Homeless shelter residents receptive to STD testing

NEW YORK (Reuters Health) - The vast majority of people living in homeless shelters are willing to undergo testing for sexually transmitted infections (STI), and to receive treatment if they are found to have these infections, a new study shows.

"It is worth emphasizing that all infected persons identified in this study were asymptomatic and would have been unlikely to seek screening or treatment if they had not been approached at the shelters by our outreach staff," Dr. Diane M. Grimley of the University of Alabama at Birmingham and her colleagues note.

Homeless people are at greatly increased risk of STIs compared to the general population and may represent "missed pockets of STIs within communities," according to the investigators.

While homeless shelters would seem to be a good place to offer testing and treatment for these infections, little is known about how acceptable this type of outreach would be to homeless individuals.

To investigate, Grimley and her colleagues offered testing for chlamydia, gonorrhea, syphilis and HIV to 430 adults at three homeless shelters in two cities. Ninety-seven percent of people approached agreed to testing, they report in the journal Sexually Transmitted Diseases.

Among those tested in the first city who reported having had sexual activity in the past two months, 12.9 percent had an STI, compared to 19.9 percent of those in the second city. Rates of syphilis, gonorrhea and HIV were similar in the two cities, although chlamydia was more common in the second city.

Overall, the researchers found, 97.5 percent of people who underwent testing learned their results, and 91.5 percent of those who tested positive were treated successfully.

"The large number of individuals who were receptive to screening and voluntarily returned to the shelters to learn their test results strongly support the continuation of such efforts to deplete the reservoir of pathogens in this population," the researchers conclude. "Future research is needed to evaluate whether such outreach efforts can be sustained in a cost-effective way."

SOURCE: Sexually Transmitted Diseases, November 2006.