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• W3207366874 abstract "The Treat pillar of the Ending the HIV Epidemic in the U.S. plan calls for comprehensive strategies to enhance linkage to, and engagement in, HIV medical care to improve viral suppression among people with HIV and achieve the goal of 95% viral suppression by 2025. The U.S. has seen large increases in the proportion of people with HIV who have a suppressed viral load. Viral suppression has increased 41%, from 46% in 2010 to 65% in 2018. An additional increase of 46% is needed to meet the Ending the HIV Epidemic in the U.S. goal. The rate of viral suppression among those in care increased to 85% in 2018, highlighting the need to ensure sustained care for people with HIV. Greater increases in all steps along the HIV care continuum are needed for those disproportionately impacted by HIV, especially the young, sexual and racial/ethnic minorities, people experiencing homelessness, and people who inject drugs. Informed by systematic reviews and current research findings, this paper describes more recent promising practices that suggest an impact on HIV care outcomes. It highlights rapid linkage and treatment interventions; interventions that identify and re-engage people in HIV care through new collaborations among health departments, providers, and hospital systems; coordinated care and low-barrier clinic models; and telemedicine-delivered HIV care approaches. The interventions presented in this paper provide additional approaches that state and local jurisdictions can use to reach their local HIV elimination plans’ goals and the ambitious Ending the HIV Epidemic in the U.S. Treat pillar targets by 2030. The Treat pillar of the Ending the HIV Epidemic in the U.S. plan calls for comprehensive strategies to enhance linkage to, and engagement in, HIV medical care to improve viral suppression among people with HIV and achieve the goal of 95% viral suppression by 2025. The U.S. has seen large increases in the proportion of people with HIV who have a suppressed viral load. Viral suppression has increased 41%, from 46% in 2010 to 65% in 2018. An additional increase of 46% is needed to meet the Ending the HIV Epidemic in the U.S. goal. The rate of viral suppression among those in care increased to 85% in 2018, highlighting the need to ensure sustained care for people with HIV. Greater increases in all steps along the HIV care continuum are needed for those disproportionately impacted by HIV, especially the young, sexual and racial/ethnic minorities, people experiencing homelessness, and people who inject drugs. Informed by systematic reviews and current research findings, this paper describes more recent promising practices that suggest an impact on HIV care outcomes. It highlights rapid linkage and treatment interventions; interventions that identify and re-engage people in HIV care through new collaborations among health departments, providers, and hospital systems; coordinated care and low-barrier clinic models; and telemedicine-delivered HIV care approaches. The interventions presented in this paper provide additional approaches that state and local jurisdictions can use to reach their local HIV elimination plans’ goals and the ambitious Ending the HIV Epidemic in the U.S. Treat pillar targets by 2030. Prevention, care, and treatment efforts to end the American HIV epidemic by 2030 are guided by the Ending the HIV Epidemic (EHE) in the U.S. Initiative1Fauci AS Redfield RR Sigounas G Weahkee MD Giroir BP. Ending the HIV epidemic: a plan for the United States.JAMA. 2019; 321: 844-845https://doi.org/10.1001/jama.2019.1343Crossref PubMed Scopus (617) Google Scholar and the recently released HIV National Strategic Plan: A Roadmap to End the Epidemic (HIV Plan).2HHSHIV National Strategic Plan for the United States: a road map to end the epidemic 2021–2025. HHS, Washington, DCPublished 2021https://files.hiv.gov/s3fs-public/HIV-National-Strategic-Plan-2021-2025.pdfDate accessed: January 16, 2021Google Scholar The EHE plan includes 4 strategies visualized as pillars: Diagnose, Treat, Prevent, and Respond. The Treat pillar, summarized as “Treat people with HIV rapidly and effectively to reach sustained viral suppression,” calls for comprehensive strategies to enhance linkage to, and engagement in, HIV medical care; expand re-engagement and retention in care; and improve viral suppression among people with HIV (PWH). This paper describes the progress to date to reach the Treat pillar goal of 95% viral suppression by 2025 and summarizes recent interventions, promising practices, and new approaches that state and local health departments (HDs) and providers can utilize to reach EHE goals. IIndicators used to measure national progress on the Treat pillar are derived from data reported to the National HIV Surveillance System. Based on historical data from the Centers for Disease Control and Prevention (CDC) HIV Prevention Progress Report (2019)3Centers for Disease Control and PreventionHIV prevention progress report, 2019: includes national and state level data for 2010 through 2017 where available. Centers for Disease Control and Prevention, Atlanta, GAPublished March 