Building Capacity to Implement Rapid ART Start

Implementation Sites | Project Goals | Implementation Resources

Under the Building Capacity to Implement Rapid ART Start for Improved Care Engagement in Ryan White HIV/AIDS Program initiative, 14 clinical sites across the United States were funded to implement and evaluate “Rapid Start” antiretroviral therapy (ART) services. The Health Resources and Services Administration’s Ryan White HIV/AIDS Program (RWHAP) Part F–Special Projects of National Significance (SPNS) Program sponsored this initiative to accelerate the initiation of ART and entry into HIV medical care for people with HIV who are newly diagnosed, new to care, or out of care. Each of the implementation sites had the capacity and infrastructure to support Rapid Start ART, had initiated pilot projects, or were ready to expand Rapid Start ART services, with the goal of replicating and expanding successful Rapid Start ART models. Implementation sites included RWHAP-funded clinics, Federally Qualified Health Centers, academic medical centers, and community-based organizations. Funding from the Department of Health and Human Services (HHS) Minority HIV/AIDS Fund (MHAF) also supported this initiative.

Download Fact Sheet

Implementation Sites

Project Goals

The University of California San Francisco Center for AIDS Prevention Studies (CAPS) was the initiative’s Evaluation and Technical Assistance Provider (ETAP). CAPS offered technical assistance to the implementation sites, evaluated the implementation of Rapid Start ART services, assessed HIV care continuum outcomes, and produced resources for future replication and scale-up of Rapid Start ART in other RWHAP provider organizations. All 14 sites participated in the initiative-wide Learning Collaborative that provided the structure for technical assistance and the cross-site evaluation, which used an implementation science approach to assess the implementation of rapid start ART, with a focus on:

• Organizational characteristics, adaptations, and implementation barriers and facilitators.
• Labor, programmatic and structural costs.
• Patient outcomes, including linkage to care, initiation of ART, rates of viral suppression, and elapsed time to viral suppression.

Implementation Resources

The Rapid Start ART Implementation Resources are designed to provide the tools to effectively implement rapid initiation of antiretroviral therapy (ART) in diverse settings like community-based organizations and health clinics. Key resources developed include an Implementation Guide, which outlines the steps and best practices for adopting Rapid Start ART services from pre-implementation considerations through strategies to support sustaining Rapid Start ART as standard of care; Quality Improvement Tools, which offer frameworks and metrics to enhance service delivery and track patient outcomes; Site Protocols, detailing specific procedures and workflow maps tailored to different clinical settings; and Site Spotlights, showcasing successful models and strategies from participating sites.