Exportability of an intervention to increase HIV testing in the Veterans Health Administration.

Background: Exportability, or the dissemination of successful health services interventions from one site to another, must be demonstrated before systemwide implementation.

Methods: The effectiveness of a previously successful multicomponent intervention to increase rates of HIV testing in Veterans Health Administration (VHA) health care facilities among those without records of previous testing was evaluated in two other VHA facilities. Whereas the principle responsibility for the provider-activation component of the intervention was previously borne by research staff, nonresearch staff now took on these responsibilities.

Evaluation of the sustainability of an intervention to increase HIV testing.

Background: Sustainability-the routinization and institutionalization of processes that improve the quality of healthcare-is difficult to achieve and not often studied.

Objective: To evaluate the sustainability of increased rates of HIV testing after implementation of a multi-component intervention in two Veterans Health Administration healthcare systems.

Design: Quasi-experimental implementation study in which the effect of transferring responsibility to conduct the provider education component of the intervention from research to operational staff was assessed.

The impact of integrated HIV care on patient health outcomes.

Background: Control of viral replication through combination antiretroviral therapy (cART) improves patient health outcomes. Yet many HIV-infected patients have comorbidities that pose social and clinical barriers to achieving viral suppression. Integration of subspecialty services into HIV primary care may overcome such barriers.

HIV/AIDS health service utilization by people who have been homeless.

People living with HIV/AIDS (PLWHA) who experience homelessness have competing priorities (e.g., food, security of property) and experience complex health-related issues (e.