2019https://www.cdc.gov/hiv/pdf/policies/progressreports/cdc-hiv-preventionprogressreport.pdfDate accessed: December 6, 2020Google Scholar and recent data from the Monitoring Selected National HIV Prevention and Care Objectives report,4Centers for Disease Control and PreventionMonitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2018. HIV surveillance supplement report 2020;25(no. 2). Centers for Disease Control and Prevention, Atlanta, GAPublished May 2020https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-25-2.pdfDate accessed: January 6, 2021Google Scholar this paper describes progress made in the following indicators relevant to the Treat pillar: linkage to care (measured by having ≥1 CD4 or viral load test within 1 month of diagnosis), receipt of HIV medical care (measured by documentation of ≥1 CD4 or viral load test in a calendar year), retention in care (measured by having ≥2 CD4 or viral load tests ≥3 months apart in a calendar year), and viral suppression (measured by a viral load result of <200 copies/mL at the most recent viral load test). Overall, linkage to HIV care increased considerably between 2010 and 2018 (14%, from 70% in 2010 to 80% in 2018). Although the U.S. is close to achieving the linkage to care goal of 85% by 2020, a further 18% relative increase is needed to meet the 2025 and 2030 target of 95%. Far greater increases are needed to reach the target for disproportionately affected groups, such as racial/ethnic minorities. Based on 2018 data, linkage to care data range from 82% to 84% for Asians, Whites, and Hispanics/Latinos to 77% for Blacks/African Americans. In general, linkage to HIV medical care increased as age at time of diagnosis increased, suggesting that more attention is needed for individuals diagnosed at younger ages.4Centers for Disease Control and PreventionMonitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2018. HIV surveillance supplement report 2020;25(no. 2). Centers for Disease Control and Prevention, Atlanta, GAPublished May 2020https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-25-2.pdfDate accessed: January 6, 2021Google Scholar Considerably less progress has been made in both receipt of, and retention in, HIV medical care, essential steps toward ensuring people reach and sustain viral suppression. Receipt of care was relatively stable, with a 3% increase between 2016 (74%) and 2018 (76%). Retention in care increased a modest 5%, from 55% in 2010 to 58% in 2018. Although there are no specific 2030 targets for retention in care, the 90% 2020 retention in care target has still not been achieved. Far greater increases are needed for disproportionately affected groups, especially among male individuals who inject drugs (51% in 2018).4Centers for Disease Control and PreventionMonitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2018. HIV surveillance supplement report 2020;25(no. 2). Centers for Disease Control and Prevention, Atlanta, GAPublished May 2020https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-25-2.pdfDate accessed: January 6, 2021Google Scholar Most relevant and encouraging are the large increases observed in viral suppression, the end goal of the Treat pillar. Between 2010 and 2018, the proportion of PWH (both in and out of care) who are virally suppressed increased 41%, from 46% in 2010 to 65% in 2018. Despite significant progress in viral suppression for all PWH, a 46% increase is still needed to reach the 2025 and 2030 targets of 95%. Far greater increases are needed for disproportionately affected groups, and reaching the 2030 target will depend on improvements in linkage to, receipt of, and retention in care. Disparities are observed among male individuals who inject drugs, who have lower viral suppression rates than those with infection attributed to male-to-male sexual contact (53% vs 67% in 2018). Disparities by race/ethnicity were also large, with viral suppression ranging from 70% to 71% for Asians and Whites to 64% for Hispanics/Latinos and 60% for Blacks/African Americans. In general, viral suppression increased as age increased.4Centers for Disease Control and PreventionMonitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2018. HIV surveillance supplement report 2020;25(no. 2). Centers for Disease Control and Prevention, Atlanta, GAPublished May 2020https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-25-2.pdfDate accessed: January 6, 2021Google Scholar Higher viral suppression percentages are seen among those who received care (85% in 2018). A similar rate, 88% in 2019, is found among in-care Ryan White HIV/AIDS Program (RWHAP) participants.5Health Resources and Services AdministrationRyan White HIV/AIDS Program annual client-level data report 2019. Health Resources and Services Administration, Rockville, MDPublished December 2020https://hab.hrsa.gov/sites/default/files/hab/data/datareports/RWHAP-annual-client-level-data-report-2019.pdfDate accessed: January 8, 2021Google Scholar The path to reaching EHE goals and the resources to do so for all PWH also vary considerably from state to state. According to the 2019 CDC progress report that examined progress in key indicators, among the 38 states with 2016 data available, 32% met and 39% made progress