Observational studyJournal of the International AIDS Society2024
An observational cohort study evaluating PrEP reach, engagement and persistence through a community-based mobile clinic in Miami-Dade County, Florida.
Observational study in Journal of the International AIDS Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The trial behind it
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Who cites it
5 citing papers in PubMed.
- What Tools Do We Have to End the US HIV Epidemic? A Review of Structural, Biomedical and Implementation Interventions and Their Potential Population Impact.Journal of the International AIDS Society · 2026Review
- Barriers and Facilitators of Oral PrEP Uptake Against HIV Among Selected Priority Populations: A Global Perspective.Current HIV/AIDS reports · 2026Review
- Brief Report: Long-Acting Injectable PrEP Can Substantially Reduce HIV Incidence in Los Angeles County: A Simulation Study.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- The intersection of place and health: neighborhood and socioeconomic factors associated with viral suppression.AIDS care · 2026Article
- Innovation in Providing Equitable Pre-exposure Prophylaxis Services in the United States: Expanding Access in Nontraditional Settings.Journal of acquired immune deficiency syndromes (1999) · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
introductionBarriers to pre-exposure prophylaxis (PrEP) access have limited its reach to priority populations. Community-based mobile clinics have potential to broaden PrEP engagement. We evaluated reach and persistence for fixed and mobile clinic cohorts in Miami-Dade County, Florida.
methodsThis observational cohort study analysed data from 1896 clients engaged through our fixed or mobile clinic from August 2018 to March 2023. Services were offered at no cost to clients. The same staff and package of barrier-lowering strategies was deployed across fixed and mobile clinic sites. Chi-square and Fisher's exact test or the Kruskal-Wallis test were used to test for differences in characteristics across sites as well as across services sought. Kaplan-Meier curves were generated to evaluate persistence on PrEP and in care, defined as completion of at least one clinic visit (including PrEP prescribing, for PrEP persistence, or for any reason, for persistence in care) within 24 weeks of the prior visit. Cox proportional hazards models were used to evaluate risk factors for discontinuation of PrEP or clinic care by 48 weeks by gender, race, ethnicity, insurance status and site.
resultsThe fixed and mobile clinics reached 781 and 1109 clients, respectively, during the study period. The median client age was 35 years; the majority (70.4%) of clients were cisgender men, identified as Hispanic/Latino (62.5%) and were men who have sex with men (54.5%). The mobile clinic extended reach to a higher proportion of cisgender women (32.1% mobile vs. 12.9% for fixed clinic), Black clients (34.5% vs. 13.1%) and older clients (median 37 vs. 33 years) compared with the fixed setting. Uninsured individuals, men and those who initiated services in the mobile clinic were more likely to continue PrEP to 48 weeks (HR: 1.20, p = 0.01; HR: 2.02, p<0.01; HR: 1.68, p<0.01, respectively). Persistence did not differ by race or ethnicity.
conclusionsA mobile clinic strategy for PrEP engagement can increase reach to key populations underrepresented in HIV prevention care including cisgender women and Black clients. Persistence in PrEP was increased for the mobile clinic cohort, suggesting an additional benefit to this modality beyond other barrier-lowering strategies employed in our fixed and mobile clinics.
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