Ryan White and World AIDS Day
Ryan White and World AIDS Day
December 1, 2016 is World AIDS Day. The U.S. theme is: Leadership. Commitment. Impact.
Below is a brief review of the work of HRSA and the RWHAP over the past quarter-plus century to address this year's theme, which is but one way to frame a continuum of efforts to enhance HIV care and health outcomes for underserved populations.
One can reflect on RWHAP leadership from many angles. We choose to start by looking at the work of people living with HIV (consumers), who have revolutionized the concept of individual involvement in care decision-making over the course of the epidemic. Equally important is the leadership of health care staff and communities in putting a system of Ryan White-funded HIV care in place while simultaneously confronting stigma and discrimination. The Ryan White model is made possible under a framework of clinical care guidelines, clinical training to guide the delivery of quality HIV care, quality management and performance measures that provide the framework for agencies to achieve high standards, a client level data system, and care delivery models/best practices to reach specific needs and populations. Ongoing attention to care needs is guided under planning that brings communities together to assess needs, set priorities, and implement services.
HRSA and the RWHAP have always made adjustments to meet emerging needs. Just as the early days of the HIV/AIDS epidemic were focused on palliative care and transitioned to a primary care model in the mid 1990s, more recent efforts have expanded attention to significant needs as defined by care issues and populations. Over the past several years, for example, HRSA has funded a range of national initiatives to adjust to health care reform: help for Ryan White clients to enroll and access Affordable Care Act coverage as well as support for agencies adjust agency operations, improve their contracting and billing with third party payers, and improve their overall fiscal health. Other projects have focused on improving HIV care outcomes among black men who have sex with men (MSM) in terms of health care engagement and health literacy.
Newer projects (funded and upcoming in 2017) are focused on such areas as improving minority HIV care among transgender populations, black MSM, and enhancing the capacity of people of color to participate in planning activities. Other projects include development of hepatitis and HIV care best practices and additional planning body support. HRSA also continues to work with grant recipients in providing guidance on legislative and program requirements and emerging issues, such as recent program letters on housing and PrEP-related services.
The impact of RWHAP care is well documented and is remarkable. RWHAP patients have achieved retention in care rates (80%) and viral suppression rates (81%) that far exceed national averages, according to the program's client-level data. In addition, disparities in outcomes have been significantly reduced through the provision of antiretroviral therapies and a supportive comprehensive system of HIV care.