ClinicalTrials.gg
CompletedNCT05140421D2SUpdated Nov 4, 2026Results posted

Testing a Novel Data-to-Suppression (D2S) Intervention Strategy in the Ryan White HIV/AIDS Program

An interventional study of Data to Suppression (D2S) and Usual practice in Hiv, sponsored by City University of New York. Completed at 27 sites in United States. Per ClinicalTrials.gov, last updated 2026-11-04.

Sponsored by City University of New York · Not applicable, Interventional, and Treatment

Updated Nov 4, 2026Now CompletedPosted results revisedGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
1,494
Allocation
Randomized
Sex
All
01

Study summary

The Ryan White HIV/AIDS Program (RWHAP) for low-income people with HIV (PWH) is a key resource for reducing HIV health disparities and scaling up evidence-based interventions. As RWHAP serves >50% of US PWH, RWHAP outcomes are vital to achieving "getting-to-zero"/ Ending the HIV Epidemic (EHE) Plan targets.

As a grantee for RWHAP Part A (RWPA) funding distributed to the counties/cities severely affected by HIV, New York City (NYC) conducts regular HIV care continuum monitoring citywide and in its RWPA programs, which offer support services to reduce social and behavioral barriers to care/treatment. Local data consistently show lower viral suppression (VS) among RWPA clients in HIV care than among non-RWPA PWH in HIV care. Relative to NYC HIV cases overall, NYC RWPA clients (\~14,000 per year) over-represent Black and Latinx PWH and high-poverty neighborhoods. To address local outcome disparities and to fill gaps left by data-to-care strategies and research focused on medical care (re-)linkage, the investigators propose to implement and rigorously evaluate the effectiveness of a novel 'data-to-suppression' (D2S) intervention among RWPA behavioral health and housing program clients who are in HIV care but unsuppressed. Surveillance-based reports on unsuppressed clients plus D2S capacity-building assistance will guide RWPA providers in targeting and delivering evidence-informed strategies to improve VS.

Read the detailed description

The investigators will implement and evaluate the Data-to-Suppression (D2S) intervention in Aim 1, which applies a cluster-randomized, stepped-wedge design. Agencies eligible for the trial will be matched in pairs and then randomized within pairs to the Early Implementation arm (receiving the D2S intervention in Periods 1 and 2, months 13-36) or the Delayed Implementation arm (receiving the D2S intervention in Period 2 only, months 25-36). Our design will also use baseline data from a 12-month pre-implementation period (Period 0, months 1-12), for which D2S reports will be retrospectively generated. Each period will include two rounds of report releases (six months apart), each with a 12-month look-back period. In both arms, clients without viral suppression (VS) will be followed forward for viral load (VL) outcomes after report issue date. Outcomes data will be derived from the NYC HIV Surveillance Registry, a population-based data source of longitudinal laboratory (VL, CD4) testing records on all diagnosed NYC PWH, regardless of medical provider within NYC, and for periods extending before and after RWPA program enrollment or discontinuation.

02

Conditions studied

  • Hiv

Keywords

  • viral load suppression
  • surveillance
  • HIV treatment engagement
  • structural intervention
03

In context

Acquired Immunodeficiency Syndrome

3,035 studies on the registry are indexed under Acquired Immunodeficiency Syndrome; 306 are open to participants now.

This study's enrollment of 1,494 is above the median of 96 across 2,251 interventional studies indexed under Acquired Immunodeficiency Syndrome.

Browse Acquired Immunodeficiency Syndrome studies →

Lead sponsor

City University of New York is the lead sponsor of 12 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • For each stepped-wedge implementation period (Period 0, 1, or 2), clients eligible for trial inclusion must have: (1) ≥1 viral load (VL) test in the report year (evidence that they are in care in NYC); (2) unsuppressed VL (≥200 copies/mL) at last reported VL test during that year; and (3) a reported service in one of the eligible programs/agencies during the report year. In addition, they must still have an open RWPA enrollment in one of the eligible programs and agencies and be presumed living at the time of report generation (two months following the end of the report year on which data are being shared with providers).

