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

Fletcher, Michelle R.; Hussen, Sophia A.; Brown, Devon; Ackerley, Cassie Grimsley; Henkhaus, Michelle; Jones, Marxavian D.; Nedell, Emma R.; Rı́o, Carlos del; Kalokhe, Ameeta S.

doi:10.1080/09540121.2022.2124226

Cited by 3 publications

(1 citation statement)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…29 The operating hours of the OIC are weekdays 7 am-5 pm, which may also make it more difficult for working PLWH to schedule an appointment, further delaying care. 30 As a well-known center for HIV treatment, there may also be a stigma associated with presenting to care at the OIC. Prior research has shown these factors may be more important in Black PLWH.…”

Section: Discussionmentioning

confidence: 99%

Racial/ethnic disparities in HIV care outcomes among insured patients at a large urban sexual health clinic

Mathai

Hinestrosa

DeJesus

et al. 2023

Journal of Investigative Medicine

View full text Add to dashboard Cite

Prior studies demonstrate that non-White patients are less likely to achieve human immunodeficiency virus (HIV) suppression compared to White patients due to lack of health insurance. This study aims to determine whether racial disparities in the HIV care cascade persist among a cohort of privately and publicly insured patients. This retrospective analysis evaluated HIV care outcomes during the first year of care. Eligible patients were aged 18–65 years, treatment-naïve, and seen between 2016 and 2019. Demographic and clinical variables were extracted from the medical record. Differences in the proportion of patients achieving each HIV care cascade stage by race were evaluated using unadjusted chi-square testing. Risk factors for viral non-suppression at 52 weeks were analyzed using multivariate logistic regression. We included 285 patients; ninety-nine were White, 101 were Black, and 85 identified as Hispanic/LatinX ethnicity. Significant differences in retention in care for Hispanic/LatinX patients (odds ratio (OR): 0.214, 95% confidence interval (CI): 0.067–0.676) and viral suppression for both Black (OR: 0.348, 95% CI: 0.178, 0.682) and Hispanic/LatinX patients (OR: 0.392, 95% CI: 0.195, 0.791) compared to White patients were observed. In multivariate analyses, Black patients were less likely to achieve viral suppression compared to White patients (OR: 0.464, 95% CI: 0.236, 0.902). This study showed that non-White patients were less likely to achieve viral suppression after 1 year despite insurance and suggests that other unmeasured factors may disproportionately affect viral suppression in these patients. Interventions to identify and address these factors are needed to improve HIV care outcomes for non-White populations.

show abstract

Section: Discussionmentioning

confidence: 99%

Racial/ethnic disparities in HIV care outcomes among insured patients at a large urban sexual health clinic

Mathai

Hinestrosa

DeJesus

et al. 2023

Journal of Investigative Medicine

View full text Add to dashboard Cite

show abstract

Addressing disparities in Pre-exposure Prophylaxis (PrEP) access: implementing a community-centered mobile PrEP program in South Florida

Butts,

Young,

Blackmon

et al. 2023

BMC Health Serv Res

View full text Add to dashboard Cite

Background Pre-exposure prophylaxis (PrEP) for HIV prevention is highly effective, but disparities in PrEP access remain considerable, particularly among Black and Latino men who have sex with men (MSM). To address this, the University of Miami Mobile PrEP Program was created, offering mobile HIV prevention/PrEP services in areas throughout South Florida where HIV incidence is high and PrEP access is geographically limited. Using a community-centered participatory approach, the program strategized and executed expansion into the Liberty City neighborhood of Miami. This study qualitatively assessed factors affecting Mobile PrEP implementation as perceived by community stakeholders, clients, and program staff. Methods Forty-one in-depth interviews were conducted with 21 Mobile PrEP clients, 10 key informants from local health organizations, and 10 program staff. Interview questions queried perceived organizational and positional barriers and facilitators to mobile clinic implementation. Service satisfaction, setting preferences, social factors, and likelihood of recommending Mobile PrEP were also assessed. A thematic content analysis was performed using the Consolidated Framework for Implementation Research (CFIR) taxonomy as the guiding constructs for the analysis. Results Participant statements indicated that providing no-cost services, convenient location, program-covered rideshares, individualized patient navigation, and a community-centric approach to patient care, which included staff members with shared lived experiences to increase positive interactions and renewed trust among poorly served communities, were facilitators of PrEP access and intervention uptake. The importance of program familiarization with the community before implementation, particularly for Black and African American communities, who may experience unique barriers to accessing sexual healthcare was strongly emphasized by participants. Conclusions The Mobile PrEP intervention was found to be an acceptable and accessible mode of HIV/STI preventive care. The importance of pre-implementation community engagement and preparation is emphasized. Future research is needed to refine understanding of the intervention’s components and evaluate implementation determinants in other highly impacted neighborhoods.

show abstract

Addressing Disparities in Pre-Exposure Prophylaxis (PrEP) Access: Implementing a Community- Centered Mobile PrEP Program in South Florida

Butts

Young

Blackmon

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Pre-exposure prophylaxis (PrEP) for HIV prevention is highly effective, but disparities in PrEP access remain considerable, particularly among Black and Latino men who have sex with men (MSM). To address this, the University of Miami Mobile PrEP Program was created, offering mobile HIV prevention/PrEP services in areas throughout South Florida where HIV incidence is high and PrEP access is geographically limited. Using a community-centered participatory approach, the program strategized and executed expansion into the Liberty City neighborhood of Miami. This study qualitatively assessed factors affecting Mobile PrEP implementation as perceived by community stakeholders, clients, and program staff.Methods Forty-one in-depth interviews were conducted with 21 Mobile PrEP clients, 10 key informants from local health organizations, and 10 program staff. Interview questions queried perceived organizational and positional barriers and facilitators to mobile clinic implementation. Service satisfaction, setting preferences, social factors, and likelihood of recommending Mobile PrEP were also assessed. A thematic content analysis was performed using the Consolidated Framework for Implementation Research (CFIR) taxonomy as the guiding constructs for the analysis.Results Participant statements indicated that providing no-cost services, convenient location, program-covered rideshares, individualized patient navigation, and a community-centric approach to patient care, which included staff members with shared lived experiences to increase positive interactions and renewed trust among poorly served communities, were facilitators of PrEP access and intervention uptake. The importance of program familiarization with the community before implementation, particularly for Black and African American communities, who may experience unique barriers to accessing sexual healthcare was strongly emphasized by participants.Conclusions The Mobile PrEP intervention was found to be an acceptable and accessible mode of HIV/STI preventive care. The importance of pre-implementation community engagement and preparation is emphasized. Future research is needed to refine understanding of the intervention's components and evaluate implementation determinants in other highly impacted neighborhoods.

show abstract

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

Cited by 3 publications

References 16 publications

Racial/ethnic disparities in HIV care outcomes among insured patients at a large urban sexual health clinic

Racial/ethnic disparities in HIV care outcomes among insured patients at a large urban sexual health clinic

Addressing disparities in Pre-exposure Prophylaxis (PrEP) access: implementing a community-centered mobile PrEP program in South Florida

Addressing Disparities in Pre-Exposure Prophylaxis (PrEP) Access: Implementing a Community- Centered Mobile PrEP Program in South Florida

Contact Info

Product

Resources

About