HIV Care Con+nuum: Raising the Bar Ryan White HIV/AIDS Program Part B Administra+ve Reverse Site Visit Mee+ng February 5, 2016
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1 HIV Care Con+nuum: Raising the Bar Ryan White HIV/AIDS Program Part B Administra+ve Reverse Site Visit Mee+ng February 5, 2016 Susan RobiloIo, DO Clinical Consultant / Medical Officer Division of State HIV/AIDS Programs Division of Metropolitan HIV/AIDS Programs
2 Content Overview of the HIV Care Con+nuum The Care and Preven+on in the United States (CAPUS) Ini+a+ve Working with the Recently Incarcerated Popula+on 2
3 Overview of the HIV Care Con+nuum Objec+ves: Understand what the HIV Care ConCnuum is Understand the role of Ryan White Programs in improving the concnuum Know how fundable service categories support the HIV Care ConCnuum 3
4 What is a Con+nuum of Care? An integrated service network that guides and tracks HIV clients over +me through a comprehensive array of clinical, mental, and social services in order to maximize access and effec+veness. 4
5 Con+nuum of Care Points of Entry 5
6 Consequences of a Failed Con+nuum of Care 6
7 HRSA Con+nuum of Engagement in HIV Care Cheever L. Clinical Infec+ous Diseases 2007;44:
8 Framework for HIV Care Service Delivery Mugavero M et al. Clinical Infectious Diseases 2011; 52(Suppl 2): S238-S246 8
9 Engagement in HIV Care The Author Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please Gardner E M et al. Clin Infect Dis. 2011;52:
10 Engagement in HIV Care Stage of Engagement in HIV Care Number of Individuals HIV- Infected 1,106, HIV- Diagnosed 874, Linked to HIV Care 655, Retained in HIV Care 437, Need AnCretroviral Therapy 349, On AnCretroviral Therapy 262, Adherent/Undetectable 209, The Author Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please Gardner E M et al. Clin Infect Dis. 2011;52:
![Na+onal HIV Care Con+nuum h]ps://www.aids.](/docs-images/83/87979668/images/11-1.jpg "gov/federal- resources/policies/care-")
11 Na+onal HIV Care Con+nuum h]ps:// resources/policies/care- concnuum/ 11
12 Na+onal HIV/AIDS Strategy Updated in July 2015 Five- year plan to direct the na+onal response to the HIV epidemic Four overarching goals Defined indicators to assess progress 12
13 Moving Forward Framework 13
14 Reten+on in Care among Ryan White HIV/ AIDS Program (RWHAP) Clients, 2014 Percentage, % Lower than overall RWHAP retencon by 5% Overall years years Unstable housing Higher than overall RWHAP retencon by 5% <13 years years years 65 years Popula+on 14
15 Viral Suppression among RWHAP Clients, 2014 Lower than overall RWHAP viral suppression by 5% Higher than overall RWHAP viral suppression by 5% Percentage, % Popula+on 15
16 Gay, Bisexual, and other Men who have Sex with Men (MSM) Served by the RWHAP: Reten+on in Care and Viral Suppression, Reten+on in Care 100 Viral Suppression Percentage, %
17 Youth Aged Years Served by the RWHAP: Reten+on in Care and Viral Suppression, Reten+on in Care 100 Viral Suppression Percentage, %
18 Young, Black/African American MSM (YBMSM), Aged Years Served by the RWHAP: Reten+on in Care and Viral Suppression, 2014 Percentage, % RWHAP Overall Reten+on in Care Young MSM overall YBMSM 65.1 Unstable housing Viral Suppression RWHAP Overall Young MSM overall YBMSM Unstable housing 18
19 HIV Care Con+nuum Crosswalk with Ryan White HIV/AIDS Program Services 19
20 HIV Care Con+nuum Crosswalk with Ryan White HIV/AIDS Program Services Case Study: RetenCon in care is well below the jurisdiccon's average for young, black MSM TransiConing from pediatric clinic to adult clinic No show rates in the adult clinic for those transiconing were 30-50% 20
21 HIV Care Con+nuum Crosswalk with Ryan White HIV/AIDS Program Services Case Study: HIV viral suppression has been decreasing in those over the age of 50 for the past 3 years The number of those over the age of 50 that are retained in care is also declining The number of those that are having regular medical and non- medical case management visits has been increasing during this same period 21
22 Summary The HIV Care Con+nuum provides a framework to engage and retain PLWHA in care and to maximize beneficial outcomes RWHAP funds services that directly impact outcomes along the HIV Care Con+nuum Improvements in the delivery of services will help to achieve the goals of the Na+onal HIV/AIDS Strategy 22
23 Ques+ons 23
24 Contact Informa+on Susan RobiloIo, D.O Clinical Consultant / Medical Officer Division of State HIV/AIDS Programs Division of Metropolitan HIV/AIDS Programs srobiloio@hrsa.gov 24
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