somebody! Developing Leaders in your PC/PB
Discussion of ways to develop leaders in your Planning Council/Planning Body (PC/PB).Resource updated 01/05/2024
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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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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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A Selection of Community Engagement Tools
Access these National Academy of Medicine and RWHAP consumer engagement tools.News Article updated on 06/23/2023