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

By
Nicky J. Mehtani
Stephen J. Matzat
Kathleen B. O’Connor
Laura Cordoba
Sarah Strieff
Alix Strough
Morgan M. Philbin
Mallory O. Johnson
Monica Gandhi
Barry Zevin
June 26, 2026
0 min

Jama Network Open

Background

Individuals experiencing homelessness (PEH) in the US have a significantly higher HIV prevalence compared to the general population, coupled with lower rates of viral suppression. Structural and psychosocial barriers contribute to challenges in adhering to oral antiretroviral therapy (ART). Long-acting ART (LA-ART) presents a potential solution, yet its implementation in community-based settings remains underexplored.

Data Highlights

No numerical data available in the provided source material.

Key Findings

LA-ART has been shown to be effective in patients with viremia facing challenges to oral ART adherence.
The MXM Health Resource Center serves a diverse population of PEH, with a significant proportion identifying as Black or Hispanic/Latine.
Eligibility for LA-ART was streamlined to enhance access for individuals with housing instability and substance use issues.
Prior studies have established the safety and efficacy of LA-ART, but most were conducted in specialty settings.
Recent updates to guidelines support the use of LA-ART for select individuals with HIV viremia and adherence barriers.

Clinical Implications

The findings suggest that community-based clinics can effectively implement LA-ART for individuals experiencing homelessness, addressing significant barriers to care. This approach may improve treatment adherence and viral suppression among this vulnerable population.

Conclusion

The integration of LA-ART in community settings like the MXM Health Resource Center represents a critical step in addressing HIV treatment disparities among individuals experiencing homelessness.