Stakeholder-led design of a mobile HIV clinic model to enhance engagement and retention in HIV care in the Southern United States

ABSTRACT

To foster retention of people living with HIV (PLWH) in HIV care in the Southern United States, we aimed to develop a stakeholder-driven mobile HIV clinic (MHC) model. From June 2019 to May 2021 we conducted a mixed-methods study: 50 surveys with out-of-care PLWH and 41 in-depth interviews with PLWH, HIV clinic staff, city officials, AIDS service organizations, and mobile clinics to examine preferences for MHC implementation. Survey data was analyzed descriptively, and interview transcripts were coded thematically. Participants recommended the MHC: (1) have nondescript exterior and HIV services nested in non-HIV care to foster confidentiality, (2) be located along public transportation and have extended hours to promote accessibility, (3) have established protocols addressing security, biosafety, and data safety; (4) provide comprehensive clinical and support services to address retention barriers; and (5) be integrated within the health system, use low-cost, diverse staffing, and establish appointment notification systems. By informing MHC design, these findings add to the toolbox of strategies that can render HIV care more accessible.

KEYWORDS:

• HIV care
• retention
• community-based
• mobile clinic

Acknowledgements

The authors would like to acknowledge the Emory CFAR Prevention Science Core for provision of data collection devices. We express gratitude to each of the individuals who participated in the study and candidly shares their perspectives with us.

Data availability statement

The data underlying this study contain sensitive and potentially identifying information, and therefore cannot be shared publicly. Interested researchers can request access to the data from the Corresponding Author.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Center for AIDS Research at Emory University [grant number P30 AI050409].