Exclusion criteria

Exclusion Criteria:

  • Agencies without current NYC RWPA funding for housing assistance or behavioral health (mental health, supportive counseling or harm reduction) services are excluded. Agencies with \<5 clients meeting the above inclusion criteria over three recent pre-implementation sample periods of data are also excluded (due to insufficient numbers of unsuppressed clients). Clients enrolled in NYC RWPA behavioral health or housing programs are excluded from the trial if they are virally suppressed, deceased, or lacking any evidence of NYC care for a full year at the time a D2S report is issued. Given the potential lag in reporting to surveillance and the need to use the freshest available surveillance data for D2S reports, some clients may later be found to have died or to have a VL\<200 dated after their qualifying VL≥200 but prior to D2S report generation; such clients will be excluded post hoc from that round of follow-up due to VS at the time of intervention. Similarly, clients later reported (in programmatic data) to have been closed out of all eligible programs before the report issue date will be excluded post hoc.
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
1,494 participants (actual)

Study arms

  • Experimental
    Early implementation: UC first, then D2S, then D2S again

    This arm will receive usual quality management supports (usual practice) from the NYC Health Department during Period 0 (months 1-12) and D2S intervention components during Period 1 (months 13-24) as well as throughout Period 2 (months 25-36) of the stepped-wedge trial.

    Other: Data to Suppression (D2S) · Other: Usual practice

  • Active comparator
    Delayed implementation: UC first, then UC again, then D2S

    This arm will receive the usual quality management supports (usual practice) from the NYC Health Department during Period 0 (months 1-12) and Period 1 (months 13-24), and will transition to receiving the D2S intervention components during Period 2 (months 25-36).

    Other: Data to Suppression (D2S) · Other: Usual practice

Interventions

  • OtherData to Suppression (D2S)

    Intervention components include (1) reporting and (2) capacity building to facilitate identification of and follow-up with PWH who are in care but virally unsuppressed. The NYC Health Department will send client-level, surveillance-based reports on individual clients' viral suppression status to the current Ryan White Part A behavioral health and housing service providers for those clients. The Health Department will also provide capacity building and technical assistance (TA) support to service providers on following up with clients flagged as unsuppressed, and on addressing barriers to viral suppression through root cause analyses and the development and implementation of D2S quality improvement projects. The intervention components are all delivered to Ryan White Part A providers by the Health Department, in order to enhance program resources to achieve and maintain viral suppression in the Ryan White Part A client population in NYC.

  • OtherUsual practice

    The NYC Health Department's usual practice with Ryan White Part A behavioral health and housing service providers includes sharing an annual aggregate surveillance-based report on viral suppression prevalence at each site and across all Part A sites (with trends for the past three years and breakdowns of viral suppression for specific populations in the latest year), a guidance document delivered with the aggregate viral suppression report, annual site visits to monitor program delivery, and on-demand quality improvement project guidance (for whatever Part A quality improvement project each site may identify and select).

06

What researchers measure

Primary outcomes

  1. Timely Viral Suppression

    Registry-reported VL \<200 copies/mL on any VL test dated in the six months after the client first appeared as unsuppressed on a D2S report for the period

    Time frame: 6 months

Secondary outcomes

  1. Time to Viral Suppression

    Time to first VL \<200 copies/mL after client's first appearance on a D2S report for the period

    Time frame: 12 months

07

Results

Posted Mar 19, 2026
Limitations and caveats
The intervention was administered to sites, whose implementation of any follow-up with individual clients was voluntary, left to the discretion of service providers at the sites. The trial spanned the pandemic period. Sites reported some implementation barriers, e.g., understaffing and resource constraints. The Health Department did not administer any intervention to individuals followed for the trial and did not interview or otherwise collect study-specific data from those individuals directly.

