Nearly half of those getting care from HRSA’s Ryan White HIV/AIDS Program (RWHAP) are black/African American. Viral suppression rates are comparable to the overall RWHAP client population, but disparities remain. HIV care programs and technical assistance and training focus on overcoming such challenges as limited access to health services, stigma due to sexual orientation, and housing.
Best Practices
- SPNS Black MSM InitiativeResources to facilitate the replication or adaption of successful interventions for engaging Black MSM in HIV care.
- Center for Innovation and EngagementCollection of implementation guides on evidence-informed best practices in HIV care delivery.
- IHIPComponents of an intervention focused on BMSM with HIV who have not yet been successfully maintained in care.
- SPNS Transgender Women of Color Initiative
Innovative models for linking and retaining transgender women of color in HIV care.
- NASTAD
Ideas for RWHAP Part B/ADAPs to support access to medications and tailor related services for Black/African American men living with HIV.
- IHIP
Implementation guide for HIV providers on addressing the unique needs of women of color living with HIV.
- Best Practices Compilation+LOVE is an integrated case management intervention with behavioral health and crisis support to enhance and improve HIV care and outcomes for Black gay, bisexual, and other men who have sex with men. An evaluation of +LOVE showed improvements in retention in care.
- Best Practices Compilation2BU is a case management intervention designed to engage and reengage Black men who have sex with men with HIV into HIV care services. Peer case managers work closely with clients to increase HIV health literacy, troubleshoot accessibility issues to HIV care, and connect clients directly to behavioral health and support services. Clients who participated in 2BU had increased retention in care and viral suppression 12 months after enrollment.
- Best Practices CompilationE-VOLUTION is a two-way text messaging intervention, originally developed by Washington University School of Medicine and piloted at Project ARK. The intervention focuses on improving health outcomes for youth, particularly young Black men who have sex with men. E-VOLUTION was designed for people ages 18-29 who have HIV and are receiving clinical care but require support to remain adherent. E-VOLUTION was evaluated and found to improve viral suppression and retention in care rates.
- Best Practices CompilationERASE was developed to address the unique needs of Black MSM. Through an intensive case management intervention, peer case managers provide health education and wellness support, and connect clients to medical and behavioral healthcare. ERASE also offers a physical “safe space” for Black MSM to meet with a case manager, access medical services, or connect with peers. Enrollment in ERASE improved retention in HIV care for clients.
- Best Practices CompilationFrom 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.
- 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.
- Best Practices CompilationProject 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.
- Evidence-Informed Interventions (E2i)Project CONNECT is an evidence-informed intervention that engages Black men who have sex with men with HIV into medical care through early orientation to the clinic, relationship building, and enhanced personal contact.
- Best Practices CompilationProject nGage is a support intervention approach that offers participants an initial 90-minute session with a social work interventionist and a participant support confidant to develop a tailored care and support plan. The social work interventionist then offers four follow-up sessions to each participant to discuss progress on the care and support plan. Project nGage was evaluated in a randomized controlled trial from 2012 to 2015: participants in the intervention were more likely to have at least three HIV primary care visits in the last 12 months than those who received usual care.
- Best Practices CompilationSTYLE 2.0 is a multi-component intervention designed to help reduce stigma and social isolation for Black gay, bisexual, and other men who have sex with men. The intervention relies on health care navigators who facilitate linkage and engagement activities. They also connect clients to behavioral health providers who conduct motivational interviewing, as well as to a mobile application that supports all intervention activities. STYLE 2.0 participation has been associated with positive trends across HIV care continuum outcomes, including retention in care and increased viral suppression.
- Center for Innovation and EngagementProject to increase HIV awareness through outreach and testing events on college campuses and in the larger community through partnerships and care linkages.
- Best Practices CompilationProject Vogue provided community-based care coordination, HIV care, and behavioral health services to Black men who have sex with men (MSM) within New York City’s House & Ball community to address the unique cultural barriers that Black MSM experience when trying to access care. Project Vogue participants were linked to behavioral health services as well as to non-clinical supportive services, such as food and housing assistance.
- Best Practices CompilationTailored Motivational Interviewing (TMI) delivers brief motivational interviewing counseling sessions customized to encourage people with HIV to engage in HIV care, take HIV medications as prescribed, and improve other health-related behaviors. Three sites implemented TMI as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017 to 2021. Clients who participated in TMI had significant improvement in engagement in care, prescription of antiretroviral therapy, retention in care, and viral suppression.
- Best Practices CompilationThe Text Messaging Intervention to Improve Antiretroviral Adherence among HIV-Positive Youth (TXTXT) is designed to keep young people, particularly young, Black, gay, bisexual, same-gender loving, and other men who have sex with men, engaged in HIV medical care, by delivering personalized, daily, interactive text messages that remind them to take their antiretroviral therapy as prescribed. Two sites implemented TXTXT as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017–2021. The intervention resulted in a statistically significant improvement in engagement in HIV care.
- 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 CompilationThe Village Project is an intensive case management-based intervention that harnesses peer navigation and integrated behavioral health services to improve the health outcomes of young Black gay, bisexual, and men who have sex with men. The Village Project was associated with increased retention in care and viral suppression.
Resources
- University of Washington
Online clinician training platform with evidence-based core competency training on HIV prevention, screening, diagnosis, care, and key populations.
- In It Together
Health literacy training initiative to help health professionals incorporate health literacy approaches into their services.
- SPNS Improving Care and Treatment Coordination Black Women with HIVUse of participatory arts to generate dialogue and engage individuals in receiving health care and participating in community activities.
- SPNS Improving Care and Treatment Coordination Black Women with HIVHow consumer and community advisory boards can inform the development of evidence based interventions for Black women with HIV.
- SPNS Improving Care and Treatment Coordination Black Women with HIVInnovative strategies for delivery of bundled interventions for improving health outcomes for Black women with HIV during COVID-19.
- National Minority AETCGuide and promising practices that address cultural competency for specific racial/ethnic populations.
Training Modules
- Center for Engaging Black MSM across the Care Continuum
Provider training on the delivery of HIV health care services for black men who have sex with men to enhance engagement/retention in care.
- IHIP
Tools to help health care providers adapt SPNS models within their existing operations in order to better engage hard-to-reach people with HIV into care.
Webinars
- Technical Assistance Provider Innovation Network (TAP-in)Role of health centers in increasing PrEP access and use among women.
- SPNS Improving Care and Treatment Coordination Black Women with HIVHow to create a photovoice: participatory action research that engages people in the process of naming, capturing, and strengthening their community through photography.