Actively Recruiting
Enhancing the Organizational Social Context to Improve Viral Suppression and Retention in HIV Care: A Randomized Controlled Trial
Led by University of Pennsylvania · Updated on 2026-05-19
1500
Participants Needed
1
Research Sites
N/A
Total Duration
On this page
AI-Summary
What this Trial Is About
This research aims to reduce racial disparities in HIV outcomes among people living with HIV (PLWH), focusing on Black/African American populations who experience lower rates of viral suppression and retention in care. The study evaluates the impact of structural racism and discrimination within healthcare organizations on these outcomes. It uses a randomized controlled trial (RCT) to test an intervention called Accessibility, Responsiveness, Continuity (ARC) designed to improve organizational social contexts that affect care quality and patient outcomes. The trial involves four clinics randomized to either receive ARC or continue with standard care. ARC uses evidence-based strategies including principles, tools, and mental models to create supportive organizational environments that help improve care for PLWH by addressing issues like referral and treatment patterns affected by structural racism. The intervention period lasts 36 months following a pre-implementation phase, with a subsequent 12-month post-implementation period to continue measuring outcomes in both groups. Participants include PLWH and clinic staff from the selected clinics. Researchers will collect data on viral suppression and retention in care over 12-month periods, along with intermediate outcomes such as linkage to mental health treatment and staff turnover. They will also evaluate individual and organizational factors influencing outcomes. The study includes assessments of acceptability, sustainability, and the cost of implementing ARC to better understand its impact on HIV care and health services.
CONDITIONS
Brief Title
Enhancing the Organizational Social Context to Improve Viral Suppression and Retention in HIV Care
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Adults aged 18 years or older
- People living with HIV (PLWH) receiving care in one of 12 clinics in Philadelphia
- HIV diagnosis made at least one year before clinic organizational social context measures
- Philadelphia address at the time of HIV diagnosis
- Linked to care with documentation of at least one CD4 or viral load test after diagnosis
- Clinic workers including leaders, administrators, frontline staff, and providers in participating clinics
- For Aim 2, PLWH must have been receiving care at one of 4 clinics for at least 6 months before pre-implementation
- Clinic workers in the 2 clinics assigned to ARC will be invited to participate
You will not qualify if you...
- PLWH currently in a correctional facility
- Clinic workers not employed in designated roles
- PLWH discharged from clinic due to moving or other reasons or who died before pre-implementation
- Clinics assigned to standard of care will not receive ARC but will complete surveys on the same schedule as ARC clinics
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - 12 months
Participants receive the ARC behavioral intervention aimed at improving organizational social contexts to support HIV care, or continue with standard care. Clinic workers in selected clinics participate in the intervention.
Periodic visits depending on clinic schedule and role
Duration - Up to 12 months after treatment
Participants are monitored for viral suppression and retention in HIV care after the intervention period.
Visits aligned with routine clinic care
Trial Site Locations
Total: 1 location
1
University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104
Actively Recruiting
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
OTHER
Number of Arms
2
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