Impact of a revised Ryan White Part A HIV Care Coordination Program on viral suppression and durable viral suppression

Background: In 2018, the New York City Health Department implemented a revised care coordination program (CCR) to facilitate delivery and strengthen the impact of an already effective intervention among people with HIV (PWH) struggling with viral suppression (VS). We examined CCR effects on 12-month VS and 36-month durable VS (DVS). Methods: Using merged population-based HIV surveillance and Ryan White programmatic data, we identified PWH enrolled in the CCR between August 2018 and March 2021 and a contemporaneous group of CCR-eligible yet not enrolled PWH. We used inverse probability weighted models to estimate CCR effects, stratified by baseline treatment status: lacking evidence of VS, newly diagnosed, inconsistently suppressed, and consistently suppressed. Results: Comparing the CCR to usual care, the adjusted relative risk [aRR] of VS was 1.91 (95% CI: 1.67-2.19) among those lacking evidence of VS, 1.30 (95% CI: 1.17-1.45) among those newly diagnosed, 1.14 (95% CI: 1.05, 1.23) among those inconsistently suppressed, and 1.04 (95% CI: 0.94, 1.16) among those consistently suppressed. Comparing the CCR to usual care, the aRR of DVS was 1.39 (95% CI: 1.09-1.77) among those lacking evidence of VS, 1.29 (95% CI: 0.98, 1.71) among those newly diagnosed, 0.92 (95% CI: 0.79, 1.09) among those inconsistently suppressed, and 1.07 (95% CI: 0.88, 1.30) among those consistently suppressed. Conclusions: Relative to usual care, the CCR enhanced VS across most baseline treatment status groups and showed promise for DVS among PWH lacking evidence of VS or newly diagnosed.