Reducing HIV-Related Health Disparities in the Health Resources and Services Administration’s Ryan White HIV/AIDS Program

Abstract

The Health Resources and Services Administration’s Ryan White HIV/AIDS Program (RWHAP) supports direct health care treatment and support services to more than 50% of all people living with diagnosed HIV in the United States. A critical goal of the RWHAP is to reduce HIV-related health disparities to help end the HIV epidemic. From 2010 through 2016, the RWHAP made significant progress reducing viral suppression disparities among client populations, particularly among women, transgender persons, youths, Blacks or African Americans, and unstably housed clients. To assist with the reduction of the remaining disparities in HIV-related health outcomes among clients, the RWHAP continues to support planning and resource allocation for RWHAP Parts A through D and AIDS Drug Assistance Program, as well as through implementing policy and program initiatives, Special Projects of National Significance, evaluation studies, and collaborations to disseminate effective interventions.

Sustained HIV viral suppression among men who have sex with men in the Miami-Dade County Ryan White Program: the effect of demographic, psychosocial, provider and neighborhood factors

“…Our finding that young MSM had lower odds of sustained viral suppression is consistent with national studies of the general population of PLHIV [7,9,[13][14][15]. A study of 33 United States jurisdictions with complete reporting of viral load tests found that in 2014, [13][14][15][16][17][18][19][20][21][22][23][24] year old PLHIV were more likely to have unsuppressed viral loads Fig. 1 Factors associated with sustained viral suppression among men who have sex with men.…”

“…Our rate of sustained viral suppression among MSM (84.4%) was higher than that reported in previous national studies [7,[13][14][15][16]. This may be due to a significant upward trend in sustained viral suppression overtime nationwide [13,17] and among PLHIV enrolled in the Ryan White Program [18] since previous studies used data from 2009 to 2016 and our study used 2017 data. Furthermore, previous studies have focused on the general population of PLHIV.…”

“…Further, a study of New York City HIV surveillance data found that younger PLHIV were more likely to have at least 2 consecutive viral loads ≥100, 000 copies/mL [20]. It is worth noting that a study by Mandgasar et al [18] suggested that age gaps in viral suppression among Ryan White Program clients decreased 2010-2016, thus disparities may be declining. However, this finding was not specific to MSM.…”

“…Although sustained viral suppression among Blacks has increased significantly in recent years [13], our findings suggest that Blacks continue to be disproportionately affected by challenges in sustaining viral suppression. Nevertheless, a study of Ryan White Program clients found significant declines in the difference between Blacks and Whites who were virally suppressed from 2010 (13.0 percentage point difference) to 2016 (8.1 percentage point difference) [18]. Worth noting, the percentage of undiagnosed infections is disproportionately higher among some groups including young MSM compared with older MSM and Black MSM compared with White MSM [21].…”

Ending HIV in America: Not Without the Power of Community

“…Such collaborations have also played a crucial role in the development and scale-up of systems of care for persons living with HIV. The federally-funded Ryan White HIV/AIDS Program (RWHAP), which now provides direct health care and support services for over half of all people diagnosed with HIV in the US [21], was first authorized some 9 years after the epidemic initially emerged [22]. The record shows that during the early years of the American epidemic, federal government was "slow to develop targeted programs to provide care" for persons sickened by the virus [22].…”