Roundtable: HRSA/SPNS initiatives to improve housing and health outcomes for HIV homeless populations

The National AIDS Strategy (NAS) sets priorities and action steps to address the HIV/AIDS epidemic in the US. Its goals are to 1) increase access to HIV care and improve health outcomes for people living with HIV and 2) reduce HIV-related disparities and health inequities. The strategy has a specific indicator for homeless populations seeking to reduce the percentage of persons in HIV medical care who are homeless to no more than 5 percent. The Health Resources & Services Administration (HRSA) HIV/AIDS Bureau through its Special Programs for National Significance (SPNS) funded a national initiative with the goal of building a medical home for HIV-positive homeless/unstably housed populations. Nine clinic and community-based organizations and one multisite coordinating center are funded to implement and evaluate service delivery models aimed to achieve two main outcomes: 1) increase engagement and retention in HIV care and treatment; and 2) improve housing stability for multiply diagnosed HIV-positive homeless/unstably housed populations. To measure achievement of these goals, the nine programs are conducting a longitudinal multisite evaluation study of the nine patient navigation/care coordination interventions providing services to homeless/unstably housed clients. The priority population is persons who are homeless or unstably housed living with HIV/AIDS with co-occurring mental health or substance use disorders. Additional outcomes to understand the impact on these interventions include quality of life, patient experience with care, and stigma. Presenters from HRSA and the SPNS Initiative will share current federal initiatives to meet the NAS goals through improved housing and health care coordination through Ryan White funding programs and the approach for evaluating achievement of the NAS goals. Approximately 800 PLWHA are currently receiving services. Baseline findings from the national SPNS Initiative evaluation will describe the demographics, barriers to care, unmet service needs for this population, experience with care and stigma. Challenges will be discussed in trying to engage and retain the priority population in the evaluation and strategies employed to improve retention in care.