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Formative Research

Formative Research Featuring AIDS United Supported Work

AIDS United’s mission is to end the AIDS epidemic in the United States. We seek to fulfill our mission through strategic grantmaking, capacity building, policy/advocacy, technical assistance and formative research. The books and peer-reviewed articles, listed chronologically below, highlight the formative research that has come out of AIDS United supported programs and grantmaking initiatives.  


Books

Improving Access to Care: Lessons Learned from Five U.S. Sites (2015)
Jain, K., Holtgrave, DR, Maulsby, C. Kim, J., Zulliger, R., Massey, M., & Charles, V.  
While programs to boost linkage to and retention in HIV care are critical to improving the health of PLWH, efforts to evaluate these programs are surprisingly scarce. Using cutting-edge implementation science, this book tackles the issue of how to better link and retain PLWH in ongoing primary medical care. A multipart case study examines successful strategies and provides detailed profiles of the organizations involved and their processes for reaching, linking, and retaining PLWH. Barriers to and facilitators of implementation are explored qualitatively, network analysis is used to assess changes in interagency collaboration among organizations serving PLWH, and evidence-based recommendations are offered for improving linkage to HIV care in the U.S. Read more.



Scholarly Articles

2015–2020 National HIV/AIDS Strategy Goals for HIV Linkage and Retention in Care: Recommendations From Program Implementers (2016)
Jain, K., Maulsby, C., Kinsky, S., Charles, V., Holtgrave, D.R., & The Positive Charge Implementation Team. 
Below are recommendations derived from the five networks of agencies who were part of an AIDS United initiative called Positive Charge.10 These agencies worked across Louisi- ana; Chicago, Illinois; New York City, New York; North Caro- lina; and the San Francisco Bay Area, California, from 2010 to 2013. Positive Charge sought to address the needs of people living with HIV who had never en- gaged in or had dropped out of care. Each site designed a pro- gram tailored to their population and collaborated with local partners. Partners included medical providers, AIDS service organizations, local public health departments, and social service organizations. Read more.

The Impact of Comprehensive Case Management on HIV Client Outcomes 
(2016)
Brennan-Ing, M., Seidel, L., Rodgers, L., Ernst, J., Wirth, D., Tietz, D., Morretti, A., & Karpiak, S. 
In 1990, New York State instituted Comprehensive Medicaid Case Management, also known as Target Case Management (TCM), for people dealing with multiple comorbid conditions, including HIV. The goal of TCM is to assist clients in navigating the health care system to increase care engagement and treatment adherence for individuals with complex needs. HIV-positive individuals engaged in care are more likely to be virally suppressed, improving clinical outcomes and decreasing chances of HIV transmission. The purpose of this study was to understand the impact of TCM management on outcomes for people with HIV.... Read more.

Implementation and Operational Research: The Navigation Program: An Intervention to Reengage Lost Patients at 7 HIV Clinics in Los Angeles County, 2012-2014 (2016)
Wohl, A.R., Dierst-Davies, R., Victoroff, A., James, S., Bendetson, J., Bailey, J., Daar, E., Spencer, L., Kulkarni, S., & Pérez, MJ. 
The Navigation Program is a health department-community agency collaboration to reengage lost HIV clinic patients in Los Angeles County using best practices from disease investigator services locator activities and the Antiretroviral Treatment Access Study (ARTAS), a CDC-recommended intervention. Clinic databases were reviewed to identify HIV patients who: (1) had no HIV care visits in 6-12 months and last viral load was greater than 200 copies per milliliter; (2) had no HIV care visits in >12 months; (3) were newly diagnosed and never in care; or (4) were recently released from jail/prison/other institution with no regular HIV medical provider.... Read more.

Barriers and Facilitators to Implementing Access to HIV Care Interventions: A Qualitative Analysis of the Positive Charge Initiative (2015)
Kinsky, S., Maulsby, C., Jain, K., Charles, V., Riordan, M., & Holtgrave, D.R. 
Research indicates that less than half of people living with HIV (PLWH) have undetectable levels of virus, despite recent findings that viral load suppression dramatically reduces the transmissibility of HIV. Linkage to HIV care is a crucial initial step, yet we know relatively little about how to effectively implement linkage interventions to reach PLWH who are not in care. AIDS United's initiative, Positive Charge (PC), funded five U.S. sites to develop and implement comprehensive linkage interventions. Evaluation of the initiative included qualitative interviews with management and service staff from each intervention site.... Read more.

Exploring Changes in Interagency Collaboration Following AIDS United’s Positive Charge, a Five Site HIV Linkage and Retention in Care Program (2015)
Jain, K., Maulsby, C., Kinsky, S., Khosla, N., Charles, V., Riordan, M., The Positive Charge Intervention Team, & Holtgrave, D.R.  
Out-of-care people living with HIV (PLWH) are often marginalized and have many unmet basic needs. This population is often served by a network of loosely connected agencies, such as HIV primary care providers and AIDS Service Organizations. Prior research suggests that increasing coordination among these agencies may lead to higher quality, better coordinated care for PLWH. This study examines interagency collaboration in four U.S. geographies in the context of an HIV linkage and retention in care program, called Positive Charge (PC).... Read more.

