Part F: Special Projects of National Significance (SPNS) Program

The Special Projects of National Significance (SPNS) Program supports the development of innovative models of HIV care and treatment in order to quickly respond to emerging needs of clients served by Ryan White HIV/AIDS Programs. SPNS advances knowledge and skills in the delivery of health care and support services to underserved populations living with HIV. Through its demonstration projects, SPNS evaluates the design, implementation, utilization, cost, and health related outcomes of treatment models while promoting the dissemination and replication of successful interventions.

Current SPNS Initiatives

Capacity Building in the Ryan White HIV/AIDS Program to Support Innovative Program Model Replication

Funded 2019–2022

This initiative will build and enhance the capacity of RWHAP recipients and subrecipients to replicate evidence-informed models of care/interventions among RWHAP jurisdictions using previously developed program implementation tools, manuals, and other resources. In addition, this initiative will increase system-level capacity for adopting these models of care/interventions that offer comprehensive, high-quality, culturally competent HIV screening, care, and treatment for people with HIV who are not fully engaged in primary care. By building capacity and encouraging the implementation or replication of effective models of care, the RWHAP will improve systems of care, reduce health disparities, and improve outcomes along the HIV care continuum. The Center for AIDS Prevention Studies (CAPS) of the University of California San Francisco will lead and support the dissemination and replication of evidence-informed innovative models of care/interventions in Atlanta, GA, Jackson, MS, Las Vegas, NV, and New Orleans, LA.

Enhancing Linkage of Sexually Transmitted Infection (STI) and HIV Surveillance Data in the Ryan White HIV/AIDS Program

Funded 2019–2022

This initiative will improve linkage, re-engagement in care, and health outcomes for people with HIV in the RWHAP. HRSA funded Georgetown University to serve as the Technical Assistance Provider (TAP) to identify and fund up to five jurisdictions (state, city, and/or local health departments) to provide programmatic technical assistance for each jurisdiction to create or improve data sharing across their STI and HIV surveillance systems, as well as an evaluation contractor to evaluate the overall effectiveness of the project. The TAP will assess jurisdictional barriers to data sharing across STI and HIV surveillance departments and develop tools to address these barriers. Improved data sharing will allow the matching of STI (chlamydia, gonorrhea, and/or syphilis cases) and HIV surveillance data, which will be used to improve the capacity of RWHAP clinics to prioritize resources for linking and re-engaging people with HIV into care. Improving the frequency of this data sharing will inform RWHAP clinics’ decision-making around allocation of resources and services to improve health outcomes of people with HIV.

Strengthening Systems of Care for People with HIV and Opioid Use Disorder

Funded 2019–2022

This initiative supports two entities, referred to as System Coordination Providers (SCPs), who will assist states in leveraging resources at the federal, state, and local levels for people with HIV and opioid use disorder (OUD). JSI Research and Training Institute and Yale University are serving as the SCPs for this initiative and will work across 14 state partners, which include Arizona, Connecticut, Iowa, Louisiana, Massachusetts, New Jersey, Rhode Island, Utah, Vermont, Virginia, Washington, and West Virginia. This initiative will strengthen system-level coordination and networks of care between RWHAP recipients and other federal, state and local entities funded to respond to the opioid epidemic to ensure people with HIV and OUD have access to behavioral health care, treatment, and recovery services. In addition, this initiative will build upon existing systems of care and treatment that will maximize cross-sector collaboration in order to achieve improvements in the system-level coordination and to leverage available resources for improving the health outcomes of people with HIV and OUD.

Improving Sexually Transmitted Infection Screening and Treatment among People Living with or at Risk for HIV

Funded 2018-2021

This three-year initiative will support the implementation and evaluation of clinical and system-level interventions to improve screening and treatment of sexually transmitted infections among low-income people living with HIV or who are at risk for HIV. The François-Xavier Bagnoud Center, Rutgers School of Nursing, will partner with clinical and systems-level institutions in Washington, DC, Florida, and Louisiana to implement, evaluate, and disseminate results and best practices of select interventions. This cooperative agreement is a collaborative effort between HRSA’s HIV/AIDS Bureau and Bureau of Primary Health Care, with input from the Centers for Disease Control and Prevention’s (CDC) Division of STD Prevention.

