Barriers and facilitators to use of a mobile HIV care model to re-engage and retain out-of-care people living with HIV in Atlanta, Georgia

• Type of Material: Article
• Authors: Michelle E Henkhaus, Emory University; Sophia Hussen, Emory University; Devon N Brown, Emory University; Carlos del Rio, Emory University; Michelle R Fletcher, Emory University; Marxavian D Jones, Emory University; Amulya Marellapudi, Emory University; Ameeta Kalokhe, Emory University
• Language: English
• Date: 2021-03-11
• Publisher: PUBLIC LIBRARY SCIENCE
• Publication Version: Final Published Version
• Copyright Statement: © 2021 Henkhaus et al
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0247328
• Title of Journal or Parent Work: PLOS ONE
• Volume: 16
• Issue: 3
• Start Page: e0247328
• End Page: e0247328
• Grant/Funding Information: This study was funded by the National Institutes of Health/National Institute of Allergy and Infectious Diseases through the Emory Center For AIDS Research (P30 AI050409) to ASK. http://www.cfar.emory.edu/; https://www.niaid.nih.gov/; The funders had no role in the study design, data collection, and analysis, decision to publish, or preparation of the manuscript.
• Keywords: Science & Technology; Science & Technology - Other Topics; Multidisciplinary Sciences
• Research Categories: Health Sciences, Public Health

Abstract

Novel strategies to re-engage and retain people living with HIV (PLWH) who are out of care are greatly needed. While mobile clinics have been used effectively for HIV testing and linkage, evidence guiding their use in providing HIV care domestically has been limited. To guide the development of a mobile HIV clinic (MHC) model as a strategy to re-engage and retain PLWH who are out of care, we aimed to explore stakeholder perceptions of barriers and facilitators to MHC implementation and use. From June 2019-July 2020, we conducted 41 in-depth interviews with HIV clinic providers, administrators, staff, legal authorities, and community advisory board members, PLWH, AIDS service organizations and city officials in Atlanta, Georgia, and domestic and international mobile health clinics to explore barriers and facilitators to use of MHCs. Interviews were transcribed, coded and thematically analysed. Barriers raised include potential for: breach of confidentiality with resulting heightened stigmatization, fractured continuity of care, safety concerns, staffing challenges, and low community acceptance of MHC presence in their locality. Participants provided suggestions regarding appropriate exterior design, location, timing, and co-delivery of non-HIV services that could facilitate MHC acceptance and address the concerns. In identifying key barriers and facilitators to MHC use, this study informs design and implementation of an MHC as a novel strategy for re-engaging and retaining PLWH who are out of care.