Despite advances in HIV diagnosis and treatment, approximately 13% of the one million people living with HIV in the US are unaware of their status, and one-third of those diagnosed have not achieved viral suppression. Mobile service delivery serves as a critical strategy to overcome individual and systems-level barriers, such as stigma, cost, and geographic distance, by bringing services directly into the community. However, mobile clinic implementation remains highly variable and context-specific, lacking a generalizable framework to guide replication or scale-up. In particular, the decision-making processes regarding the timing and location of these services are often driven by localized data or qualitative perceptions rather than standardized, evidence-based models.
The goal of this pilot study is to establish a replicable theoretical and implementation framework for mobile HIV service delivery. Using a multi-jurisdictional approach involving three Ending the HIV Epidemic (EHE) jurisdictions, the study will: (1) Use the Implementation Research Logic Model (IRLM) to specify the implicit logic of mobile HIV service delivery initiatives, synthesizing findings into a generalizable model validated by a focus group, and (2) Characterize the real-world processes for context-specific decision making, including selecting clinic services, locations, and timing, through semi-structured interviews with implementation staff. This research leverages the investigative team’s expertise in geographic healthcare barriers, implementation science, HIV care, and community-engaged research. The resulting generalized logic model will provide a foundational framework for a subsequent NIH R34 study to refine systematic, data-informed implementation of mobile service delivery strategies, ultimately improving the reach, fidelity, and effectiveness of mobile HIV services to increase engagement and retention in care.
Project Summary provided by investigator.