Both the Data-to-Suppression (D2S) project and the Program Refinements to Optimize Model Impact and Scalability Based on Evidence (PROMISE) project aim to strengthen HIV care within the Ryan White health programs by addressing barriers that prevent people with HIV from achieving viral suppression. While PROMISE evaluates improvements to a large-scale care coordination model, D2S focuses on using surveillance data within support-service programs to directly target adherence challenges.
With contributions by ISPH Investigators Denis Nash and Honoria Guarino, with colleagues including ISPH Affiliated Investigator Tigran Avoundjian, AIDS Patient Care & STDs recently published two articles on the D2S and PROMISE projects. In “Provider perspectives on the Data-to-Suppression initiative in Ryan White Part A housing and behavioral health programs,” details interviews with 24 providers from 8 agencies indicating that D2S was feasible, useful for identifying clients in need of support, and facilitated outreach. The study found that barriers included staffing constraints, competing client needs, and limited report timeliness and detail, suggesting opportunities to strengthen implementation and impact. In the article, “We’re going to be here’: Providers’ perspectives on implementing a revised HIV Care Coordination Program,” the PROMISE study includes semi-structured interviews with 30 providers across six agencies, highlighting the strengths of the program’s client-centered flexibility and dedicated staff, while also identifying barriers such as excessive administrative burden, unrealistic expectations, understaffing, and provider burnout. Findings underscore the importance of sustaining client-centered approaches while reducing administrative challenges and enhancing provider support to strengthen implementation and long-term sustainability.
ISPH research staff Rebecca Zimba, Chunki Fong, Madellena Conte, along with Denis Nash, Honoria Guarino, and Tigran Avoundjian with colleagues, published “Are client and provider preferences for HIV Care Coordination Program features concordant? Discrete choice experiments in Ryan White Part A-funded New York City Care Coordination Programs,” in BMJ Open. This study compared client and provider preferences for components of New York City’s HIV Care Coordination Program using a discrete choice experiment with 181 clients and 152 providers. Clients prioritized support for ART adherence and valued lower-intensity options such as phone/text reminders and remote visits, while providers emphasized higher-intensity services including directly observed therapy, specialty medical care, and tolerance for longer travel times. The divergence in preferences underscores the need to incorporate client perspectives to optimize program design and alignment with client values.