toward the intermediary 2020 national linkage to care target of 85%. The 2020 retention in care target of 90% was not met by any state, but more than half (55%) had made progress. Similarly, the viral suppression target of 80% was not met, but 68% of the states had made progress.3Centers for Disease Control and PreventionHIV prevention progress report, 2019: includes national and state level data for 2010 through 2017 where available. Centers for Disease Control and Prevention, Atlanta, GAPublished March 2019https://www.cdc.gov/hiv/pdf/policies/progressreports/cdc-hiv-preventionprogressreport.pdfDate accessed: December 6, 2020Google Scholar To reach the ambitious Treat pillar target that 95% of PWH achieve viral suppression by 2030, carefully crafted and targeted strategies are needed to address the complex challenges that are fueling HIV disparities. States and local jurisdictions are actively working on this, and >46 states, counties, and cities have developed their own EHE plans that address the individual-, community-, and policy-level factors that affect the health and well-being of those most affected by HIV in their jurisdiction.6EHE Plans and Websites. NASTAD, Updated June 16, 2021https://www.nastad.org/ehe-plansDate accessed: July 10, 2021Google Scholar Although progress has been made in the EHE indicators, the aforementioned data show that considerable work is still needed to achieve the 2030 targets, especially for populations disproportionately affected by HIV. The HIV Plan highlights the importance of reducing HIV-related disparities and health inequities and calls for the development and scale-up of evidence-based and evidence-informed interventions and best practices to address the well-documented challenges to HIV prevention, care, and treatment.7Mugavero MJ Norton WE Saag MS. Health care system and policy factors influencing engagement in HIV medical care: piecing together the fragments of a fractured health care delivery system.Clin Infect Dis. 2011; 52: S238-S246https://doi.org/10.1093/cid/ciq048Crossref PubMed Scopus (177) Google Scholar Through multiple systematic reviews conducted over the last decade, there is a robust and burgeoning collection of effective U.S.-based interventions and best practices that can lead to significant improvements in linkage, re-engagement retention, adherence, and viral suppression.8Compendium of evidence-based interventions and best practices for HIV prevention. Centers for Disease Control and Prevention, Updated December 29, 2020https://www.cdc.gov/hiv/research/interventionresearch/compendium/index.htmlDate accessed: December 17, 2020Google Scholar, 9Liau A Crepaz N Lyles CM et al.Interventions to promote linkage to and utilization of HIV medical care among HIV-diagnosed persons: a qualitative systematic review, 1996-2011.AIDS Behav. 2013; 17: 1941-1962https://doi.org/10.1007/s10461-013-0435-yCrossref PubMed Scopus (69) Google Scholar, 10Higa DH Crepaz N Mullins MM Prevention Research Synthesis Project. Identifying best practices for increasing linkage to, retention, and re-engagement in HIV medical care: findings from a systematic review, 1996-2014.AIDS Behav. 2016; 20: 951-966https://doi.org/10.1007/s10461-015-1204-xCrossref PubMed Scopus (58) Google Scholar, 11Higa DH Marks G Crepaz N Liau A Lyles CM. Interventions to improve retention in HIV primary care: a systematic review of U.S. studies.Curr HIV AIDS Rep. 2012; 9: 313-325https://doi.org/10.1007/s11904-012-0136-6Crossref PubMed Scopus (135) Google Scholar, 12Risher KA Kapoor S Daramola AM et al.Challenges in the evaluation of interventions to improve engagement along the HIV care continuum in the United States: a systematic review.AIDS Behav. 2017; 21: 2101-2123https://doi.org/10.1007/s10461-017-1687-8Crossref PubMed Scopus (36) Google Scholar For example, Risher and colleagues’12Risher KA Kapoor S Daramola AM et al.Challenges in the evaluation of interventions to improve engagement along the HIV care continuum in the United States: a systematic review.AIDS Behav. 2017; 21: 2101-2123https://doi.org/10.1007/s10461-017-1687-8Crossref PubMed Scopus (36) Google Scholar 2017 comprehensive systematic review of linkage, retention, re-engagement, and adherence studies published through June 2015 identified 152 studies, most of which focused on adherence (77%) and retention (22%), with few focusing on linkage and re-engagement. Another important ongoing systematic literature review is CDC's Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention, which evaluates individual interventions for efficacy. It currently presents >40 domestic evidence-based and evidence-informed interventions that impact linkage, retention, and re-engagement outcomes.13Complete listing of LRC best practices. Centers for Disease Control and Prevention, Updated June 28, 2021https://www.cdc.gov/hiv/research/interventionresearch/compendium/lrc/completelist.html#Date accessed: June 29, 2021Google Scholar These sources form a rich resource from which state and local jurisdictions can identify interventions most suitable to address the EHE Treat pillar and the HIV Plan's goal to improve HIV-related health outcomes of PWH. This paper provides background on current