Participant flow

There is no client recruitment for this trial, which relies on data collected as part of surveillance and routine Ryan White HIV/AIDS Program (RWHAP) Part A reporting. The settings are 20 NYC community-based organizations and 7 hospitals funded through the RWHAP Part A grant to provide housing and behavioral health services. The 27 sites were matched in pairs (in one case, two smaller sites were matched to one larger one), and then randomized within pairs to early or delayed implementation.

Period 0: months 1-12/Dec 2020-Nov 2021
Participant flow — Period 0: months 1-12/Dec 2020-Nov 2021
MilestoneEarly Implementation: UC First, Then D2S, Then D2S AgainDelayed Implementation: UC First, Then UC Again, Then D2S
Started292322
Completed292322
Not completed00
Period 1: months 13-24/Dec 2021-Nov 2022
Participant flow — Period 1: months 13-24/Dec 2021-Nov 2022
MilestoneEarly Implementation: UC First, Then D2S, Then D2S AgainDelayed Implementation: UC First, Then UC Again, Then D2S
Started209279
Completed209279
Not completed00
Period 2: months 25-36/Dec 2022-Nov 2023
Participant flow — Period 2: months 25-36/Dec 2022-Nov 2023
MilestoneEarly Implementation: UC First, Then D2S, Then D2S AgainDelayed Implementation: UC First, Then UC Again, Then D2S
Started197195
Completed197195
Not completed00

Outcome measures

PrimaryTimely Viral Suppression

Registry-reported VL \<200 copies/mL on any VL test dated in the six months after the client first appeared as unsuppressed on a D2S report for the period

Time frame:
6 months
Reported as:
Count of participants · Participants
Timely Viral Suppression
ParticipantsD2S InterventionUsual Care
Timely Viral Suppression309352
SecondaryTime to Viral Suppression

Time to first VL \<200 copies/mL after client's first appearance on a D2S report for the period

Time frame:
12 months

Results for this outcome have not been posted.

Adverse events

Collected over The three 12-month trial periods were: December 2020 - November 2021 (no intervention at all sites; months 1-12, Period 0) , December 2021 - November 2022 (D2S intervention at Early Implementation sites only, no intervention at Delayed Implementation sites; months 13-24, Period 1), December 2022 - November 2023 (D2S intervention at all sites; months 25-36, Period 2). For TVS outcome follow-up, clients who appeared on D2S reports were followed for six months after they first appeared on a report.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
D2S Intervention119/601 (19.8%)——
Usual Care121/893 (13.5%)——

Baseline characteristics

There is no difference, in that the total numbers in each arm are the sum of the per-arm subtotals in each period of the trial. There is no duplication of individuals within a given period; however, as stated in the Protocol, individuals could be included in more than one period, if they were included on a D2S report (as virally unsuppressed) in more than one period.

Age, Categorical
Age, Categorical(Participants)Early Implementation: UC First, Then D2S, Then D2S AgainDelayed Implementation: UC First, Then UC Again, Then D2STotal
<=18 years101
Between 18 and 65 years6287431371
>=65 years6953122
Sex/Gender, Customized
Sex/Gender, Customized(Participants)Early Implementation: UC First, Then D2S, Then D2S AgainDelayed Implementation: UC First, Then UC Again, Then D2STotal
Cisgender man or boy460500960
Cisgender woman or girl200225425
TGNCNB* individual3871109
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Early Implementation: UC First, Then D2S, Then D2S AgainDelayed Implementation: UC First, Then UC Again, Then D2STotal
Hispanic or Latino200235435
Not Hispanic or Latino4975561053
Unknown or Not Reported156
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Early Implementation: UC First, Then D2S, Then D2S AgainDelayed Implementation: UC First, Then UC Again, Then D2STotal
American Indian or Alaska Native358
Asian033
Native Hawaiian or Other Pacific Islander101
Black or African American5265731099
White108140248
More than one race131124
Unknown or Not Reported4764111
Region of Enrollment
Region of Enrollment(Participants)Early Implementation: UC First, Then D2S, Then D2S AgainDelayed Implementation: UC First, Then UC Again, Then D2STotal
United States6987961494
08

