HIV risks in a homeless population

Homeless people are one of the most vulnerable with regard to HIV transmiss ion However, most research on this population has been carried out on sampl es from health clinics. We surveyed 390 homeless people in Houston at a day shelter with regard to their HIV/AIDS knowledge and risk behaviours. The s ample was 76% African-American, 11% Euro-American, with small numbers of La tin-Americans, Native-Americans and Asian-Americans: half were born in Texa s, and 92% were male. Data indicated that HIV/AIDS knowledge was higher in those who were at higher behavioural risk, although the direction of causal ity in these cross-sectional data cannot be inferred. African-Americans wer e at slightly higher risk. Compared with previous clinic samples, this samp le was older and a higher number (one-third) slept the last night outside. Eighty per cent had had an HIV test. Condom use was low with both males and females most commonly not reporting using condoms although more than half had had sexual contact in the past month. Multivariate analysis indicated t hat ethnicity and HIV/AIDS knowledge were independent predictors of risk be haviour. Lifetime risks included one-third who had injected drugs (and shar ed needles), and nearly 10% had had sex with someone they knew to be HIV se ropositive. Lack of future time perspective rather than level of knowledge may be a barrier to reducing HIV risks, and the data are discussed in terms of policy implications and homelessness.