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Beliefs and Intentions of the Homeless toward HIV Screening

Tuesday, 14 July 2009: 4:05 PM

Catherine J. Fogg, ARNP
Nursing, Saint Anselm College, Manchester, NH
Barbara Mawn, PhD
Nursing, University of Massachusetts Lowell, Lowell, MA

Learning Objective 1: describe significant attitudes and beliefs of this study population of homeless people toward HIV screening.

Learning Objective 2: describe the implementations of this study in promoting HIV screening among this homeless population.

Purpose:   HIV screening is a necessary first step in the prevention, diagnosis, and treatment of human immunodeficiency virus (HIV). However, the use of screening globally is very low.  In the U.S., approximately one in four persons living with HIV infection is unaware that s/he is HIV positive. Homeless persons in the U.S. have been noted to be at high risk for HIV behaviors and yet their acceptance of HIV screening remains poorly understood. The purpose of this study was to investigate the beliefs and intentions of the homeless in the U.S. toward HIV screening.  Using a survey design, this study applied the Theory of Planned Behavior (TPB) to investigate attitudes, social norms, and perceived behavioral control and their relationship to the intention to screen for HIV among the homeless. 

Methods:  From July to September 2008, 323 homeless people from 13 different shelters in five states in the northeastern United States participated in this survey study.  

Results: Twenty-four percent reported no prior HIV screening and 3% reported having a previous positive HIV test.  The path analysis model explained 58% of the homeless people’s intention to screen for HIV. Significant predictors included: attitude toward HIV screening, prior screening, age and subjective norms. Attitudes were positively influenced by their perception of being able to get treatment right away and free screening. Subjective norms were influenced by health care worker encouragement to have screening but not by family or sex partner recommendations.
Conclusion: Implications for nursing and health promotion include consideration of the impact of health provider recommendations and ease of administration into standards of care for this population at risk. These findings can influence targeted interventions to focus on the evaluation of attitudes and social norms of homeless persons within different sectors of the country to promote HIV screening for this vulnerable population.

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