{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T17:13:16Z","timestamp":1783703596321,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007700","name":"Miami Center for AIDS Research","doi-asserted-by":"publisher","award":["P30AI073961 admin supplement to SDL"],"award-info":[{"award-number":["P30AI073961 admin supplement to SDL"]}],"id":[{"id":"10.13039\/100007700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Barriers to pre\u2010exposure prophylaxis (PrEP) access have limited its reach to priority populations. Community\u2010based mobile clinics have potential to broaden PrEP engagement. We evaluated reach and persistence for fixed and mobile clinic cohorts in Miami\u2010Dade County, Florida.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This 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\u2010lowering strategies was deployed across fixed and mobile clinic sites. Chi\u2010square and Fisher's exact test or the Kruskal\u2013Wallis test were used to test for differences in characteristics across sites as well as across services sought. Kaplan\u2013Meier 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 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, <jats:italic>p<\/jats:italic> = 0.01; HR: 2.02, <jats:italic>p<\/jats:italic>&lt;0.01; HR: 1.68, <jats:italic>p<\/jats:italic>&lt;0.01, respectively). Persistence did not differ by race or ethnicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A 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\u2010lowering strategies employed in our fixed and mobile clinics.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26362","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T05:43:28Z","timestamp":1728971008000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["An observational cohort study evaluating PrEP reach, engagement and persistence through a community\u2010based mobile clinic in Miami\u2010Dade County, Florida"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6535-6698","authenticated-orcid":false,"given":"Susanne","family":"Doblecki\u2010Lewis","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Prevention Science Department of Medicine University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Klose","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"King","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilianne","family":"Narcisse","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefani","family":"Butts","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Whiteside","sequence":"additional","affiliation":[{"name":"Prevention305  Miami Beach Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Kobetz","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology Department of Medicine University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.1343"},{"key":"e_1_2_11_3_1","unstructured":"Centers for Disease Control and Prevention.HIV Surveillance Report 2021.2021. Available from:https:\/\/www.cdc.gov\/hiv\/library\/reports\/hiv\u2010surveillance.htmlAccessed February 2024."},{"key":"e_1_2_11_4_1","unstructured":"DenningP DiNennoE.Communities in crisis: is there a generalized HIV epidemic in impoverished urban areas of the United States?Centers for Disease Control and Prevention;2015."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2018.06.005"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462415601304"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001236"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301864"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(14)00011-3"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0172354"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2020.306035"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/13691050701243547"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1090198111436340"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0112425"},{"key":"e_1_2_11_15_1","unstructured":"Doblecki\u2010LewisS ButtsSA KloseK FeasterD CardenasG JonesD.Pilot assessment of a strengths\u2010based patient navigation program to increase access to pre\u2010exposure prophylaxis.CFAR Social and Behavioral Sciences Research Network Meeting;Miami Florida;2017."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-015-1012-3"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462413507443"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-020-1135-7"},{"issue":"2","key":"e_1_2_11_19_1","first-page":"1682","article-title":"Using mobile clinics to deliver HIV testing and other basic health services in rural Malawi","volume":"11","author":"Lindgren TG","year":"2011","journal-title":"Rural Remote Health"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2011.00947.x"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1446.2002.19504.x"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30313-2"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep13040129"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.13.129478"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2014.986053"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06920-4"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16486"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-023-07899-5"},{"issue":"1311","key":"e_1_2_11_29_1","article-title":"Addressing disparities in pre\u2010exposure prophylaxis (PrEP) access: implementing a community\u2010centered mobile PrEP program in South Florida","volume":"23","author":"Butts S","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"e_1_2_11_30_1","unstructured":"United States Census.Quick Facts: Miami\u2010Dade County Florida 2022.2023."},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.2196\/23173"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-019-00447-4"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-09475-8"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001251"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2021.0177"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.4683"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa037"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-019-02654-x"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001724"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25385"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.26362","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T03:45:18Z","timestamp":1729827918000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.26362"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":39,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1002\/jia2.26362"],"URL":"https:\/\/doi.org\/10.1002\/jia2.26362","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10]]},"assertion":[{"value":"2024-03-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e26362"}}