USCA 2015: Digging Deeper
USCA 2015: Digging Deeper
“During his recovery, the participant relapsed and lost his job and voucher.”
Even out of context, this sentence—from a poster session at USCA 2015—probably sounds very familiar to HIV care agencies. It also crytallizes a theme found in many Day Two sessions at USCA, that being: making further and notable changes in HIV care and prevention is going to require everyone to do an things differently. Agencies need to explore new ways to tackle complex health and service needs. And the focus needs to be on the very hardest to reach clients.
Three poster sessions at USCA 2015 zeroed in on ideas about doing this difficult work, featuring Ryan White programs in North Carolina and Virginia working to bridge gaps by improving systems of care under HRSA's Special Projects of National Significance (SPNS) Program.
Our lead sentence came from North Carolina's SPNS program, featured in the poster, The Quest for Stable Housing in Rural North Carolina. That project focuses on improving primary health care and supportive services to improve health outcomes for unstably housed individuals with mental health and/or substance abuse challenges. Their poster went on to read: "SPNS assisted the participant with reengagement in care. He was accepted into a long term residential treatment program."
The SPNS Linkages project in Virginia presented two posters, Disparities in the HIV Continuum of Care and Fidelity Monitoring Tools and Approaches for Patient Navigation Programs. Virginia also provided a broad overview of its SPNS Linkages project as part of the HRSA session Walking the Path: Patient Navigators, Community Health Workers, Peer Educators.
HIV and Housing
Housing has of course long been recognized as a barrier and solution to HIV care engagement. Look back to the 1992 National AIDS Commission Report. Federal staff from HRSA’s HIV/AIDS Bureau and the HOPWA program of the U.S. Department of Housing and Urban Development convened a session at USCA 2015--Housing, HIV, HRSA and HOPWA--on the interface between housing and HIV and ways both programs work together and collaborative even more to improve both housing stability and health outcomes.
HRSA presenters covered such topics as the impact of stable v. unstable housing on health outcomes for Ryan White clients:
- Retention in care was slightly better among those in stable housing.
- Viral suppression slowly declined when housing became less stable.
Joining HRSA and HUD federal staff were projects from North Carolina, Oregon and Texas, who shared many ideas and potential solutions to enhancing housing and health for unstably housed individuals living with HIV, such as:
- Integrated housing plans.
- Integrated planning.
- Coordinated case management.
- A broader array of partnerships.
- Data sharing.