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APHA Scientific Session and Event Listing

Eiko Sugano, MPH¹, Dina Wilderson, PhD², Jeffrey Klausner, MD, MPH³, Susan Obata, MD⁴, Teri Dowling, MA, MPH⁵, and Colette Auerswald, MD, MS¹. (1) Division of Adolescent Medicine, University of California, San Francisco, 3333 California Street, Suite 245, San Francisco, CA 94118, 415-502-8634, suganoe@peds.ucsf.edu, (2) Research, Evaluation and Technology, Larkin Street Youth Services, 1150 Sutter Street, San Francisco, CA 94109, (3) STD Prevention and Control Services, SFDPH, 1360 Mission Street, Suite 401, San Francisco, CA 94103, (4) Community Health Programs for Youth, SFDPH, 555 Cole Street, San Francisco, CA 94117, (5) AIDS Office, HIV Prevention Section, SFDPH, 25 Van Ness, Suite 500, San Francisco, CA 94102

Background Homeless youth suffer from disproportionate rates of STI/HIV. The highest risk youth are not found in clinics, but on the street. Street START is a collaboration of non-profit, governmental, and academic partners to create a model for outreach-based STI screening, treatment and linkage to care of homeless youth in San Francisco. Objectives 1) To determine the acceptability and feasibility of outreach-based testing and treatment for CT/GC. 2) To demonstrate that outreach-based testing reaches higher-risk youth than testing in clinics serving homeless youth. Methods STI testing was offered during joint Larkin Street Youth Services/UCSF outreach sessions. We collected behavioral risk data using PDAs. Results We recruited 124 street-based and 74 clinic-based youth. Street-recruited youth were more likely to be male (71% vs. 46%, p<.001), White (65% vs. 44%, p<.01) and older (22.3 vs. 20.1, p<.001). Street-recruited youth were more likely to engage in risky behaviors, including having more sex partners in the past 3 months (5.3 vs. 2.4, p<.01), an IDU sex partner (55% vs. 12%, p<.001) or a partner perceived to be HIV-positive (31% vs. 10%, p<.01), ever engaging in survival sex (46% vs. 22%, p<.001), or ever injecting drugs (52% vs. 6%, p<.001). There was no statistical difference in prior STI testing or STI rates in the two groups. All outreach-tested STI-positive youth have been treated. Conclusion Our results suggest that outreach-based testing is accessing a higher-risk subgroup of youth relative to clinic-based testing.

Learning Objectives: At the conclusion of this session, participants will be able to

• Identify program components that will facilitate the integration of STI testing into the outreach setting.
• Discuss challenges to outreach-based STI testing and strategies to overcome such challenges.
• Discuss next steps to make STI screening more accessible to homeless youth in alternative settings.

Keywords: Vulnerable Populations, STD Prevention

Presenting author's disclosure statement:

Any relevant financial relationships? No