“It has become very clear to us in the years of research we’ve done that HIV and sexually transmitted infection risk is significant for this population,” Wenzel said. “Rates of HIV are higher among homeless women than their stably housed counterparts.”
African-American women are at particular risk for both HIV and homelessness due to a variety of factors, including a legacy of racism, poverty and deprivation of resources, Wenzel said.
She noted that shelter providers have expressed interest in providing HIV prevention services, but evidence-based prevention programs in shelters are rare. Many community-based providers struggle due to limited funding and staffing, she said, and occasionally use interventions that are not suitable for the populations they serve or their setting.
Wenzel and her team plan to review existing evidence-based programs before adapting the most popular option to fit the needs of homeless women and service providers.
“Our goal here is to look at what is available in terms of evidence-based interventions to reduce HIV risk among women, to engage the community — engage women, HIV experts and shelter staff — in the selection of an evidence-based practice that has already been shown to be efficacious and then work with the community to adapt the program,” she said. “This is the first study to engage homeless women and other stakeholders in selecting and adapting a prevention program for use in transitional settings.”
The study will focus on two diverse regions of Los Angeles: downtown and the Westside.
“We would like to arrive at something that everyone can agree is appropriate,” Wenzel said. “There may always be a program that wants to do something different, but I think we can find some agreement on key components that can be implemented across the board.”
Once an intervention is selected and adapted, Wenzel will conduct a small pilot test to ensure the intervention accomplishes its objectives. The study, which will conclude in February 2014, will build the foundation for a larger randomized controlled trial to test the efficacy of the adapted intervention.
The University of Southern California