Novel strategies to re-engage and retain people living with HIV who are out of care (PLWH-OOC) are greatly needed. While mobile clinics have been used successfully for HIV testing and linkage, their utility for delivering HIV care has been understudied. To guide the development of a mobile HIV care model (MHC) as a strategy to re-engage and retain PLWH-OOC, we explored key stakeholder perceptions and preferences for MHC implementation.

methods

We conducted 38 qualitative interviews with key stakeholders, including: HIV clinic providers and staff, legal authorities, administrators, Community Advisory Board members, PLWH-OOC, representatives of AIDS service organizations, and Atlanta city officials. Utilizing a semi-structured interview guide, we examined perceived advantages, barriers, and facilitators of successful MHC implementation. We then conducted team-based coding and thematic analysis.

results

Many participants supported the idea of using MHCs to improve engagement of PLWH-OOC. Participants noted advantages to the MHC model, including convenience, patient-centered care and comfort, and potential to foster provider/staff understanding of patients’ environments and display their commitment. Potential barriers that were raised included confidentiality concerns, stigma, fractured continuity of care, and safety and staffing challenges. To address these barriers and facilitate MHC implementation, participants provided suggestions regarding exterior design, MHC location and timing, and co-delivery of non-HIV services.

conclusions

MHCs have potential to be acceptable, effective means of re-engaging and retaining PLWH-OOC. By identifying barriers and strategies to overcome them, this study informs the design of future MHCs and enables next steps to test their effectiveness for improving outcomes among PLWH-OOC.