interventions and highlights more recent promising practices; enhancements to existing interventions; and new approaches selected from systematic reviews, recent publications, and conference proceedings that had statistically significant results in linkage, retention, or re-engagement outcomes. These more current interventions were selected specifically for HDs and providers to inform novel directions they could consider using to address the strategies in the HIV Plan and its objectives to link people to care rapidly and provide low-barrier access to HIV treatment; identify, engage, or re-engage people not in care or not virally suppressed; and increase retention in care and adherence to HIV treatment. Interventions with prompt action shortly after HIV diagnosis are more likely to link people to care.14Udeagu CN Huang J Misra K. Duration since never in HIV care and immediate blood-draw after HIV diagnosis are associated with willingness to link to care following health department outreach, New York City.AIDS Behav. 2019; 23: 386-394https://doi.org/10.1007/s10461-018-2246-7Crossref PubMed Scopus (2) Google Scholar,15Giordano TP. Strategies for linkage to and engagement with care: focus on intervention.Top Antivir Med. 2018; 26: 62-65https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6017130/Date accessed: June 29, 2021PubMed Google Scholar Specifically, interventions focusing on rapid treatment initiation show promise in decreasing time to viral suppression and increased retention.16Mateo-Urdiales A Johnson S Smith R Nachega JB Eshun-Wilson I. Rapid initiation of antiretroviral therapy for people living with HIV.Cochrane Database Syst Rev. 2019; 6CD012962https://doi.org/10.1002/14651858.CD012962.pub2Crossref PubMed Google Scholar Retrospective and historical control studies of combined rapid linkage or referral and rapid antiretroviral therapy (ART) initiation that streamline intake processes and provide navigation services around the clock and enhance support to access medication regardless of payer source show promising findings. The New Orleans–based CrescentCare Start Initiative, which offers enhanced navigation, expedited clinic intake, and immediate ART initiation at time of diagnosis throughout a network of HIV testing sites, sexually transmitted disease clinics, and a clinic referral network, found a substantial reduction in mean time to linkage (1.3 vs 30 days in historical cohort, p<0.0001) and time to viral suppression (30 vs 68 days in historical control, p<0.0001).17Halperin J Butler I Conner K et al.Linkage and antiretroviral therapy within 72 hours at a federally qualified health center in New Orleans.AIDS Patient Care STDS. 2018; 32: 39-41https://doi.org/10.1089/apc.2017.0309Crossref PubMed Scopus (20) Google Scholar Likewise, the Rapid Entry and ART in Clinic for HIV (REACH) program in the Atlanta Grady Health System, which removes institutional barriers to initial provider visit and ART, found significant decreases in the median time to viral suppression from beginning clinic enrollment, from 77 days in pre-REACH patients to 57 days in post-REACH patients (p=0.0022).18Colasanti J Sumitani J Mehta CC et al.Implementation of a rapid entry program decreases time to viral suppression among vulnerable persons living with HIV in the southern United States.Open Forum Infect Dis. 2018; 5: ofy104https://doi.org/10.1093/ofid/ofy104Crossref PubMed Scopus (51) Google Scholar Early referral to a clinic-based RAPID ART program in San Francisco found that viral suppression was achieved by 96% of those in the program within 1 year, and the median time from the start of ART to viral load suppression was 41 days, with no statistically significant difference between those referred early to the program (within 30 days) and those with delayed referrals (between 30 days and 6 months).19Coffey S Bacchetti P Sachdev D et al.RAPID antiretroviral therapy: high virologic suppression rates with immediate antiretroviral therapy initiation in a vulnerable urban clinic population [published correction appears in AIDS. 2019;33(13):2113].AIDS. 2019; 33: 825-832https://doi.org/10.1097/qad.0000000000002124Crossref PubMed Scopus (0) Google Scholar In this special issue, Coffey et al. describe the citywide expansion of the RAPID ART program. Health department–based re-engagement interventions designed to identify PWH who are not in care are referred to as Data-to-Care (D2C) programs. These interventions use HIV surveillance data (the absence of lab results, indicating a gap in care, or persistent viremia, indicating ineffective treatment) to assign clients to dedicated staff to locate them and assist with linkage to, or re-engagement in, HIV care. D2C programs have been implemented in different ways over the years and vary in the data sources used to identify out-of-care status and the approaches taken to reach clients and re-engage them in care.20Sweeney P DiNenno EA Flores SA et al.HIV data to care-using public health data to improve HIV care and prevention.J Acquir Immune Defic Syndr. 