2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

317809
Access to HIV prevention services among chronically homeless persons entering permanent supportive housing


Tuesday, November 3, 2015

Suzanne Wenzel, PhD, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA
Harmony Rhoades, PhD, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA
Hailey Winetrobe, MPH, CHES, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA
Taylor Harris, MA, School of Social Work, University of Southern California, Los Angeles, CA
Eric Rice, PhD, School of Social Work, University of Southern California, Los Angeles, CA
Benjamin Henwood, PhD, LCSW, USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA
Background:  Integrated health care is a hallmark of permanent supportive housing (PSH) for chronically homeless persons.  There has been minimal attention paid to pre-exposure prophylaxis (PrEP) and other HIV/STI prevention services in PSH despite documented sexual risk behavior.  We investigated availability and access to these services from the perspectives of both homeless persons entering PSH and providers of PSH.

Methods:  Structured interviews conducted with 130 chronically homeless respondents upon acceptance into PSH in Los Angeles focused on PrEP, HIV/STI testing, and prevention education.  Qualitative interviews regarding availability and barriers in providing HIV services were conducted with 34 PSH providers across agencies into which homeless respondents were being housed.

Results:   71.5% of homeless respondents reported testing for HIV and 50% for all other STIs in the past year.   Only 0.8% had ever been prescribed PrEP.  Respondents reported a gap of 2.7 (sd=5.5) years since a healthcare provider had spoken to them about HIV/STI prevention.  PSH provider interviews suggested:  lack of clarity regarding which individuals and agencies should be responsible for delivering HIV services, limited awareness of PrEP and guidelines for use, and concerns about limited agency and staff resources to support access to PrEP and medication adherence.

Conclusions:   To the extent PrEP and other HIV services are poorly accessed among homeless respondents entering housing and not provided as part of integrated health care in PSH, this indicates need for a multi-pronged effort to enhance availability and provide education throughout the provider network for both homeless and formerly homeless persons in PSH.

Learning Areas:

Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Public health or related public policy
Public health or related research

Learning Objectives:
Explain PrEP and STI/HIV testing and prevention education status among chronically homeless persons entering permanent supportive housing. Discuss implications for HIV prevention service training and provision for providers of permanent supportive housing

Keyword(s): HIV/AIDS, Homelessness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student in social work at the University of Southern California. I have an MA and have 5+ years working in the area of social work and public health.
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.

Back to: 4274.0: HIV: Incarcerated, Transitioning, and Homeless Populations