• Author
    Ethan Liebross
  • Discovery PI

    Dr. Raul Macias Gil, Harbor-UCLA, Infectious Disease

  • Project Co-Author

  • Abstract Title

    Integrating HIV and STI Prevention and Treatment Strategies in Mobile Clinics Serving People Experiencing Homelessness: Assessing Provider Knowledge and Implementation Barriers

  • Discovery AOC Petal or Dual Degree Program

    Healthcare Improvement & Health Equity Research

  • Abstract

    Objective: 

     

    This project assesses provider knowledge, attitudes, and perceived barriers to prescribing Doxy-PEP, Hep C treatment, and long-acting injectable PrEP within Los Angeles County Department of Health Services (DHS) mobile clinics. Despite high STI and HIV burden among people experiencing homelessness, uptake of these novel prevention strategies remains unclear. By identifying knowledge gaps and implementation barriers, this study seeks to inform future strategies to improve equitable access to evidence-based HIV and STI prevention tools.

     

    Methods: 

     

    We will conduct a mixed-methods provider survey and qualitative interviews for prescribers (which may include MDs, PAs, NPs, or PharmDs) and for other key staff (nurses, social workers, and case managers) working in LA County DHS mobile clinics across all eight Service Planning Areas SPAs).

    Using the Capability, Opportunity, Motivation–Behavior (COM-B) implementation framework, we will structure survey instruments to assess knowledge, capacity, opportunity, and motivation related to HIV, STI, and viral hepatitis prevention interventions.

    The survey will include clinical vignettes and knowledge assessments focused on Doxy-PEP, Hep C treatment, and PrEP (including long-acting injectable PrEP), and hepatitis B and C. We will also collect information on operational workflows, medication storage and handling, follow-up processes, insurance navigation, and coordination with specialty services and community partners.

    Participants will be recruited in person during mobile clinic sessions using convenience sampling. Surveys will be completed electronically via a secure REDCap platform and will take approximately 7–10 minutes to complete.

    Participants will receive a $50 gift card as compensation for their time, supported through a Department of Medicine grant application at Harbor-UCLA Medical Center.

     

    Results: 

     

    Data collection has not yet begun and is planned across Los Angeles County Department of Health Services mobile clinics. Preliminary efforts have included survey development guided by the COM-B framework, engagement in mobile clinic care to inform study design, and incorporation of stakeholder feedback through Community Engagement and Research Program (CERP) discussions. Preliminary insights suggest potential variability in provider familiarity with newer prevention strategies, including Doxy-PEP and long-acting injectable PrEP, as well as anticipated structural barriers related to follow-up, medication logistics, and care continuity. Quantitative and qualitative analyses are planned.

     

    Conclusions: 

     

    This study will identify key knowledge gaps and implementation barriers to delivering evidence-based HIV and STI prevention strategies in mobile clinic settings serving people experiencing homelessness. Findings will inform targeted educational interventions and workflow adaptations to support the integration of Doxy-PEP, hepatitis C treatment, and long-acting injectable PrEP into low-barrier care models. Ultimately, this work aims to improve equitable access to preventive care and reduce the burden of infectious diseases among underserved populations who rely on low-barrier care.

     

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