Year of Publication

2023

College

Public Health

Date Available

4-25-2023

Degree Name

Master of Public Health (M.P.H.)

Committee Member

Anne Ray

Advisor

Richard Crosby

Co-Director of Graduate Studies

Mark Swanson

Abstract

Incidence rates of HIV have decreased in the United States in the past decade, but the southern United States has higher rates of HIV than other regions, and cities in the south, like Washington D.C., have some of the highest rates of HIV incidence in the nation. Risky sexual behavior, needle sharing, and substance use increase the risk of transmitting or acquiring HIV, and these behaviors are more common among unhoused people (CDC, 2021; CPPH, 2022).

Expansion of community resources in cities with high levels of HIV have allowed for many people at high risk for HIV to comply with the CDC’s suggestion to receive regular HIV testing and adhere to PrEP, a medication or shot that prevents HIV. Still, unhoused populations may face additional barriers, such as cost and transportation, that prevent the use of these services and leave them vulnerable to HIV (Epps et al., 2022). Mobile vans offering HIV testing and PrEP have been one strategy used to reach people experiencing unstable housing.

The PrEPARE program will use evidence-informed strategies developed in scientific literature and community partnerships with stakeholders to develop a culturally competent program to address HIV incidence among the unhoused population in Washington D.C. The Specific Aims of the PrEPARE program are as follows:

1. Establish community partnerships to form a Community Advisory Board and create culturally relevant program materials;

2. Train and mobilize a diverse and culturally competent staff;

3. Implement mobile HIV testing and PrEP vaccination at housing partner sites;

4. Evaluate the impact of the program on the HIV incidence rate of unhoused individuals in Washington D.C.

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