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This article was written by Antonio Pineda and Allison Daly, MSW, LICSW.
Metrics from the MedStar Health Research Institute reveal the Ryan White Program is helping patients with HIV live longer and access resources that help reduce transmission of the virus in DC communities.
In Washington, DC, 1.8% of the population, or about 11,904 people, are known to be living with HIV, according to the Department of Health’s most recent Annual Epidemiology and Surveillance Report.
At MedStar Washington Hospital Center, the Ryan White Program (RWP) works to identify neighbors who are at risk, help them learn their HIV status through HIV testing, and get into long-term care to reduce the amount of virus in their blood—reducing transmission and improving their quality of life. MedStar Health Research Institute partners with RWP to track program success and identify opportunities to improve care.
The program is part of the federal Ryan White HIV/AIDS Program named after Ryan White, a teen who faced discrimination and died from AIDS in 1990. That year, Congress passed the Ryan White Care Act—funding to provide support services for people living with HIV and AIDS.
Much has changed since 1990, when the life expectancy after diagnosis was about 18 months. The antiretroviral medication Cirixivan (indinavir) received FDA approval in 1996, beginning the process of changing HIV into a manageable chronic disease. Research has shown that people on modern antiretroviral therapy can expect to live for decades.
While fewer people are dying of AIDS, the need for support services increases as more people face the challenges of aging with HIV. But those gains are not shared equally by everyone. Social Determinants of Health, such as income, education, and environment, continue to drive disparities.
RWP helps pay for expenses that insurance and other sources don’t cover, closing the financial gap for patients to ensure everyone can access ongoing care. And data from MedStar Health Research Institute shows that this program is working.
Making a difference for DC patients.
The Ryan White Program at MedStar Washington Hospital Center is creating a significant local impact for patients with HIV. MedStar Health Research Institute’s most recent full year of data from 2022 reveals:
- 784 adult patients and 156 pediatric patients were served by the Ryan White Program
- 779 adults and 156 children got outpatient HIV care
- 52% of RWP patients were 52 or older
- 91% of patients identified as African-American
- 76% of patients lived at or below 200% of the Federal Poverty Level
- 2,188 case management services were provided
- 99% of patients were prescribed antiretroviral medications
- 100% of pregnant patients were on antiretroviral medications, with 0 prenatal transmissions
- $8,500 in transportation assistance
Our team works together to help make this program effective for our patients because we know viral suppression means they can live higher quality lives. It also means we’re slowing transmission in our community because fewer people pass the virus to others.
Related reading: MedStar Health Investigates HIV and HIV Prevention in Cisgender and Pregnant Women Through Two NIH Grants.
Extending HIV care at MedStar Health.
The MWHC Infections Diseases Section offers culturally competent care for everyone regardless of race, ethnicity, sexual orientation, or gender identity. RWP extends this service to patients with barriers to care through:- Case management
- Dental care
- Home health care
- Inpatient-to-outpatient care transitions
- Partner counseling and testing
- Psychological and substance abuse counseling
- Safer sex education
- Transportation
RWP services are available to individuals over 18 who have been diagnosed with HIV and whose income is at or less than 500% of the federal poverty level.
We also work with patients to help them stay consistent with medications and keep the virus suppressed. Some patients are eligible for new treatments such as cabotegravir–rilpivirine (CAB/RPV), a long-acting injectable antiretroviral therapy approved in 2021.
RWP partnerships include MedStar Georgetown University Hospital Pediatric HIV Program women’s health and family services, Children’s National Hospital pediatric services, and community partners such as:
- Food & Friends: Home-delivered meals for eligible patients
- Housing Counseling Services: Financial assistance with food, rent, and utilities
-
Mary’s Center: Dental services
-
Whitman Walker Health: Insurance information and assistance
Related reading: PrEP: Safe, Effective HIV Prevention Medication for Everyone.
Living a longer, fuller life with HIV.
Those with HIV who are diagnosed early, take antiretroviral therapy, and stay on medication live longer with suppressed viruses. Today, more than half the people in the U.S. with HIV are over age 50.
This is great news, but it makes care coordination like that provided by RWP even more critical. Aging patients with HIV have more underlying conditions, such as low bone density and cardiovascular disease, that require care from additional medical specialists.
At MedStar Health, we work closely throughout our system to ensure patients receive comprehensive care. With streamlined communication through electronic medical records, providers work seamlessly with social workers, treatment navigators, and community partners. Our work to break down barriers to care and reduce stigma through RWP means more of our neighbors are living with HIV as a chronic, manageable disease.
