MOBILE, Ala. — Researchers from the University of Alabama at Birmingham met recently with Mobile County health officials and local partners to take stock of the COAST-AL HIV initiative, a research-driven effort on the Alabama coast, and to map out how its work on HIV testing, treatment and viral suppression can continue.
The meeting brought together UAB investigators with implementation teams and community stakeholders from the Mobile County Health Department, Family Health and AIDS Alabama South. Participants reviewed what the partnership has accomplished so far and discussed how to sustain it, according to the health department.
What COAST-AL Is
COAST-AL is a Type 2 hybrid effectiveness-implementation trial. In plain terms, that means the study is designed to answer two questions at once: whether a combination of public health interventions actually improves HIV outcomes, and how well those interventions can be put into practice by the agencies and clinics that serve patients every day.
The intervention being evaluated is a population-health combination approach meant to advance three goals in coastal Alabama:
- Increasing HIV testing, so more people learn their status earlier.
- Improving linkage to care, so people who test positive connect quickly with treatment.
- Raising rates of viral suppression, the point at which treatment keeps the virus at very low levels in the body.
The initiative pairs researchers with public health professionals, health care providers and community-based organizations to identify which approaches work and to apply them locally.
Viral suppression is a central measure in HIV care because it reflects whether treatment is working over time. Federal health agencies note that people with HIV who take their medication as prescribed and maintain an undetectable viral load can live long, healthy lives and do not transmit the virus to sexual partners. Getting there depends on every earlier step in the chain — testing, diagnosis, a first appointment and ongoing care — which is why COAST-AL focuses on the connections between those steps.
Progress Partners Highlighted
During the review, participants pointed to several areas of progress:
- Expanded coordination among service providers.
- Stronger connections between HIV testing and treatment services.
- Continuing work to reduce barriers that can delay diagnosis, care and viral suppression.
The discussion also underscored the role of trusted community partners in reaching people who may be underserved or who face obstacles in getting health care.
Dr. Kevin Michaels, Mobile County’s health officer, credited the collaboration for those results.
“COAST-AL has shown what can be accomplished when researchers, healthcare providers, public-health agencies, and community organizations work toward a shared goal,” Michaels said. “The progress made through this partnership is helping strengthen the systems that connect people to HIV testing, timely care, treatment, and the ongoing support needed to achieve better health outcomes.”
The Local Partners
Each organization at the table plays a different role in the local HIV response.
The Mobile County Health Department oversees public health services for the county, including disease surveillance, prevention programs and community health education. Its Data Analytics and Epidemiology Division tracks health indicators across the county.
Family Health operates as the clinical arm of the Mobile County Health Department and has served uninsured, underinsured, insured and medically underserved residents of Mobile County for more than four decades. Its services include primary care, behavioral health, a 340B pharmacy and HIV early intervention services, delivered through its Downtown Health Center on North Bayou Street and roughly a dozen sites across the region.
AIDS Alabama South is a community-based organization serving the coastal region, part of the network of groups that provide outreach, support and connections to care for people living with or affected by HIV.
UAB, home to one of the Southeast’s largest academic HIV research and care programs, provides the research investigators who designed and are evaluating the trial.
Looking Ahead
A central focus of the meeting was how to keep the momentum going. Partners discussed sharing lessons learned and best practices from the initiative, strengthening coordination across the region and pursuing future resources to support HIV prevention and care for residents of Mobile County and surrounding counties.
“Addressing HIV requires a long-term commitment to prevention, early diagnosis, access to treatment, and support for people throughout their care journey,” Michaels said. “We are encouraged by the collaboration represented in COAST-AL and remain committed to carrying this work forward for the people and communities we serve.”
The health department thanked the UAB investigators, Family Health, AIDS Alabama South, the implementation teams, community stakeholders, health care professionals and partner organizations whose work has contributed to the initiative. The department said their continued collaboration is essential to making sure residents across coastal Alabama have access to the information, services and support needed to prevent HIV and live healthy lives.
Why Coastal Alabama
The South carries a disproportionate share of the nation’s new HIV diagnoses, and Alabama has been identified by federal health officials as one of several states with a substantial share of cases in rural areas. In a region like coastal Alabama, where residents may live far from specialty clinics and where stigma can discourage testing, the gaps between a positive test and steady treatment can be wide.
That is the problem COAST-AL is built to address. By testing a combination of strategies in real-world settings — and studying how well local agencies can carry them out — the trial is meant to produce findings that the health department and its partners can keep using after the research phase ends.
The health department described the initiative as a shared commitment to evidence-informed strategies, meaningful partnerships and coordinated services to improve health outcomes across the region.
How to Get Tested
Federal health guidelines recommend that everyone ages 13 to 64 be tested for HIV at least once as part of routine health care, and that people with ongoing risk be tested more often. Mobile County residents who want testing, information about prevention options such as PrEP, or help connecting to HIV care can contact the Mobile County Health Department or Family Health, or ask their primary care provider.