JMIR Publications

ABSTRACT

Background:

Research has shown integrating community health workers (CHWs) into the formal healthcare system can improve outcomes for Black people living with HIV (BPLH), yet the standard of care continues to be delivered through the traditional clinic-based framework.

Objective:

Herein, we discuss the design and feasibility of a clinic-embedded CHW strategy to improve ART adherence among BPLH in Miami-Dade County, a designated priority region for the U.S. Department of Health and Human Services’ Ending the HIV Epidemic Initiative (EHE).

Methods:

From December 2022 – September 2023, three CHWs were trained and integrated into the hospital workflow as members of the clinical team. Ten Black adults with an HIV viral load over 200 copies/mL were enrolled to received three-months of CHW support focused on navigating the health system and addressing poor social determinants of health. Intervention feasibility was based on four criteria: recruitment rate, demographic composition, study fidelity, and qualitative feedback on implementation from the CHW team.

Results:

Participants were recruited at a rate of 5.7 per month, and the sample was evenly distributed between men and women. Retention was moderately strong, with seven of the ten of participants attending more than 75% of CHW sessions. Qualitative feedback reflected CHW perceptions on clinical interactions and intervention length.

Conclusions:

Outcomes indicate a clinic-integrated CHW approach is a feasible and acceptable methodology to address adverse social determinants and improve HIV treatment adherence among BPLH. By offering targeted social and clinical support, CHWs may be a promising solution to achieve sustained viral suppression and care engagement for BPLH.