Grant: Team Grant: HIV Implementation Science - Component 2

Today, the people most at risk of HIV are those who are vulnerable, marginalized, and living in difficult situations. One such group is homeless youth. We already know that homeless youth are driven to the streets by poverty, family dysfunction, and child abuse and neglect. The circumstances of their lives once on the street involve many challenges including poverty, substance abuse and addiction, mental health issues, and vulnerability to sexual violence and trafficking; all of which raise their risk of acquiring and dying from HIV since they are also hard to engage in HIV care and treatment. We also know that homeless youth in Canada's cities are more likely to come from marginalized communities, including lesbian, gay, bisexual, trans, queer, Two-Spirited and other Indigenous youth. Almost no research exists to guide HIV and other health service providers in successfully engaging with and caring for these extremely vulnerable populations. We are proposing a Peer Navigator (PN) program to engage homeless youth in Canada and western Kenya in HIV prevention, testing, and treatment. The PN model is based on the idea that peers-people who have themselves experienced youth homelessness and live with or are at-risk of HIV-intimately understand the challenges facing other homeless youth in a way that no researcher or healthcare worker can. As a result, peers are uniquely able to guide, connect, refer, and educate, and accompany homeless youth through the process of HIV prevention, testing and treatment.This project has three objectives:1) Adapt the Peer Navigator Model to three Canadian and two Kenyan sites: Toronto, London, Montreal, Kitale, and Huruma. 2) Describe and evaluate the feasibility, acceptability, and ethics of the PN program among homeless youth, community, and stakeholders. 3) Evaluate the equitability (reach, uptake) and sustainability (cost, impact, uptake) of the PN program across the implementation sites.