Cost and Threshold Analysis of Positive Charge, a Multi-Site Linkage to HIV Care Program in the United States (2015)
Kim, J.J., Maulsby, C., Zulliger, R., Jain, K., Davey-Rothwell, M., The Positive Charge Intervention Team, Charles, V., Riordan, M. &  Holtgrave, D.R.   
Positive Charge (PC) is a linkage to HIV care initiative implemented by AIDS United with sites in New York, Chicago, Louisiana, North Carolina, and the San Francisco/Bay Area. This study employed standard methods of cost and threshold analyses, as recommended by the US Panel on Cost-effectiveness in Health and Medicine, to calculate cost-saving and cost effective thresholds of the initiative. The overall societal cost of the linkage to care programs ranged from $48,490 to $370,525. The study found that PC's five unique evidence-based linkage to care programs have relatively low costs per client served and highly achievable cost-saving and cost-effectiveness thresholds.... Read more.

Unpacking Linkage and Reengagement in HIV Care: A Day in the Life of a Positive Charge Care Coordinator (2015)
Maulsby, C., Kinsky, S., Jain, K., Charles, V., Riordan, M., The Positive Charge Intervention Team, & Holtgrave, D.R.   
To better understand the process of linkage and reengagement in care, we conducted interviews with care coordinators and program supervisors at 20 PC implementing agencies. Though linkage to care is often considered a single column in the HIV continuum of care, we found that it contains several underlying and often complex steps. The steps described are: identifying individuals in need of services; contacting those individuals through a variety of means; assessing and addressing needs and barriers to care; initial engagement (or reengagement) in HIV primary care; and provision of ongoing support to promote retention.... Read more.

Positive Charge: Filling the Gaps in the U.S. HIV Continuum of Care (2015)
Maulsby, C., The Positive Charge Intervention Team, Charles, V., Kinksy, S., Riordan, M., Jain, K., & Holtgrave, D.R.   
Adequate engagement in HIV care is necessary for the achievement of optimal health outcomes and for the reduction of HIV transmission. Positive Charge (PC) was a national HIV linkage and re-engagement in care program implemented by AIDS United. This study describes three PC programs, the characteristics of their participants, and the continuum of engagement in care for their participants. Eighty-eight percent of participants were engaged in care post PC enrollment. Sixty-nine percent were retained in care, and 46 % were virally suppressed at follow-up.... Read more.

The Development and Implementation of the National Evaluation Strategy of Access to Care, a Multi-Site Linkage to Care Initiative in the United States (2014)
Kim, JJ., Maulsby, C., Kinsky, S., Riordan, M., Charles, V., Jain, K., & Holtgrave, D.R.   
The Access to Care (A2C) is a multi-site initiative that seeks to increase the access to and retention in effective HIV healthcare and support services by people living with HIV across the United States. As the initiative imple- mented evidence-based programs in new settings with diverse populations, it was important to document these innovative efforts to contribute to the evidence base for best practices. In a partnership between Johns Hopkins University, AIDS United, and the A2C sites, a national evaluation strategy was developed and implemented to build knowledge about how linkage to care interventions could be most effectively implemented within the context of local, real-world settings.... Read more.

Technical Summit on Women, HIV, and Violence (2014)
On February 13 and 14, 2014, AIDS United, with the generous support of AbbVie, convened an interdisciplinary group of activists, thought leaders, academics and federal partners to review and respond to the report issued by the President’s Federal Interagency Working Group on the Intersection of HIV/AIDS, Violence against Women and Girls, and Gender- Related Health Disparities. Released in September 2013, the report identified five objectives and recommended actions for federal agencies to increase interventions to not only link women living with HIV and affected by violence to much needed services and care, but to also ensure retention in care, provide support, as well as encourage broader prevention efforts and research.... Read more.

Knowledge, Attitudes, and Likelihood of Pre-Exposure Prophylaxis (PrEP) Use Among Women at Risk of Acquiring HIV (2014)
Auerbach, J., Kinsky, S., Brown, G., Charles, & Charles, V.
 Although the Food and Drug Administration (FDA) approved oral Truvada for pre-exposure prophylaxis (PrEP) for women at risk of HIV infection in the US in July 2012, and the Centers for Disease Control and Prevention (CDC) issued guidance for clinicians to provide PrEP to women ‘‘at substantial risk of HIV acquisition’’ in May 2014, there remain no clinical trial data on efficacy among US women, and there is a dearth of research on knowledge, attitudes, and likelihood of use of PrEP among them. We conducted a qualitative focus group (FG) study with 144 at-risk women in six US cities between July and September 2013, including locations in the Southern US, where HIV infections among women are most prevalent... Read more. 

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