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Dina Wilderson, PhD (Larkin Street Youth Services)

Meeting homeless youth where they're at: Integrating STI testing and treatment into a street outreach program. Dina Wilderson, PhD (Larkin Street Youth Services) Eiko Sugano, MPH (UCSF Division of Adolescent Medicine) Jeffrey Klausner, MD, MPH (SFDPH, STD Prevention & Control)

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Dina Wilderson, PhD (Larkin Street Youth Services)

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  1. Meeting homeless youth where they're at: Integrating STI testing and treatment into a street outreach program Dina Wilderson, PhD (Larkin Street Youth Services) Eiko Sugano, MPH(UCSF Division of Adolescent Medicine) Jeffrey Klausner, MD, MPH (SFDPH, STD Prevention & Control) Colette Auerswald, MD, MS (UCSF Division of Adolescent Medicine)

  2. Background Homeless youth: • Engage in high-risk behaviors • Have disproportionate rates of STIs and HIV • Have limited access to health care

  3. Street START (STI Testing And Rapid Testing) Collaborative project designed to create a model program for street-based STI and HIV screening, treatment, and linkage to care for homeless youth

  4. Project Goals • To train outreach workers to conduct street-based CT/GC screening and to dispense field-based therapy and partner-delivered therapy for those who test positive for an STI • To train outreach workers to conduct street-based rapid HIV testing

  5. Collaborative Partners • Larkin Street Youth Services • Outreach activities • UCSF Division of Adolescent Medicine • Research activities • Community Health Programs for Youth • Medical care for homeless youth • Recruitment of comparison group (clinic based) • STD Prevention and Control, SFDPH • Training, supplies, and technical support • HIV Prevention Section, SFDPH • Training, supplies, and technical support

  6. Trainings • Outreach staff trainings • Introduction to STIs • STI testing and treatment • Principles of research • Research staff trainings • Outreach skills

  7. Methods • UCSF-Larkin joint outreach sessions • Recruitment of youth • Data collection • Testing • Tracking of STI positive youth • Field-delivered therapy • Patient-delivered partner therapy • Linkage to services

  8. Areas of Recruitment

  9. Gender

  10. Ethnicity * Categories are not mutually exclusive

  11. Age

  12. STI Prevalence 138 street recruited youth were tested for CT and GC

  13. Treatment • 10 youth (100%) were treated: • 7 - field based • 3 - clinic based • Patient-delivered partner therapy • 4 – given partner packs • 1 – did not take partner pack (no contact with sex partner) • 2 – sex partners (treated individually)

  14. Challenges • Impact of testing and tracking on outreach activities • Integrating researchers into outreach • Balancing research and outreach roles • Logistics of sample collection • Staff time • Neighborhood differences

  15. Strengths/Key Factors • Availability of FDT and PDPT protocols • Incremental implementation • Ongoing communication • Consistency of testing shifts • PDA’s for data collection • Documentation – use of field notes • Referrals and linkages to services • Collaborators working toward common goal

  16. Street START Project Coordinator: Eiko Sugano, MPH(UCSF Division of Adolescent Medicine) Co-Principal Investigators: Dina Wilderson, PhD (Larkin Street Youth Services) Colette Auerswald, MD, MS (UCSF Division of Adolescent Medicine) Collaborators: Jeffrey Klausner, MD, MPH (SFDPH, STD Prevention & Control) Teri Dowling, MA, MPH (SFDPH, AIDS Office) Susan Obata, MD (SFDPH, Community Health Programs for Youth

  17. Acknowledgements • Ed Melendez (LSYS Outreach Manager) and Chandra Sivakumar (LSYS HIV Prevention Manager) • Outreach/HSRC staff: Kelley Cutler, Lochlan McHale, Vinh Nguyen, Tamara Thomas, Jasmin Serim, John Pirkopf • Research assistants: Adrienne Schroeder, Arturo Durazo, Jacob Laurent, Jen Hecht • AIDS Office: Shelley Facente • STD Control and Prevention: Kate Scott, Ameera Snell, Lesly Soto, Monica Lee • Michael Baxter, Cielita Bess and CHPY clinic staff • SFDPH laboratory staff

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