Special Interest Mobile Healthcare: HIV Testing and Treatment
HIV mobile healthcare clinics are an integral part of the effort to end the HIV epidemic. The clinics test and counsel those who do not know their status—connecting those who test positive to long-term care and empowering those who test negative to remain that way. The mobile clinics work to counteract the stigmas that lead to transmission and lack of treatment for both those who do and those who do not know their status. The mobile clinics educate high-risk individuals about preventative measures to reduce the likelihood of infection. Most HIV mobile clinics also provide additional STD and STI testing.
Goals
- Contribute to the public health effort to end the HIV epidemic.
- Test vulnerable populations for HIV, STDs and STIs.
- Get newly diagnosed HIV positive individuals into treatment.
- Prevent HIV transmission among those who are negative.
- Counteract associated stigmas.
Considerations
HIV Screening Algorithm: Create one that includes rapid tests, education on the importance of testing and good social history intake in order to understand risk factors and behaviors that increase risk.
Referral partners: Strong connections for long-term HIV care are essential, since consistent care is the only way to effectively treat infection and it remains a challenge for the vulnerable populations served by most mobile healthcare clinics. As part of the planning process, identify who is responsible for determining if patients are continuing to seek care—perhaps a case manager or health care coach. In many cases, it will also be important to provide referrals for issues that make it difficult to seek treatment, including mental health, substance abuse and homelessness.
Support for those who test positive for HIV: Provide immediate reassurance, support and comfort so that patients have a positive attitude immediately following initial diagnosis. The goal is to get people medicated, either through the mobile clinic (grant permitting) or a referral clinic. It’s also important to provide positive messaging and counteract the stigma and short-life span expectations. Finally, it is essential to educate about HIV prevention.
Support for those who test negative for HIV: The goal is to keep the patient negative, so encourage regular testing. If the person might have been exposed to HIV or engages in risky behavior, provide education to the individual about PREP (pre-exposure prophylaxis).
Additional STD/STI Screening: Determine if the clinic will also deliver point of care STD, STI and Hepatitis C testing and treatment.
Outreach and location: Outreach efforts help build trust and inroads into the community. Base location(s) on an assessment of the location of the most vulnerable population, including sex workers, the homeless and young men having sex with men, especially people of color and immigrant populations.
Staffing: Often includes a medical provider, medical technician (who might double or triple as the driver and/or registrar) and possibly an educator or peer counselor.
Costs: After the vehicle, costs will mostly include salaries and testing materials.
Design: Testing can occur in a public part of the vehicle and counseling in a private room (or rooms).
Materials: Educational pamphlets on topics like PEP, PREP, the advantages of treating HIV, maintaining personal health and becoming untransmittable.
Resources
- Mobile Health Map
- The scope and impact of mobile health clinics in the United States: a literature review
- HIV/HCV Co-infection: An AETC National Curriculum (membership required)
- Mobile Hep C and Harm Reduction (membership required)
Next Steps
- Become a member of Mobile Healthcare Association
- Review our start-up resources, some for members only.