Long-Acting Antiretroviral Therapy for HIV via Drop-in Community-Based Care

Can long-acting injectable antiretroviral therapy (LA-ART) for HIV be delivered in a community-based drop-in clinic for people experiencing homelessness, mental illness, and substance use disorders?In this quality improvement study of 128 people with HIV experiencing homelessness or housing instability over a 2-year period, all 24 (100%) receiving LA-ART achieved and maintained HIV viral suppression; among 123 prescribed standard treatment, 69 (56%) had viral suppression at last follow-up. LA-ART was delivered without requiring baseline viral suppression and involved frequent clinical encounters, reflecting a high-touch care model.These findings indicate that when paired with intensive, flexible support, LA-ART can be delivered with high rates of viral suppression outside of traditional HIV specialty centers.

Corresponding Author: Nicky J. Mehtani, MD, MPH, Department of Medicine, University of California, San Francisco, 2540 23rd St, UCSF Pride Hall, Room 4316, San Francisco, CA 94110 (nicky.mehtani@ucsf.edu).

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