201533 Rates of HIV and STI Infection among Homeless Women

Monday, November 9, 2009: 9:30 AM

Eustace Hsu, MA , Mailman School of Public Health, Columbia University, New York, NY
Carol L. M. Caton, PhD , Mailman School of Public Health, Columbia University, New York, NY
Nabila El-Bassel, DSW , Social Intervention Group - School of Social Work, Columbia University, New York, NY
Andrew Gelman, PhD , Statistics Department, Columbia University, New York, NY
Ana Zanger, MSW , Mailman School of Public Health, Columbia University, New York, NY
Karen Andrene Johnson, MSW , Mailman School of Public Health, Columbia University, New York, NY
Susan Barrow, PhD , Mailman School of Public Health, Columbia University, New York, NY
Alan Felix, MD , Psychiatry, Columbia University, New York, NY
Daniel Herman, DSW , Mailman School of Public Health, Columbia University, New York, NY
Background:

Homeless women face risks that make them vulnerable to sexually transmitted infections. While studies have estimated rates of HIV and STI infection among women, there has been little information on such rates among homeless women. We studied the prevalence of biologically-confirmed HIV,Chlamydia,and gonorrhea in a randomly selected sample of sheltered homeless women in New York City.

Methods:

Study subjects were English or Spanish-speaking, 18 years of age or older, and met informed consent requirements. A two-stage sampling procedure consisted of a random selection of shelters based on type and size, followed by a random selection of subjects within the selected shelters. 329 women staying in 28 family and single adult shelters were interviewed and tested. HIV status was determined with the Orasure test, while STI's were based on DNA amplification assays on urine specimens. An interview included social and homeless history and standardized assessments of psychiatric and substance use disorders.

Results:

The prevalence of HIV was 1.8%, for STI's it was 4.6%. Nearly one-third of women self-reported a history of prior STI infections. The prevalence of HIV and STI's together was greater among women under age 30, and among those with long durations of homelessness, childhood trauma histories, post-traumatic stress, mood, and substance use disorders, and Axis I and substance use comorbidity.

Conclusions:

The prevalence of HIV and STI infection among sheltered homeless women demands that screening, medical, mental health, and substance abuse treatment, and HIV prevention interventions be made available to this population.

Learning Objectives:
Identify rates of HIV and two STI's in a randomly selected sample of sheltered homeless women. Assess the implications of HIV and STI prevalence for the treatment and service needs of women who experience homelessness.

Keywords: Homelessness, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked on the project whose results are being presented since its beginning; as the data manager, and as a data analyst under the supervision of Andrew Gelman, the statistician on the project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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