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Identifying Health Services Preferences for a Community-Based HIV Status-Neutral Mobile Clinic Among Marginalized
Jose I Gutierrez1,2,3,4,5,6, Elizabeth S Nguyen1,2,3,4,5,6, Kristin D Soriano1,2,3,4,5,6
1Jose I. Gutierrez, Jr., PhD, FNP-BC, is an Assistant Professor, University of California, San Francisco (UCSF), School of Nursing, San Francisco, California, USA.
The Journal of the Association of Nurses in AIDS Care : JANAC
|February 28, 2025
Summary
Marginalized populations prioritize essential services like housing and mental health support for HIV care engagement. Tailoring mobile clinic services to these needs can improve patient satisfaction and health outcomes.
Area of Science:
- Public Health
- Health Services Research
- HIV/AIDS Research
Background:
- Patient preferences are crucial for enhancing satisfaction and engagement in health services.
- Marginalized populations face unique barriers to accessing HIV-related care.
- Mobile clinic models offer a potential solution for delivering integrated health services.
Purpose of the Study:
- To explore the health service preferences of marginalized populations seeking HIV care.
- To inform the development of an HIV prevention and treatment mobile clinic model tailored to community needs.
Main Methods:
- A maximum-difference survey was administered to 154 participants at community events and homeless encampments in Oakland, CA.
- Participants ranked 32 health services based on importance using a tablet interface.
- Data were analyzed using Hierarchical Bayesian modeling to identify prioritized services.
Main Results:
- Fourteen essential services were prioritized by participants.
- Key preferences included housing, mental health counseling and screening, drug overdose prevention, personal hygiene, and food assistance.
- Participants favored services addressing basic physiological and safety needs, alongside physical examinations, screenings, and medication refills.
Conclusions:
- Incorporating community-identified preferences into service design is vital for improving engagement in HIV care.
- A syndemic approach, addressing interconnected health and social issues, is crucial for ending the HIV epidemic.
- Tailored mobile clinic services can effectively meet the complex needs of marginalized populations in HIV care.
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