Lessons learned from conducting a community-based, nurse-led HIV prevention trial with youth experiencing homelessness: Pivots and pitfalls.
Diane M Santa Maria, Higinio Fernandez-Sanchez, Adey Nyamathi and 4 others
PMID 38573238WHAT IT FOUND
Nurse-led HIV prevention for youth experiencing homelessness required flexible, mostly in-person delivery.
Mailed self-testing failed, lost phones blocked contact, and virtual recruitment had lower session completion and follow-up than in-person recruitment.
Key findings
01A total of 450 youth experiencing homelessness were enrolled, and 54 (12%) were recruited virtually while 396 were recruited in person.
02Virtually recruited participants were less likely to complete all intervention sessions (65% vs. 76%), complete follow-ups on time (63% vs. 72%), or be retained overall.
03Mailed home test kits for syphilis, chlamydia, and gonorrhea proved ineffective for this youth population.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a lessons-learned report, not a report of the randomized trial's primary HIV or STI outcomes. Most implementation strategies are described as team actions and observations, not as tested comparisons against a control group. Pandemic restrictions and shelter demolition changed the study conditions, making it hard to separate the effect of the strategies from those disruptions. The article does not report the trial's randomisation method, blinding, dropout handling, or primary outcome results. The work is described in one Houston trial with youth experiencing homelessness, so it may not transfer to other settings or populations.
Declared interests
No conflicts-of-interest declaration is provided in the paper text. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not read this as evidence that nurse-led HIV prevention reduces HIV or STI risk. It reports implementation lessons from one trial, not the trial's primary health outcomes.