Kathleen McManus, MD, Awarded $2.9 Million Grant to Improve HIV Care for People With Low Incomes

Kathleen McManus, MD, MSCR, MSDS

Kathleen McManus, MD, MSCR, MSDS, an assistant professor in the School of Medicine’s Department of Medicine, was recently awarded an R01 grant from the National Institutes of Health’s National Institute of Allergy and Infectious Diseases providing $2.9 million in funding over the next four years to identify how to improve viral suppression for people with HIV with low incomes and how to reduce viral suppression disparities for this population that are related to race/ethnicity.

The team will use epidemiologic methods, including a causal inference framework, and qualitative methods informed by an implementation science framework. This award will support the efforts of Dr. McManus and UVA Health’s Jessica Keim Malpass, RN, NP, ACPNP, PhD; Andrew Strumpf, MPH; and Amber Steen; National Alliance of State & Territorial AIDS Directors staffers Tim Horn and Auntré Hamp; Emory’s Elizabeth Rogawski McQuade; and public health consultant Amy Killelea.

As the United States makes advancements in HIV care and treatment and gets closer to ending the HIV epidemic, it is important to ensure that no one is left behind. About a quarter of people with HIV in the United States have low incomes and rely on state AIDS Drug Assistance Programs (ADAPs) for affordable, sustained access to HIV medications. While these state ADAPs are federally mandated, the programs are implemented at the state level. State ADAPs have extensive decision-making flexibilities for healthcare delivery programs and policies, and there are geographic disparities in viral suppression rates for state ADAPs. For this project, McManus and her collaborators have partnered with 10 state health departments, giving them anonymized information about approximately 25% of ADAP clients across the nation. This is a first-of-its-kind multistate database, based on state health department partnerships, with information about approximately 60,000 people with HIV over 10 years. The research team will identify the specific policies and healthcare delivery programs that increase viral suppression rates and reduce viral suppression disparities related to race/ethnicity. The team also plans to interview AIDS/ADAP leaders in many states for additional insights that could lead to cost-effective strategies for equitable care delivery. By quantifying the impact of ADAPs, the research team will help policymakers and advocates understand state ADAPs’ crucial role in United States’ HIV care. Additionally, by identifying specific best practices, the research team will help state health departments to improve their programs and federal policy makers to identify areas for technical assistance or support. Ultimately, the team’s work will help to translate data into policy and action and will result in improved viral suppression in the United States.