2019; 82: S1-S5https://doi.org/10.1097/QAI.0000000000002059Crossref PubMed Scopus (20) Google Scholar D2C approaches that are HD–based and rely solely on surveillance data may be less likely to have a significant impact. Findings from a cluster randomized evaluation of a D2C program in King County, Washington found no significant effect of the intervention, highlighting the need for locally tailored and optimized D2C approaches.21Dombrowski JC Hughes JP Buskin SE et al.A cluster randomized evaluation of a health department data to care intervention designed to increase engagement in HIV care and antiretroviral use.Sex Transm Dis. 2018; 45: 361-367https://doi.org/10.1097/OLQ.0000000000000760Crossref PubMed Scopus (19) Google Scholar Recent studies suggest that D2C programs that entail close collaboration between both the HD and providers for identification of people out of care and re-engagement activities may increase efficiency and improve re-engagement outcomes.22Arey AL Cassidy-Stewart H Kurowski PL Hitt JC Flynn CP. Evaluating HIV surveillance completeness along the continuum of care: supplementing surveillance with health center data to increase HIV data to care efficiency.J Acquir Immune Defic Syndr. 2019; 82: S26-S32https://doi.org/10.1097/QAI.0000000000001970Crossref PubMed Scopus (8) Google Scholar, 23Hart-Malloy R Brown S Bogucki K Tesoriero J. Implementing data-to-care initiatives for HIV in New York state: assessing the value of community health centers identifying persons out of care for health department follow-up [published correction appears in AIDS Care. 2018;30(3):397].AIDS Care. 2018; 30: 391-396https://doi.org/10.1080/09540121.2017.1363851Crossref PubMed Scopus (22) Google Scholar, 24Wohl AR Dierst-Davies R Victoroff A et al.Implementation and operational research: the navigation program: an intervention to reengage lost patients at 7 HIV clinics in Los Angeles county, 2012-2014.J Acquir Immune Defic Syndr. 2016; 71: e44-e50https://doi.org/10.1097/QAI.0000000000000871Crossref PubMed Scopus (38) Google Scholar Preliminary findings from CDC-funded randomized control cooperative re-engagement clinical trial (CoRECT) study, which was designed to evaluate effectiveness of a collaborative HD/provider re-engagement intervention in 3 U.S. cities, found significant improvements at all 3 sites in 2 of the 4 primary outcomes, time to re-engagement and proportion re-engaged, compared with usual services.25Fanfair RN, Khalil G, Camp N, et al. Health department randomized trial to re-engage out-of-care HIV infected persons. Seattle, WA: March 4–7, 2019. Conference on Retroviruses and Opportunistic Infections.https://www.croiconference.org/abstract/health-department-randomized-trial-re-engage-out-care-hiv-infected-persons/. Accessed December 6, 2020.Google Scholar Final results recently presented from the Connecticut site show significantly higher re-engagement in care at 90 days in the intervention versus the usual care arm, but no statistically significant differences in long term retention in care and viral suppression.26Villanueva M, Miceli J, Carroll C, et al. Project CoRECT (Cooperative Re-Engagement Clinical Trial): final Connecticut results. Seattle, WA: Conference on Retroviruses and Opportunistic Infections. https://www.croiconference.org/abstract/project-corect-cooperative-reengagement-clinical-trial-final-connecticut-results/. Published XXX. Accessed March 25, 2021.Google Scholar Sachdev and colleagues27Sachdev DD Mara E Hughes AJ et al.Is a bird in the hand worth 5 in the bush?”: a comparison of 3 data-to-care referral strategies on HIV care continuum outcomes in San Francisco.Open Forum Infect Dis. 2020; 7: ofaa369https://doi.org/10.1093/ofid/ofaa369Crossref PubMed Scopus (8) Google Scholar compared 3 different D2C strategies and data sources to identify people out of care: healthcare providers, HD HIV surveillance, and a combination list derived by matching an electronic medical record registry to HIV surveillance. They found that PWH identified as being out of care by providers were more likely to be located and enrolled in navigation linkage (40%) than PWH identified by surveillance (9%) or combination lists (24%). Nevertheless, PWH from all 3 sources who enrolled in navigation linkage showed improvements in viral suppression. Other novel uses of data to identify and re-engage people in care have emerged in recent years and are showing promising results. Frequent and routine linking of clinic or surveillance data with jail booking rosters,28Eastment MC Toren KG Strick L Buskin SE Golden MR Dombrowski JC. Jail booking as an occasion for HIV care reengagement: a surveillance-based study.Am J Public Health. 2017; 107: 717-723https://doi.org/10.2105/AJPH.2017.303668Crossref PubMed Scopus (9) Google Scholar electronic alerts from emergency department and hospital electronic medical records,29Lubelchek RJ Fritz ML Finnegan KJ Trick WE. Use of a real-time alert system to identify and re-engage lost-to-care HIV patients.J Acquir Immune Defic Syndr. 2016; 72: e52-e55https://doi.org/10.1097/QAI.0000000000000973Crossref PubMed Scopus (7) Google Scholar or pharmacy discharge databases30McCree DH Byrd KK Johnston M Gaines M Weidle PJ. Roles for pharmacists in the “Ending the HIV Epidemic: a Plan for America” initiative.Public Health Rep. 2020; 135: 547-554https://doi.org/10.1177/0033354920941184Crossref PubMed Scopus (7) Google Scholar,31Byrd KK Camp NM Iqbal K Weidle PJ. Pharmacy data as an alternative data source for implementation of a data to care strategy.J Acquir Immune Defic Syndr. 