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Implications for PrEP Uptake in Young Adults Experiencing Homelessness: A Mixed Methods Study.

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Summary

Youth experiencing homelessness (YEH) have low awareness and high interest in HIV pre-exposure prophylaxis (PrEP). Barriers like cost and stigma limit PrEP use, despite its acceptability among this vulnerable population.

Keywords:
HIV preventionPrEP perceptionspre-exposure prophylaxis (PrEP)youth experiencing homelessness (YEH)

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Area of Science:

  • Public Health
  • HIV Prevention
  • Vulnerable Populations

Background:

  • Youth experiencing homelessness (YEH) are at high risk for HIV infection.
  • Current pre-exposure prophylaxis (PrEP) initiatives do not effectively reach YEH.
  • Understanding PrEP knowledge, interest, and barriers is crucial for effective HIV prevention in this demographic.

Purpose of the Study:

  • To explore PrEP knowledge, interest, facilitators, and barriers among YEH.
  • To identify factors influencing PrEP uptake in a homeless youth population.
  • To inform the development of targeted PrEP interventions for YEH.

Main Methods:

  • Cross-sectional mixed-methods study design.
  • Recruitment of young adults from agencies serving YEH in Houston, TX (n=30) and Los Angeles, CA (n=15).
  • Data collection via electronic self-report surveys and semistructured interviews.

Main Results:

  • 68.2% of YEH reported low or no prior knowledge of PrEP.
  • 63.7% of YEH expressed interest in taking PrEP.
  • Facilitators included high acceptability and supportive social networks; barriers included cost, access, stigma, low perceived risk, and medical mistrust.

Conclusions:

  • Despite high PrEP acceptability among YEH, uptake remains low.
  • Low PrEP awareness, perceived low HIV risk, and medical mistrust are significant barriers.
  • Targeted interventions addressing these barriers are needed to improve PrEP access and utilization for YEH.