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NYC Ryan White Part A: Program Model of Care for HIV and Aging
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International Workshop on HIV and Aging, September 23-24, 2021
Download the PDF here
G. Harriman, D. Martin, L. Best, R. Bruce, D. Klotz, C. Rodriguez-Hart
The Consumers Committee (CC) of the HIV Health and Human Services Planning Council of New York began developing a service directive for NY Ryan White Part A (RWPA) in December 2020. Subject Matter Experts (SME) on HIV and Aging knowledgeable about current research, racial/ ethnic inequities, women with HIV, and broader healthcare system needs for aging PWH presented to the CC. The CC then drafted a Directive using the Implementation Science Consolidated Framework for Implementation Research (CFIR) and held a virtual forum to receive community input. The guidance resulted in the following services, organized by CFIR elements (Determinants, Implementation Strategies, Mechanisms, and Outcomes) to ensure fidelity (additional details in logic model below).
Background:
1) PWH over 50 represent a majority of the total PWH population (59% of PWH in New York City (NYC) in 2019)i and yet their unique intersectional needs are often underrecognized and unaddressed by HIV service organizations;ii, iii, iv
2) Local focus group results underscore the need for improved resources for Aging PWH, including developing services that address social isolation, address medical conditions of women with HIV over 50, and increase coordination between programs, the benefits of navigation, and the availability of services offered in Spanish.
i HIV Surveillance Report, 2019. New York City Department of Health and Mental Hygiene. Pl 4. https://www1.nyc.gov/assets/doh/downloads/pdf/dires/hiv-surveillance-annualreport-2019.pdf
ii Marcus. J. Increased overall life expectancy but not comorbidity free years for People with HIV. Conference on Retrovirals and Opportunistic Infections. March 8-11, 2020. https://www.croiconference.org/abstract/increased-overall-life-expectancy-but-not-comorbidity-free-years-for-people-with-hiv/
iii Chiappini, E., Bianconi, M., Dalzini, A., Petrara, M. R., Galli, L., Giaquinto, C., & De Rossi, A. (2018). Accelerated aging in perinatally HIV-infected children: clinical manifestations and pathogenetic mechanisms. Aging, 10(11), 3610–3625. https://doi.org/10.18632/aging.101622
Iv Libman, H., Justice, A., Berkenblit, G., Chaudhry, A., J Cofrancesco, J., and J Sosman, J. Challenges and Opportunities: Primary Care and HIV in 2011 Society of General Internal Medicine https://www.sgim.org/File%20Library/SGIM/Resource%20Library/Meeting%20Handouts/SGIM/2011/WD07handout.pdf
V Harriman, G., Spiegler, S., Sarah Kozlowski, S., Response to the Needs of Older People with HIV 2020 National Ryan White Conference on HIV Care & Treatment August 11-14, 2020
Vi Smith, J.D., Li, D.H. & Rafferty, M.R. The Implementation Research Logic Model: a method for planning, executing, reporting, and synthesizing implementation projects. Implementation Sci 15, 84 (2020). https://doi.org/10.1186/s13012-020-01041-8
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