Untangling Regional Disparities: HIV and STI Testing Patterns Among Youth Experiencing Homelessness in Seven U.S. Cities

Youth experiencing homelessness (YEH) face elevated risks of HIV and STIs compared to their housed counterparts. HIV and STI testing services are pivotal for prevention and early detection. Investigating utilization rates and associated factors among YEH provides critical insights for intervention efforts in major U.S. regions. This study analyzed secondary data from the Homeless Youth Risk and Resilience Survey (HYRRS) conducted between 2016 and 2017. Participants were recruited in seven major cities: Los Angeles, San Jose, Phoenix, St. Louis, Denver, Houston, and New York City (n = 1426). Notably, YEH in Denver, Houston, Phoenix, San Jose, and St. Louis were significantly less likely to use HIV testing services than those in Los Angeles. YEH reporting early sexual activity were less likely to undergo HIV testing, while having online sex partners increased the likelihood of HIV testing. Moreover, YEH in New York City were more likely to receive STI testing, while Phoenix and San Jose had lower testing rates. Disparities in testing rates highlight questions about equitable resource allocation, accentuating the need for enhanced educational and community outreach efforts to address barriers across diverse urban settings.