Study locations

27 sites
  • Alliance for Positive Change
    New York, New York 10001, United States
  • Mount Sinai Beth Israel
    New York, New York 10003, United States
  • Exponents, Inc.
    New York, New York 10004, United States
  • GMHC
    New York, New York 10018, United States
  • African Services Committee, Inc.
    New York, New York 10027, United States
  • Harlem United
    New York, New York 10027, United States
  • New York Presbyterian Hospital
    New York, New York 10032, United States
  • Bailey House, Inc.
    New York, New York 10035, United States
  • New York Harm Reduction Educators, Inc.
    New York, New York 10035, United States
  • The Institute for Family Health
    New York, New York 10035, United States
  • NYC Health and Hospitals Harlem
    New York, New York 10037, United States
  • Project Hospitality, Inc.
    New York, New York 10302, United States
  • Boom!Health
    New York, New York 10451, United States
  • BronxWorks, Inc.
    New York, New York 10453, United States
  • St. Ann's Corner of Harm Reduction
    New York, New York 10459, United States
  • Tolentine Zeiser Community Life Center
    New York, New York 10463, United States
  • Housing Works
    New York, New York 11201, United States
  • Research Foundation of State University of New York
    New York, New York 11203, United States
  • La Nueva Esperanza, Inc.
    New York, New York 11206, United States
  • NYC Health and Hospitals Woodhull
    New York, New York 11206, United States
  • Interfaith Medical Center
    New York, New York 11213, United States
  • Bridging Access to Care, Inc.
    New York, New York 11216, United States
  • After Hours Project
    New York, New York 11221, United States
  • Planned Parenthood of Greater New York
    New York, New York 11225, United States
  • CAMBA, Inc.
    New York, New York 11226, United States
  • AIDS Center of Queens County, Inc.
    New York, New York 11432, United States
  • NYC Health and Hospitals Queens
    New York, New York 11432, United States
09

References and documents

Publications

  • Irvine MK, Abdelqader F, Levin B, Thomas J, Avoundjian T, Peterson M, Zimba R, Braunstein SL, Robertson MM, Nash D. Study protocol for data to suppression (D2S): a cluster-randomised, stepped-wedge effectiveness trial of a reporting and capacity-building intervention to improve HIV viral suppression in housing and behavioural health programmes in New York City. BMJ Open. 2023 Jul 14;13(7):e076716. doi: 10.1136/bmjopen-2023-076716. PubMed 37451738 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No — Due to New York State Public Health Law and the confidential nature of HIV surveillance data in New York, public health authorities in New York City cannot release individual-level data on reported HIV cases for purposes other than ensuring appropriate HIV care. The NYC Department of Health and Mental Hygiene (DOHMH) staff are available to assist external researchers who may have further specific data questions or uses. Please send an email to the DOHMH PI Mary Irvine (mirvine@health.nyc.gov) with questions or requests for additional information.

10

Updates

1 registry update since Sep 25, 2026
Status
Active, not recruiting→Completed
changed Nov 4, 2026
Results
Posted results revised
revised Nov 4, 2026
Show all 1 update
  1. Nov 4, 2026
    Active, not recruiting→Completed
    Posted results revised
    + 2 other changes: verification date and date precision

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

11

Registry details

Key details

Study ID
NCT05140421
Lead sponsor
City University of New York
Collaborators
New York City Department of Health and Mental Hygiene, National Institute of Mental Health (NIMH)
Responsible party
Mary Irvine (Director of HIV Care and Treatment Research and Evaluation, New York City Department of Health and Mental Hygiene) — Principal investigator
First posted
Dec 1, 2021
Start date
Dec 15, 2021
Primary completion
Jun 1, 2024
Completion
Apr 30, 2026
Results posted
Mar 19, 2026
Last update
Nov 4, 2026

Study contacts

Denis Nash, PhD
principal investigator · CUNY School of Public Health and Health Policy
Mary K Irvine, DrPH
principal investigator · New York City Department of Health and Mental Hygiene

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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