2019; 82: S53-S56https://doi.org/10.1097/QAI.0000000000001969Crossref PubMed Scopus (3) Google Scholar facilitate prompt identification of people recently lost to care or at risk of ART discontinuation and offer the opportunity for rapid delivery of re-engagement strategies. Findings from the Link-Up Rx pilot program in Michigan, which used prescription refill data to trigger a 3-tiered pharmacist–provider–HD re-engagement in care response over a 3-week period, suggest faster re-engagement than traditional D2C programs and improved service delivery for PWH.32Kinsinger L Savola L Hale K et al.Link-up Rx: re-engagement in HIV care using pharmacy refill data. HIV Prevention Conference. Centers for Disease Control and Prevention, Atlanta, GAPublished 2019https://www.cdc.gov/nhpc/pdf/NHPC-2019-Abstract-Book.pdfDate accessed: January 15, 2021Google Scholar In this supplement, Thompson et al. describe another pharmacist-based medication adherence approach to promote viral suppression. Effective retention interventions address the many factors associated with decreased engagement in care using multiple strategies, including case management, cognitive behavioral approaches, colocation of services, and appointment accompaniment.11Higa DH Marks G Crepaz N Liau A Lyles CM. Interventions to improve retention in HIV primary care: a systematic review of U.S. studies.Curr HIV AIDS Rep. 2012; 9: 313-325https://doi.org/10.1007/s11904-012-0136-6Crossref PubMed Scopus (135) Google Scholar,33Mugavero MJ Norton WE Saag MS. Health care system and policy factors influencing engagement in HIV medical care: piecing together the fragments of a fractured health care delivery system.Clin Infect Dis. 2011; 52: S238-S246https://doi.org/10.1093/cid/ciq048Crossref PubMed Scopus (167) Google Scholar An observational cohort study of New York City's HIV Care Coordination program, which combines outreach, case management, multidisciplinary clinical care, patient navigation, and ART adherence support, found significant improvements in engagement in care and viral suppression from pre- to post-enrollment among people with lower mental health functioning, unstable housing, or hard drug use.34Irvine MK Chamberlin SA Robbins RS Kulkarni SG Robertson MM Nash D. Come as you are: improving care engagement and viral load suppression among HIV care coordination clients with lower mental health functioning, unstable housing, and hard drug use.AIDS Behav. 2017; 21: 1572-1579https://doi.org/10.1007/s10461-016-1460-4Crossref PubMed Scopus (31) Google Scholar Clinical care models tailored to the needs of the out-of-care population have also shown effectiveness. The Max Clinic in Seattle/King County, Washington was designed specifically to engage virally unsuppressed PWH who do not engage in conventional HIV care.35Dombrowski JC Ramchandani M Dhanireddy S Harrington RD Moore A Golden MR. The Max Clinic: medical care designed to engage the hardest-to-reach persons living with HIV in Seattle and King County, Washington.AIDS Patient Care STDS. 2018; 32: 149-156https://doi.org/10.1089/apc.2017.0313Crossref PubMed Scopus (30) Google Scholar,36Dombrowski JC Galagan SR Ramchandani M et al.HIV care for patients with complex needs: a controlled evaluation of a walk-in, incentivized care model.Open Forum Infect Dis. 2019; 6: ofz294https://doi.org/10.1093/ofid/ofz294Crossref PubMed Scopus (13) Google Scholar The clinic includes walk-in access to care, high-intensity case management, and incentives for clinic visits and viral suppression and is integrated with other HD efforts to identify virally unsuppressed PWH. The clinic has engaged >200 PWH to date and, among those enrolled, viral suppression (defined as ≥1 viral load <200 copies/mL) quadrupled from 20% in the year before enrollment to 82% in the year after enrollment. The clinic was instrumental in engaging PWH who were part of a cluster outbreak of HIV among people who inject drugs.37Golden MR Lechtenberg R Glick SN et al.Outbreak of human immunodeficiency virus infection among heterosexual persons who are living homeless and inject drugs - Seattle, Washington, 2018.MMWR Morb Mortal Wkly Rep. 2019; 68: 344-349https://doi.org/10.15585/mmwr.mm6815a2Crossref PubMed Scopus (110) Google Scholar Other low-threshold clinic models are emerging that address the complex needs of specific populations, such as San Francisco's Ward 26 clinic for PWH who are experiencing homelessness or are unstably housed38POP-UP: helping homeless and unstably housed people with HIV. UCSF, Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, Updated 2021https://hividgm.ucsf.edu/pop-upDate accessed: January 7, 2021Google Scholar and the CIRCLE Clinic in Jackson, Mississippi.39All-in at CIRCLE. The University of Mississippi Medical Center. https://www.umc.edu/evers-williams/Focus-Areas/health-care/all-in-at-circle.html. Accessed June 29, 2021.Google Scholar,40Dombrowski JC. Service delivery: the evolution and impact of innovative HIV care models. Paper presented at: 15th International Conference on HIV