Background: People with HIV can experience reduced morbidity and mortality and live longer, healthier lives by taking ongoing antiretroviral treatment and reducing HIV viral load to undetectable levels. However, social determinants and other factors serve as barriers to care and treatment for many people with HIV resulting in disparities in health and HIV-related outcomes. This analysis examines disparities in viral suppression among people with HIV who received medical care through the Health Resources and Services Administration’s (HRSA) Ryan White HIV/AIDS Program (RWHAP) during 2010 through 2018.

Methods: Client-level data were used from the annual RWHAP Services Report to calculate viral suppression among clients with ≥1 medical visit and ≥1 HIV viral load test reported during the measurement year. Viral suppression in 2010 was compared to 2018 for all clients, with focus on key populations such as youth, transgender women, and black men who have sex with men (MSM).

Results: From 2010 through 2018, HIV viral suppression among RWHAP clients increased from 69.5% to 87.1%. During the same time, viral suppression in youth aged 13-24 increased 30 percentage points, from 46.6% in 2010 to 76.3% in 2018. Similar gains were evident across all key populations; however transgender women, young black MSM, and people with temporary and unstable housing continued to experience lower viral suppression.

Conclusions: While HIV-related disparities in viral suppression continue to exist for some RWHAP subpopulations, substantial progress has been made. To address these disparities, HRSA supports the implementation of evidence-informed interventions in RWHAP settings.

Issues: With advances in science and antiretroviral therapy, HIV has become a manageable condition and people with diagnosed HIV are living longer. In the United States (U.S.), over 450,000 people with HIV were aged ≥50 years in 2015, an increase of nearly 40% since 2011. Older people with HIV share many of the same health concerns as the general population over age 50, however, those with HIV may also experience unique health needs.

Description: This presentation will highlight the changes in age distribution and characteristics among RWHAP clients from 2010 through 2018. Presenters will discuss the evolving needs of aging people with HIV, as well as care and treatment for people with HIV as they age. HRSA initiatives focused on aging people with HIV will also be discussed.

Lessons Learned: The rapid growth of the aging population of people with HIV highlights the need to identify and implement aging-appropriate HIV care and support services. HRSA’s Ryan White HIV/AIDS Program (RWHAP) is well positioned to meet these needs.

Recommendations: A multidisciplinary approach to care for the aging population of people with HIV can be incorporated into existing HIV care systems.

Issues: The Health Resources and Services Administration’s HIV/AIDS Bureau (HAB) administers the Ryan White HIV/AIDS Program (RWHAP), which supports direct medical care and support services for more than half a million people with HIV – more than 50% of all people with diagnosed HIV in the United States. While HAB has played a pivotal role in supporting the implementation of effective intervention strategies for people with HIV for over 30 years, implementation science frameworks and approaches have created new opportunities to maximize the impact of the RWHAP.

Description: In this talk, we present “HAB IS,” a framework developed by HAB, to support the translation of implementation science for real world application. Core components of the framework are presented for other public health agencies and/or faith- and community-based organizations looking to leverage implementation science theories to advance their work toward ending the HIV epidemic.

Lessons Learned: Reaching the goal of ending the HIV epidemic will require us to move beyond current practices, even those that have been highly impactful. Insights from implementation science are vital to identify opportunities to innovate, but real-world translation frameworks like HAB IS are essential.

Recommendations: By supporting the scale-up of effective intervention strategies to decrease morbidity and mortality and improve health outcomes along the HIV care continuum for people with HIV, implementation science can advance the work of HIV care and treatment providers, ultimately bringing us closer to ending the HIV epidemic in the U.S.

Issues: Eliminating disparities and improving health outcomes along the HIV care continuum among key populations is essential to ending the HIV epidemic in the U.S. The Using Evidence-Informed Interventions to Improve Health Outcomes among People Living with HIV (E2i) initiative was developed within the Health Resources and Services Administration HIV/AIDS Bureau’s (HRSA HAB’s) implementation science framework ("HAB IS”) to identify and implement interventions in four focus areas with known disparities in the Ryan White HIV/AIDS Program (RWHAP): transgender women, black men who have sex with men (BMSM), behavioral health, and trauma.

Description: This presentation will describe a key component of the successful implementation/replication of known evidence-informed interventions in the E2i project: implementation toolkits. Attendees will learn from E2i implementation sites and project staff how the toolkits were developed. Topics will include involvement of key stakeholders, identification of intervention core components, and development of multimedia content. This particular presentation will focus on transgender women and BMSM subpopulations.

Lessons Learned: Best practices are needed to effectively collaborate with providers, intervention developers, and subject matter experts when developing these products.

Recommendations: Implementation toolkits are essential to the successful implementation/replication of innovative strategies to reduce disparities for transgender women and black MSM with HIV. The widespread dissemination of these toolkits will be essential to end the HIV epidemic in the U.S.