Cost Analysis for a Retail Mobile Community Pharmacy Addressing Substance Use and HIV Prevention Services in Underserved Communities

Opioid use disorder (OUD) remains a leading factor in the spread of HIV with injection drug use alone responsible for over 4 million HIV cases worldwide. People who use drugs (PWUD) and have HIV are also less likely to receive and adhere to HIV care, increasing the risk of treatment failure and HIV transmission. While novel approaches like mobile health clinics support equitable healthcare delivery by providing screening for OUD, mobile clinics have yet to offer immediate access to diagnoses and treatment.

To meet the United States Ending the HIV Epidemic (EHE) plan’s goal of reducing new HIV infections, this pilot study will introduce the first legal retail mobile pharmacy to integrate HIV treatment/prevention with OUD treatment. The proposed cost analysis will provide insights into resource requirements to inform future implementation and adoption of mobile pharmacies. Additionally, study findings can potentially extend to mobile clinics and people delivering care to communities such as community health workers or mobile clinic clinicians.

Adati Tarfa is a pharmacist and a PhD-trained health services researcher currently a postdoctoral associate at the Yale School of Medicine, Division of Infectious Diseases, in the Integrating Substance Use Treatment Research with Infectious Disease for Everyone (InSTRIDE) lab led by Dr. Sandra Springer. Tarfa holds a PharmD from Drake University (2017) and master’s and doctoral degree in Health Services Research from the University of Wisconsin-Madison (2023).

Tarfa’s research focuses on the intersection of HIV and Substance Use Disorder (SUD) using pharmacist-centered interventions. Tarfa has explored the perceptions of patients, pharmacists, and social workers on barriers to linkage and retention in HIV care within community pharmacies. Using the Addiction-Comprehensive Health Enhancement Support System (A-CHESS) mobile app intervention, Tarfa investigated factors influencing HIV medication adherence among individuals with HIV and SUD. Additionally, she has used qualitative discourse analysis and illness perception theories to explore patients' perspectives and the barriers they encounter when seeking care for their comorbid HIV and SUD. Using pharmacist-focused approaches, Tarfa’s research interests center around the application of mixed methods and social behavioral theories to inform the development and dissemination of interventions targeting comorbid substance use disorders and HIV.