Implications for prep uptake in young adults experiencing homelessness: A mixed methods study

Diane Santa Maria, Kathryn R. Gallardo, Sarah Narendorf, Robin Petering, Anamika Barman-Adhikari, Charlene Flash, Hsun Ta Hsu, Jama Shelton, Kristin Ferguson, Kimberly Bender

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Youth experiencing homelessness (YEH) have a high risk of contracting HIV; however, they remain relatively unreached by pre-exposure prophylaxis (PrEP)-based HIV prevention initiatives. We used a cross-sectional mixed-methods study to explore PrEP knowledge, interest, facilitators, and barriers among YEH. Young adults were recruited from agencies serving YEH in Houston, TX (n = 30) and Los Angeles, CA (n = 15) to participate in an electronic self-report survey and a semistructured interview. Survey results indicate that 68.2% of YEH had low or no prior knowledge of PrEP, though 63.7% reported interest in taking PrEP. Qualitative results revealed facilitators of PrEP use, including high PrEP acceptability and awareness, and supportive social networks. Several barriers emerged, including medication-related barriers, adherence, cost, access barriers, low perceived HIV risk, perceived stigma of PrEP use, and low PrEP awareness. Despite high PrEP acceptability, PrEP use among YEH remains low partly due to low PrEP awareness, low perceived HIV risk, and medical mistrust.

Original languageEnglish (US)
Pages (from-to)63-81
Number of pages19
JournalAIDS Education and Prevention
Issue number1
StatePublished - Feb 2019


  • HIV prevention
  • PrEP perceptions
  • Pre-exposure prophylaxis(PrEP)
  • Youth experiencing homelessness (YEH)

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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