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Background: STD Programs are challenged to deliver evidence-based and cost effective intervention activities that successfully reach underserved populations.
Objectives: Effective utilization of mobile clinics to conduct case-related and targeted screening activities that positively impact program performance and are cost effective.
Methods: In 2009, Houston STD Program utilized two mobile clinics to provide STD clinical services for DIS syphilis/HIV case identified venues and targeted screening in high syphilis morbidity areas. Documented case-related screenings were examined for impact on program performance indicators. Comparative cost analysis was conducted for the mobile clinic interventions and traditional outreach activities.
Results: January - June 2009, the mobile clinic tested 616 case-related individuals. Thirty-nine positive tests were identified, a reactivity rate 6.33%; higher than two Houston’s high-volume STD clinics. Seventy-five clusters were preventively treated for syphilis, contributing to program improvement on syphilis clustering performance indices: 1.43 (goal--1.0); syphilis treatment 89% (goal--0.75); disease intervention 60% (goal--60%); and HIV clustering 1.0 (goal--1.0). Thirty-three of 47 targeted screenings occurred in high morbidity areas where underserved and marginalized individuals reside or frequent. Serving high-risk and targeted populations through mobile clinic initiatives results in cost savings of $35,322.80 in STD services and cost savings of $1,314.12 per new syphilis case identified.
Conclusions: Incorporating mobile clinic activities in STD program operations ensures performance objectives are cost effective and achievable.
Implications for Programs, Policy, and/or Research: Mobile clinics can be utilized as a practical and cost effective alternative for STD programs providing evidence-based interventions to reach underserved populations.