Addressing the Sexual Health of the Homeless: Recommendations for STI Prevention Education for Homeless Women Open Access

Rosmarin, Rachel (2015)

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Background: The experience of homelessness in its complexity involves psychological, physical and economic constraints that contribute to an increased risk of poor health outcomes, including recurrent sexually transmitted infections (STIs). Goal The goal of this special studies project was to identify the best practices for STI education among homeless women to assist clinics who provide free STI services to this population to better address the educational needs of the women they serve.

Methods: In order to achieve this goal this project used an iterative process of information gathering and analysis from 1) the context of the project, clinics that target homeless individuals, 2) a comprehensive review of available literature, and 3) educational practices and methodologies, which guided further investigation and was used to develop recommendations.

Results: There are several factors that influence homeless women's decision-making in regards to high-risk sexual behaviors including physical health issues, both acute and chronic, mental health issues, substance abuse issues, past and recent experiences of sexual or domestic violence (i.e. intimate partner violence), poverty, and the experience of homelessness overall. Additionally, it is the complex interactions of these risk factors that further place homeless women at a greater risk for continued homelessness and partaking in high-risk sexual behaviors.

The literature suggests that the most effective intervention for homeless populations is a coordinated and integrated model of care. Additionally, structured educational sessions have been shown to be effective in reducing the likelihood of engaging in high-risk sexual health behaviors among homeless youth. According to public information, several organizations in the Atlanta area currently provide structured educational sessions to the homeless population in regards to their sexual health. Therefore, collaboration between these organizations is necessary in order to help promote safer sex practices within this population.

Table of Contents

Chapter 1. Introduction. 1

Problem Statement. 2

Project Objectives. 3

Significance. 4

Chapter 2. Review of the Literature. 5

Definition of Homelessness. 5

Prevalence of Homelessness. 6

Prevalence of STIs/HIV. 8

Vulnerabilities Associated with Homelessness. 9

Sexual Health Behaviors and Homelessness. 12

Health Literacy of the Homeless. 13

Existing Interventions for the Homeless. 14

Summary. 16

Chapter 3. Project Content. 18

Methods. 18

Results. 22

Chapter 4. Discussion. 28

Limitations. 30

Recommendations. 31

References. 32

Appendix. 36

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