The Ryan White HIV/AIDS Program for low-income people with HIV (PWH) is a key resource for reducing HIV health disparities and scaling up evidence-based interventions. As RWHAP serves >50% of US PWH, RWHAP outcomes are vital to achieving “getting to zero”/ Ending the HIV Epidemic (EHE) Plan targets.
We propose to implement and rigorously evaluate a novel “data-to-suppression” (D2S) intervention with Ryan White HIV/AIDS Program Part A (RWPA) support-service programs, specifically behavioral health and housing, to address a viral suppression (VS) deficit among RWPA clients in HIV care. While data-to-care (D2C) efforts pursue data sharing and linkages with medical providers, our premise is that support-service program staff are best positioned to address major barriers to antiretroviral adherence, once they have the information needed to triage those who struggle to maintain VS. Surveillance data sharing by health departments with their community-based Ryan White programs may be especially critical to fill communication gaps between clinical and support-service providers as ‘telehealth’ becomes more prevalent in response to the COVID-19 pandemic.
The project’s specific aims are to:
- Measure D2S intervention effects on timely VS and time to VS, in a stepped-wedge hybrid Type 1 trial;
- Identify modifiable determinants of D2S response, by comparing characteristics of D2S-exposed clients who do and do not achieve VS, to recognize opportunities to tailor and strengthen the intervention;
- Assess D2S acceptability and participant preferences and priorities for its implementation, in eight (client and provider) focus groups and in a discrete choice experiment (DCE) with RWPA staff.
This project is a collaboration between CUNY ISPH and the NYC Department of Health and Mental Hygiene.