Provider perceptions on HIV risk and prevention services within permanent supportive housing

Area of Science:

• Public Health
• Health Services Research
• Social Work

Background:

• Permanent supportive housing (PSH) is a key intervention for chronic homelessness, typically addressing physical and behavioral health.
• HIV/STI prevention services are often overlooked in PSH, despite ongoing sexual risk behaviors among residents.
• Existing PSH health services rarely focus on preventing HIV transmission, except in programs for individuals with HIV/AIDS.

Purpose of the Study:

• To explore how PSH providers approach HIV prevention strategies.
• To identify challenges PSH providers face in delivering HIV prevention services.
• To assess the feasibility and acceptability of implementing HIV/STI prevention within PSH settings.

Main Methods:

• Conducted eleven focus groups with 60 frontline staff across 10 PSH agencies in Los Angeles.
• Utilized a longitudinal mixed-methods study design examining HIV risk and prevention among homeless adults entering PSH.
• Included diverse participants: 33% African American, 32% Hispanic, and 55% women.

Main Results:

• Provider awareness and knowledge of pre-exposure prophylaxis (PrEP) for HIV prevention were found to be very limited.
• Formal HIV prevention programming within PSH is perceived as challenging by frontline staff.
• Informal, opportunistic conversations about sexual risk and HIV prevention occur when providers have established rapport and identify risk.

Conclusions:

• Significant gaps exist in the provision of HIV prevention services within PSH programs.
• There are opportunities to enhance PSH providers' capacity to promote resident health through targeted HIV/STI prevention efforts.
• Addressing provider knowledge and resource limitations is crucial for effective HIV prevention in PSH settings.