Evidence-Informed Approaches to Improving Health Outcomes for People Living with HIV

Funded  2018-2020

This three-year initiative awarded to National Alliance of State and Territorial AIDS Directors (NASTAD) will systematically identify, catalog, disseminate, and support the replication of evidence-informed approaches and interventions to engage people living with HIV (PLWH) who are out of care or at risk of not continuing care into HIV medical care. This initiative will identify acuity scales tools that will determine the likelihood of PLWH engaging or re-engaging in health care; identify data utilization interventions to actively identify and intervene with PLWH who are out of care; identify innovative service delivery models; evaluate the costs associated with each approaches/interventions; catalog the approaches and develop an implementation manual; disseminate the approaches and interventions; and support replication through technical assistance to Ryan White HIV/AIDS Program (RWHAP) and HIV health care service providers. As the Evaluation and Technical Assistance Provider (ETAP), NASTAD will evaluate and promote the effectiveness of these approaches and intervention design, implementation, utilization, cost, and health outcomes.

Implementation of Evidence-Informed Behavioral Health Models to Improve HIV Health Outcomes for Black Men Who Have Sex With Men

Funded 2018-2021

This initiative will support the implementation and evaluation of evidence-informed models of care designed to engage, link, and retain Black Men who have Sex with Men (BMSM) in HIV medical care and supportive services. This initiative is funding eight demonstration sites for three years and one Evaluation and Technical Assistance Provider for four years to implement and evaluate four evidence-informed interventions and/or models of care. These models of care include STYLE, a youth-focused case management intervention, Linkage to Care, and Project Silk, that integrate behavioral health services with HIV care to specifically address the needs of BMSM and to improve health outcomes. The demonstration projects will disseminate lessons learned and findings to promote the uptake and replication of these models. The NORC at the University of Chicago is serving as the Evaluation and Technical Assistance Provider (ETAP) for this initiative. The ETAP will coordinate the multi-site evaluation, provide programmatic technical assistance to the demonstration sites, and lead publication and dissemination efforts. In addition, grants were awarded to eight demonstration sites for this initiative.

Improving HIV Health Outcomes through the Coordination of Supportive Employment and Housing Services

Funded 2017-2020

This initiative will support the design, implementation, and evaluation of innovative interventions that coordinate HIV care and treatment, housing, and employment services to improve HIV health outcomes for low-income, uninsured, and underserved people living with HIV (PLWH) in racial and ethnic minority communities. The overall goal of this coordinated services intervention is to decrease the impact of the social determinants of health (such as unmet housing or employment needs) that affect long-term HIV health outcomes for PLWH impacted by employment and housing instability in racial and ethnic minority communities. To promote long-term health and stability for PLWH, this initiative supports 12 demonstration sites across the United States that will implement, evaluate and disseminate innovative strategies for integrating HIV care, housing and employment services into a coordinated intervention and one Evaluation and Technical Assistance Provider (ETAP). This Special Projects of National Significance Program initiative is supported through the Department of Health and Human Services (HHS) Secretary’s Minority AIDS Initiative Fund.

Curing Hepatitis C among People of Color Living with HIV

Funded 2017-2020

This three-year initiative awarded to Yale University and the University of Texas Health Science Center San Antonio will support the expansion of Hepatitis C (HCV) prevention, testing, care, and treatment capacity; improve coordination of linkage to and retention in HCV care and treatment for people living with both HIV and HCV; and improve coordination with SAMHSA-funded substance use disorder (SUD) treatment providers to deliver behavioral health and SUD treatment support to achieve treatment completion and prevent HCV infection and re-infection. In addition, the initiative will enhance state, local and tribal health department surveillance systems to increase their capacity to monitor acute and chronic infections of HIV and HCV in areas of high populations or low-income, uninsured, and underserved racial and ethnic minorities. This Special Projects of National Significance Program initiative is supported through the Department of Health and Human Services (HHS) Secretary’s Minority AIDS Initiative Fund.

