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Assessing HIV/AIDS Client Factors Associated with Detectable Viral Loads


  • Many Ryan White HIV/AIDS Program clients aren’t achieving viral suppression.
  • Abt is analyzing viral resistance, comorbidity and social factors’ interactions.
  • The study will identify practices to improve outcomes.
The Challenge

The Ryan White HIV/AIDS Program (RWHAP), administered by the Health Resources and Services Administration (HRSA), provides services to support comprehensive care for people living with HIV and AIDS.

Despite improvements in testing, linkage, and retention, a significant number of Ryan White clients are not achieving viral suppression – notably, young people and adults with unstable housing situations, living in poverty and without health insurance. Understanding the barriers and unmet needs of these vulnerable populations is necessary to strengthen the effectiveness and reach of the program.

The Approach

Abt Global is providing HRSA a sophisticated analysis of the interaction of viral resistance, comorbidities and social determinants of health of Ryan White clients.

The Abt team, drawing from a sample of 25 RWHAP provider sites, conducted staff interviews, performed client chart abstractions, administered a validated trauma scale with clients and facilitated client focus groups. Our quantitative and qualitative data were analyzed together with national RWHAP client demographics, service utilization and HIV outcomes data, in combination with a survey of about 500 RWHAP providers.

The Results

When complete, the study will provide HRSA with a comprehensive understanding of the complex factors that influence an individual’s ability to achieve viral suppression. It will identify evidence-informed promising practices to improve outcomes, particularly for those who have struggled most with retention in care and viral suppression.