Abstract
We implemented and evaluated an HIV rapid testing intervention in collaboration withthe US Department of Veterans Affairs and the Los Angeles County Department ofHealth to 1) increase HIV testing/receipt of results, and 2) increase veteran access to VA homeless services.
Ninety-seven veterans recruited in 9 shelters as part of the Los Angeles Homeless Services Authority (LAHSA) emergency shelter program were randomized (2-to-1 ratio) into one of two interventional arms: rapid test (RT) arm (on-site HIV rapid testing/referral to VA homeless program) and referral arm (VA referral only).
Recruiters approached 2664 individuals; 136 (5.1%) were eligible. Ninety-seven (71.3% of those eligible) accepted enrollment. Testing rates were 100.0% in RT arm and 3.3%in Referral arm (p<0.001). Test result receipt rates were 98.5% in RT arm and 0.0% in Referral arm (p<0.001). There was no increase in visits to VA homeless programs in either arm. HIV prevalence/rate of new incidence was 1.5%. While more than half admitted high-risk behaviors in the past 12 months, 78% reported chances of HIV infection as “none” or “low” rather than “moderate” or “high.”
On-site rapid testing in homeless shelters is feasible and acceptable for testing hard-toreach and vulnerable populations. More robust outreach efforts are needed to improve linkage to care.