Using Evidence-Informed Interventions to Improve Health Outcomes among People Living with HIV (E2i)

Funded 2016-2021

This initiative will identify and provide support for the implementation of evidence-informed interventions to reduce HIV-related health disparities and improve health outcomes, including increasing retention in care, improving treatment adherence, and improving viral suppression for people living with HIV. Fenway Community Health Center, Inc. will serve as the Evidence-Informed Interventions Coordinating Center for Technical Assistance (E2i CCTA), and up to 24 Ryan White HIV/AIDS Program funded recipients/subrecipients will support the implementation of evidence-informed interventions. The University of California San Francisco will serve as the Evidence-Informed Interventions Evaluation Center (E2i EC) for this initiative.

Jurisdictional Approach to Curing Hepatitis C among HIV/HCV Coinfected People of Color

Funded 2016 - 2019

This is a three-year initiative to develop and evaluate the implementation of comprehensive jurisdiction-level approaches for the screening, care, and treatment systems for people of color living with both HIV and Hepatitis C (HCV). The Rand Corporation serves as the Evaluation and Technical Assistance Center (ETAC), providing technical assistance and capacity building, and leading the evaluation activities across three Ryan White HIV/AIDS Program (RWHAP) Part A jurisdictions: City of Hartford, Hartford, CT; City of New York, Long Island, NY; and the City of Philadelphia, Philadelphia, PA. In addition, the National Alliance for State and Territory AIDS Directors (NASTAD) was funded to select and fund two RWHAP Part B recipients to participate in this initiative: North Carolina and Louisiana. The ETAC is collaborating with the RWHAP Part F AIDS Education and Training Center National Coordinating Resource Center (AETC/NCRC) to develop National HCV Provider Competencies and Curriculum for HCV screening, care, and treatment, with a focus on people living with HIV/HCV co-infection. The ETAC will also design and implement a multi-site evaluation to assess the implementation and impact of the jurisdiction projects and to lead and coordinate the efforts for publication and dissemination of best practices, lessons learned and other findings from the initiative. This Special Projects of National Significance (SPNS) Program initiative is supported through the Department of Health and Human Services (HHS) Secretary’s Minority AIDS Initiative Fund (SMAIF).

Dissemination of Evidence-Informed Interventions to Improve Health Outcomes along the HIV Care Continuum Initiative

Funded 2015 - 2020

This initiative will disseminate four adapted linkage and retention interventions from prior SPNS and the Secretary's Minority AIDS Initiative Fund (SMAIF) initiatives to improve health outcomes along the HIV care continuum. The initiative is funding two cooperative agreements, a Dissemination and Evaluation Center (DEC) for five years, and an Implementation Technical Assistance Center (ITAC) for four years. The end goal of the initiative is to produce four evidence-informed Care And Treatment Interventions (CATIs) that are replicable, cost-effective, capable of producing optimal HIV care continuum outcomes, and easily adaptable to the changing health care environment. The multi-site evaluation of this initiative will take a rigorous Implementation Science (IS) approach, which places greater emphasis on evaluation of the implementation process and cost analyses of the interventions, while seeking to improve the HIV care continuum outcomes of linkage, retention, re-engagement and viral suppression among client participants.

Use of Social Media to Improve Engagement, Retention, and Health Outcomes along the HIV Care Continuum

Funded 2015 - 2019

This initiative is a multi-site demonstration and evaluation of innovative social media methods designed to identify, link, and retain HIV positive underserved, underinsured, hard-to-reach youth and young adults (ages 13-34) in HIV primary care and supportive services. These methods include system approaches utilizing a variety of social media, internet, and mobile-based technologies to improve engagement and retention in care and viral suppression. Demonstration projects are expected to implement these models, evaluate their effectiveness and to disseminate findings, best practices, and lessons learned. These social media interventions will focus on youth and young adults living with HIV who are aware of their HIV infection status but have never been engaged in care; are aware but have refused referral to care; have dropped out of care; are infected with HIV but are unaware of their HIV status; or have not achieved viral suppression.

See previous SPNS Program initiatives

Date Last Reviewed:  August 2019