Knowledge and Attitudes About Pre-Exposure Prophylaxis Among Young Adults Experiencing Homelessness in Seven U.S. Cities

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

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Purpose: Evidence suggests that young adults experiencing homelessness (YEH) are at elevated risk of HIV compared to housed youth. Given the limited research on pre-exposure prophylaxis (PrEP) awareness among YEH, this study examined their PrEP knowledge and attitudes. Methods: Data from a cross-sectional survey among YEH (ages 18–26) (n = 1,427) in seven U.S. cities were used to assess their knowledge and attitudes regarding PrEP to inform HIV prevention efforts. Results: Participants were primarily male youth of color. The mean age was 20.9years. While 66% felt at risk for HIV, only 14% strongly agreed that they try to protect themselves from getting infected with HIV. Most (84%) were eligible for PrEP based on risk, yet only 29% had knowledge of PrEP. Despite this, 59% reported they were likely/extremely likely to take PrEP. Access to free PrEP (55%), HIV testing (72%), healthcare (68%), and one-on-one (62%), and text messaging support (57%) were rated as very/extremely important for PrEP uptake and adherence. Conclusions: The results of this study suggest missed opportunities to prevent new HIV infections among YEH. Efforts to increase PrEP uptake among this population should consider provider- and system-level interventions to increase PrEP awareness, decrease PrEP-associated healthcare costs, improve access to PrEP providers, and provide in-person and text messaging support.

Original languageEnglish (US)
Pages (from-to)574-580
Number of pages7
JournalJournal of Adolescent Health
Issue number5
StatePublished - May 2019


  • HIV
  • Homeless youth
  • Pre-exposure prophylaxis (PrEP)
  • Prevention
  • Young adults

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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