Treatment and Prevention Adherence, Adherence 2020; November 2–3, 2020; virtual. https://www.iapac.org/conferences/adherence-2020/. Accessed April 5, 2021.Google Scholar Financial incentive strategies can be incorporated in interventions offering a package of services to promote linkage, re-engagement, and retention in care. Although few studies have been designed to measure the direct contribution of financial incentives on prevention and care outcomes, the data show promising results for engaging the hardest-to-reach patients.41Bassett IV Wilson D Taaffe J Freedberg KA. Financial incentives to improve progression through the HIV treatment cascade.Curr Opin HIV AIDS. 2015; 10: 451-463https://doi.org/10.1097/COH.0000000000000196Crossref PubMed Scopus (70) Google Scholar, 42Fahey CA Njau PF Katabaro E et al.Financial incentives to promote retention in care and viral suppression in adults with HIV initiating antiretroviral therapy in Tanzania: a three-arm randomised controlled trial.Lancet HIV. 2020; 7: e762-e771https://doi.org/10.1016/S2352-3018(20)30230-7Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar, 43Shelus V Taylor J Greene E et al.It's all in the timing: acceptability of a financial incentive intervention for linkage to HIV care in the HPTN 065 (TLC-Plus) study.PLoS One. 2018; 13e0191638https://doi.org/10.1371/journal.pone.0191638Crossref PubMed Scopus (4) Google Scholar, 44Brantley AD Burgess S Bickham J Wendell D Gruber D. Using financial incentives to improve rates of viral suppression and engagement in care of patients receiving HIV care at 3 health clinics in Louisiana: the Health Models Program, 2013-2016.Public Health Rep. 2018; 133: 75S-86Shttps://doi.org/10.1177/0033354918793096Crossref PubMed Scopus (15) Google Scholar The TLC+ site RCT in New York and the District of Columbia evaluated the efficacy of financial incentives and found a significant impact on viral suppression, with the largest effect seen in clinics with lower viral suppression at baseline.45El-Sadr WM Donnell D Beauchamp G et al.Financial incentives for linkage to care and viral suppression among HIV-positive patients: a randomized clinical trial (HPTN 065).JAMA Intern Med. 2017; 177: 1083-1092https://doi.org/10.1001/jamainternmed.2017.2158Crossref PubMed Scopus (79) Google Scholar Successful implementation scale-up of financial incentive strategies will require addressing concerns of patients and providers, in particular negative attitudes toward the concept of paying people for health behaviors and sustainability. To examine this, Shelus and colleagues43Shelus V Taylor J Greene E et al.It's all in the timing: acceptability of a financial incentive intervention for linkage to HIV care in the HPTN 065 (TLC-Plus) study.PLoS One. 2018; 13e0191638https://doi.org/10.1371/journal.pone.0191638Crossref PubMed Scopus (4) Google Scholar conducted a qualitative study of patients, staff, and site investigators involved in the TLC+ study. Overall, patients thought the intervention was beneficial and that the financial incentives were sufficient to encourage linkage and retention. However, nearly half of participants were opposed to the concept of paying people to link to care and thought it should be self-motivated. Staff and site investigators had varying opinions. Although many had positive attitudes toward financial incentives and recognized the value to clients, others were concerned with implementation challenges, including timing of the intervention immediately after an HIV diagnosis, negative attitudes toward paying people for health behaviors, the existence and strength of existing linkage programs, and financial sustainability. Addressing these perspectives and challenges will contribute to the successful scale-up of future financial incentive–based strategies. Telemedicine-delivered HIV approaches have expanded considerably in recent years to provide HIV care and prevention services.46Todd CS Mills SJ Innes AL. Electronic health, telemedicine, and new paradigms for training and care.Curr Opin HIV AIDS. 2017; 12: 475-487https://doi.org/10.1097/COH.0000000000000402Crossref PubMed Scopus (10) Google Scholar, 47Health Resources and Services AdministrationHRSA's Ryan White HIV/AIDS Program-expanding HIV care through telehealth. Health Resources and Services Administration, Rockville, MDPublished October 2019https://hab.hrsa.gov/sites/default/files/hab/Publications/careactionnewsletter/telehealth.pdfDate accessed: January 7, 2021Google Scholar, 48Wong KYK Stafylis C Klausner JD. Telemedicine: a solution to disparities in human immunodeficiency virus prevention and pre-exposure prophylaxis uptake, and a framework to scalability and equity.mHealth. 2020; 6: 21https://doi.org/10.21037/mhealth.2019.12.06Crossref PubMed Google Scholar Although the conceptual basis for such models to improve care engagement is strong, relatively few studies have evaluated their impact on retention in care and viral suppression. Results to date support the feasibility and acceptability of this model.49Ohl M Dillon D Moeckli J et al.Mixed-methods evaluation of a telehealth collaborative care program for persons with HIV infection in a rural setting.J Gen Intern Med. 2013; 28: 1165-1173https://doi.org/10.1007/s11606-013-2385-5Crossref PubMed Scopus (29) Google Scholar,50Saifu HN Asch SM Goetz MB et al.Evaluation of human immunodeficiency virus and hepatitis C telemedicine clinics.Am J Manag Care. 2012; 18: 207-212PubMed Google Scholar A community-based collaborative model in Alabama enrolled 240 patients and retained 76% over the first year.51Jain KM Bhat P Maulsby C et al.Extending access to care across the rural U.S. South: preliminary results from the Alabama eHealth programme.J Telemed Telecare. 