Getting to Zero: Resolving Transportation Barriers to Participation in Services Among Unstably Housed PLWH

People living with HIV who are homeless or unstably housed often face significant barriers to accessing essential health services, including regular medical appointments critical for managing their condition. The current standard of care provides these individuals with limited transportation support - specifically, two $10 bus cards per month - which are quickly expended and often insufficient to meet their basic needs.

The proposed trial aims to address this gap by assessing whether providing unlimited transit passes can enhance health outcomes compared to the current standard. The intervention hypothesizes that removing transportation barriers will increase attendance at medical appointments and utilization of supportive services at The Aliveness Project, a community center offering meals and social services to people living with HIV. By enabling consistent access to public transit, the intervention targets behavioral changes - specifically, the ability of participants to reliably attend health care appointments - and fosters greater engagement with community support resources.

The clinical outcomes of interest in this trial are increased rates of viral suppression, which is a direct indicator of effective HIV management, improved attendance at healthcare appointments, and increased engagement with supportive services at The Aliveness Project. These outcomes not only measure the efficacy of the intervention in improving health management among unstably housed individuals living with HIV but also provide insights into the broader implications of transportation accessibility on public health. By alleviating a fundamental barrier to care, the intervention aims to demonstrate a superior approach to supporting this vulnerable population in achieving and maintaining viral suppression.