Abstract
We studied the prevalence of biologically confirmed HIV, Chlamydia, and gonorrhea in a randomly selected sample of sheltered homeless women in New York City, and explored their association with demographic, homeless history, and clinical risk factors. 329 women were randomly selected from 28 family and single adult shelters. The estimated prevalence of HIV in the study sample is 0.6 % (±0.3 %); for Chlamydia it is 6.7 % (±2.2 %); for gonorrhea it is 0.9 % (±0.04 %). A history of childhood sexual abuse, arrest history, current psychotic symptoms, and substance use disorder placed women at greater risk of infection. We consider contextual factors that may yield underestimates of HIV prevalence in our sample and discuss how a more comprehensive prevalence estimate might be constructed. Findings underscore the importance of offering HIV/STI testing, counseling, and HIV risk prevention interventions to homeless women and suggest that interventions should be tailored to the needs of specific subgroups of homeless women.
Similar content being viewed by others
References
Barrow SM, Herman DB, Cordova P, Struening EL. Mortality among homeless shelter residents in New York City. Am J Public Health. 1999;89:529–34.
Culhane DP, Gollub E, Kuhn R, Shpaner M. The co-occurrence of AIDS and homelessness: results from the integration of administrative databases for AIDS surveillance and public shelter utilization in Philadelphia. J Epidemiol Community Health. 2001;55:515–20.
Cheung AM, Hwang SW. Risk of death among homeless women: a cohort study and review of the literature. CMAJ. 2004;170:1243.
New York City Departments of Health and Mental Hygiene and Homeless Services. The health of homeless adults in New York City. 2005. http://www.nyc.gov/html/dhs/downloads/pdf/homeless_adults_health.pdf. Accessed Nov 2008.
Forney JC, Lombardo S, Toro PA. Diagnostic and other correlates of HIV risk behaviors in a probability sample of homeless adults. Psychiatr Serv. 2007;58(1):92–9.
Adams M. HIV and homeless shelters: policy and practice. American Civil Liberties Union AIDS Project. AIDS Housing of Washington, AIDS Housing Survey, Spring 2003. http://www.aclu.org/hiv/gen/29150pub19991221.html. Accessed Jan 2008.
Tortu S, Beardsley M, Deren S, Williams M, McCoy HV, Stark M, Estrada A, Goldstein M. HIV infection and patterns of risk among women drug injectors and crack users in low and high sero-prevalence sites. AIDS Care. 2000;12(1):65–76.
Robertson MJ, Clark RA, Charlebois ED, Tulsky J, Long HL, Bangsberg DR, Moss AR. HIV seroprevalence among homeless and marginally housed adults in San Francisco. Am J Public Health. 2004;94:1207–17.
Substance Abuse and Mental Health Services Administration. National Research Center on Homelessness and Mental Illness. 2003. http://homeless.samhsa.gov/Resource/View.aspx?id=32511&AspxAutoDetectCookieSupport=1. Accessed Nov 2008.
Caton CLM, Wilkins C, Anderson J. People who experience long-term homelessness: characteristics and interventions. In: National symposium on homelessness research, September. Washington, DC: USDHHS, USHUD; 2007.
Lohr SL. Sampling: design and analysis. Pacific Grove: Duxbury Press; 1999.
Folstein MF, Folstein SE, McHugh PR. Mini-Mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.
Metzger DS, Koblin B, Turner C, Navaline H, Valenti F, Holte S, Gross M. Randomized controlled trial of audio computer-assisted self-interviewing: utility and acceptability in longitudinal studies. Am J Epidemiol. 2000;152(2):99–109.
Spitzer RL, Williams JBW, Gibbon M, First MB. The structured clinical interview for DSM-III-R (SCID). I. History, rationale, and description. Arch Gen Psychiatry. 1992;49:624–9.
Gray MJ, Litz BT, Hsu JL, Lombardo TW. Psychometric properties of the life events checklist. Assessment. 2004;11(4):330–41.
Weathers FW, Huska JA, Keane TM. PCL-C for DSM-IV. Boston: National Center for PTSD, Behavioral Science Division; 1991.
Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, Stokes J, Handelsman L, Medrano M, Desmond D, Zule W. Development and validation of a brief screening version of the childhood trauma questionnaire. Child Abuse Negl. 2003;27(2):169–90.
Finkelhor D. Sexually victimized children. New York: The Free Press; 1979.
Sgroi SM. Handbook of clinical intervention in child sexual abuse. Massachusetts: Lexington Books; 1982.
El-Bassel N, Gilbert L, Schilling R, Wada T. Drug abuse and partner violence among women in methadone treatment. J Fam Violence. 2000;15(3):209–25.
El-Bassel N, Gilbert L, Wu E, Go H, Hill J. HIV and intimate partner violence among methadone-maintained women in New York City. Soc Sci Med. 2005;61(1):171–83.
Lumley T. Analysis of complex survey samples. J Stat Softw. 2004;9(1):1–19.
Jiminez-Hernandez IR. Testimony to City Council on Oversight-Housing Provided by HIV/AIDS Services Administration. Oct 2005.
Ms. Iris Reyes. Personal communication. Feb 2012.
Kerker BD, Bainbridge J, Kennedy J, Bennani Y, Agerton T, Marder D, Forgione L, Faciano A, Thorpe LE, A population-based assessment of the health of homeless families in New York City, 2001–2003, Am J Public Health. published ahead of print 13 Jan 2011.
New York City HIV/AIDS Annual Surveillance Statistics. New York: New York City Department of Health and Mental Hygiene. Updated November 2008. http://www.nyc.gov/html/doh/html/ah/hivtables.shtml. Accessed May 2010.
New York City Department of Health and Mental Hygiene Bureau of Sexually Transmitted Disease Control Quarterly Report Vol. 7, No. 4, Dec 2009.
Herndon B, Asch SM, Kilbourne AM, Wang M, Lee M, Wenzel SL, Andersen R, Gelberg L. Prevalence and predictors of HIV testing among a probability sample of homeless women in Los Angeles County. Public Health Rep. 2003;18:261–9.
Acknowledgments
This study was supported by grant number R01 DA 019399, from the National Institute on Drug Abuse. The authors wish to thank the New York City DHS for their assistance in carrying out this project.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Caton, C.L.M., El-Bassel, N., Gelman, A. et al. Rates and Correlates of HIV and STI Infection Among Homeless Women. AIDS Behav 17, 856–864 (2013). https://doi.org/10.1007/s10461-012-0198-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10461-012-0198-x