108. Prevalence and Correlates of HIV and STIs among Youth Experiencing Homelessness

While young adults continue to shoulder a high burden of HIV and STIs, rates among youth experiencing homelessness (YEH) are even higher. A deeper understanding of the correlates of STIs among this marginalized and underserved population is important to inform prevention and treatment strategies. Additionally, while we know that uptake of PrEP among YEH continues to be low despite high levels of risk, little is known about the knowledge, attitudes, and acceptance YEH have toward PrEP and factors that influence PrEP uptake. We assessed the prevalence of HIV and STIs among a large sample of YEH in a highly populated urban metropolitan area in the south. We also assessed PrEP knowledge, attitudes, and acceptance. Baseline data from YEH participating in a randomized trial assessing the efficacy of a nurse-led HIV prevention intervention were used to assess for point-of-care testing results for HIV and STIs (Chlamydia, Gonorrhea, and Syphilis). Additionally, baseline survey data was used to examine population demographics, and PrEP knowledge and attitudes. A behavior score was summed from protective behaviors (condom use, STI testing, and taking PrEP) with a higher score indicating uptake of more protective behaviors. Youth (N=361) averaged 21 years of age (sd = 2 y) with 60% identifying as Black/African American and 16% Hispanic. Participants’ gender was diverse with the majority identifying as male (52%) and 6.4% of youth identifying as trans or nonbinary. Approximately 35% of the sample identified as LGBQ+. We found that 2.9% of youth tested positive for HIV (unconfirmed rapid test), among whom one participant indicated that this was a new diagnosis. Additionally, 6.2% of youth tested positive for Syphilis (unconfirmed rapid test), 4.9% positive for Gonorrhea, and 10% for Chlamydia. However, only 5.8% reported that they had been treated for STIs or HIV. Fisher’s exact tests indicated that females were statistically more likely to test positive for Gonorrhea (p = 0.008) and Chlamydia (p = 0.032) but not Syphilis. While only 57% of youth had heard of PrEP, 46.2% indicated that they would be likely to take PrEP if it were free. Those who had a higher protective behavior score were statistically more likely to have heard of PrEP (p = 0.008). YEH continue to have high rates of HIV and STIs and yet few are receiving treatment when needed. While PrEP knowledge is low, it continues to increase, based on prior research. Despite the low level of PrEP knowledge, youth who become aware of PrEP appear to have a high level of interest, especially if it can be offered for free. Healthcare and social service providers should continue to discuss PrEP as prevention for YEH and find ways to support its uptake. Improvements are needed to increase the uptake of treatment for youth who test positive for STIs and increase awareness of gonorrhea and chlamydia among female YEH.