Pilot Findings From the First Legalized Mobile Retail Pharmacy Clinic in the United States for Infectious Disease Treatment and Prevention Tailored to Reach People Who Use Drugs

Abstract

Background: Mobile retail pharmacies were legalized in Connecticut in 2023 to provide primary care, human immunodeficiency virus (HIV) and hepatitis C virus (HCV) testing, preexposure prophylaxis (PrEP), immediate HIV antiretroviral therapy (ART), and medications for substance use disorders directly to people who use drugs (PWUD).

Methods: InMOTION mobile pharmacy and clinic (MPC) pilot findings describe services provided by pharmacists, clinicians, and community health workers.

Results: From 13 December 2023 through 5 November 2024, the MPC engaged with 414 participants, of whom 43% were female, 26% Black/African American, 32% uninsured, and 37% unhoused or unstably housed. Fifty-one had a previous diagnosis of an opioid use disorder (OUD), 163 accepted screening, 1 received a new diagnosis of moderate to severe OUD, and 37 received medication for OUD. Nine participants requested sexually transmitted infection testing; 3 people had positive results, all were prescribed treatment, and 1 received doxycycline postexposure prophylaxis. Four people had existing HIV diagnoses; 166 accepted rapid point-of-care (POC) testing, resulting in 1 positive test; all received ART (2 oral, 3 injectable); 9 who tested HIV negative accepted PrEP, and 1 accepted the injectable formulation. Twenty-two had known HCV, 157 accepted rapid POC HCV testing, 9 tested positive for HCV antibodies, and 11 underwent HCV viral load (VL) testing; 1 self-cleared, and 8 of 10 with detectable HCV VL received direct-acting antivirals from the MPC. Six were treated for xylazine-related wounds.

Conclusions: Health services delivered through an MPC demonstrate the potential to address healthcare gaps for PWUD and warrant exploration and expansion.

Keywords: HCV; HIV; PrEP; mobile pharmacy; substance use disorder.

Figure 1.

InMOTION project design. Abbreviations: ART, antiretroviral therapy; AUD, alcohol use disorder; Doxy-PEP, doxycycline postexposure prophylaxis; HCV, hepatitis C; HIV, human immunodeficiency virus; InMOTION, Integrated Mobile Opioid Treatment and Infectious Disease Coordinated Care in Your Neighborhood; LAI BUP, long-acting injectable buprenorphine; OUD, opioid use disorder; PEP, postexposure prophylaxis; PrEP, preexposure prophylaxis; StUD, stimulant use disorder.