2019; 25: 301-309https://doi.org/10.1177/1357633X18755227Crossref PubMed Scopus (4) Google Scholar Successful implementation and scale-up of telemedicine approaches require that they be acceptable and accessible to clients. A survey of outpatient HIV clinic clients in Houston found that more than half (57%) of participants were more likely to use telehealth for their HIV care if available compared with in-person care, and 37% would use it frequently or always as an alternative to clinic visits.52Dandachi D Dang BN Lucari B Teti M Giordano TP. Exploring the attitude of patients with HIV about using telehealth for HIV care.AIDS Patient Care STDS. 2020; 34: 166-172https://doi.org/10.1089/apc.2019.0261Crossref PubMed Scopus (31) Google Scholar Concerns with this new care delivery approach included the ability of physicians to perform a good physical examination (37%), the safety of their personal information online (28%), and their ability to communicate effectively (17%). Lack of a personal computer or smartphone and not knowing enough about computers and smartphones were considered a barrier for 30% of respondents. Such concerns must be addressed to ensure uptake does not contribute to disparities in access to care.53Mgbako O Miller EH Santoro AF et al.COVID-19, telemedicine, and patient empowerment in HIV care and research.AIDS Behav. 2020; 24: 1990-1993https://doi.org/10.1007/s10461-020-02926-xCrossref PubMed Scopus (45) Google Scholar In this supplemental issue, Salgado et al. describe Georgia's statewide telehealth program, including direct patient care via telemedicine and telementoring education for primary care providers, to offer specialized HIV care in underserved and rural areas. A wide variety of interventions discussed in this paper suggest a positive impact on care-related outcomes that can be used by HDs and service providers to achieve the goals of the EHE Treat pillar. To date, HIV prevention research has focused on the effectiveness of HIV interventions, but relatively few studies evaluate implementation strategies needed to effectively bring them to scale in multiple settings and populations.54Smith JD Li DH Hirschhorn LR et al.Landscape of HIV implementation research funded by the National Institutes of Health: a mapping review of project abstracts.AIDS Behav. 2020; 24: 1903-1911https://doi.org/10.1007/s10461-019-02764-6Crossref PubMed Scopus (15) Google Scholar Federal agency funding for implementation research collaborations among academic institutions, HDs, clinics, and community-based organizations, such as the NIH-funded EHE initiatives,55CFAR/ARC ending the HIV epidemic supplement awards. NIH, National Institute of Allergy and Infectious Diseases.Updated September 28, 2020https://www.niaid.nih.gov/research/cfar-arc-ending-hiv-epidemic-supplement-awardsDate accessed: June 29, 2021Google Scholar facilitate the exploration of these questions and can further contribute to the design, evaluation, and effective implementation of interventions that are most relevant for public health practice and local HIV priorities." @default.
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• W3207366874 cites W2117988532 @default.
• W3207366874 cites W2228001519 @default.
• W3207366874 cites W2319577658 @default.
• W3207366874 cites W2467311613 @default.
• W3207366874 cites W2583011105 @default.
• W3207366874 cites W2601453889 @default.
• W3207366874 cites W2626716901 @default.
• W3207366874 cites W2663195706 @default.
• W3207366874 cites W2745295297 @default.
• W3207366874 cites W2769604667 @default.
• W3207366874 cites W2787061857 @default.
• W3207366874 cites W2793553980 @default.
• W3207366874 cites W2793580328 @default.
• W3207366874 cites W2796508213 @default.
• W3207366874 cites W2811379394 @default.
• W3207366874 cites W2885975696 @default.
• W3207366874 cites W2900957134 @default.
• W3207366874 cites W2906055116 @default.
• W3207366874 cites W2912227521 @default.
• W3207366874 cites W2938543671 @default.
• W3207366874 cites W2955624605 @default.
• W3207366874 cites W2967117019 @default.
• W3207366874 cites W2967636574 @default.
• W3207366874 cites W2968095654 @default.
• W3207366874 cites W2995317551 @default.
• W3207366874 cites W2996898667 @default.
• W3207366874 cites W3017780551 @default.
• W3207366874 cites W3020323105 @default.
• W3207366874 cites W3020506278 @default.
• W3207366874 cites W3027174687 @default.
• W3207366874 cites W3028099097 @default.
• W3207366874 cites W3048673213 @default.
• W3207366874 cites W3048811471 @default.
• W3207366874 cites W3080908841 @default.
• W3207366874 cites W3082931197 @default.
• W3207366874 cites W3096877680 @default.
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