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New project on HIV prevention among homeless youth receives $3 million NIH grant

Photo of Diane M. Santa Maria, DrPH, MSN, RN (Photo by Todd Taylor, CEIR)
Diane M. Santa Maria, DrPH, MSN, RN (Photo by Todd Taylor, CEIR)

A new project focusing on HIV prevention among youth who are homeless, led by Diane M. Santa Maria, DrPH, MSN, RN, of The University of Texas Health Science Center at Houston (UTHealth), has been funded with a $3 million grant from the National Institute of Nursing Research, part of the National Institutes of Health.

Called “Come As You Are – Assessing the Efficacy of a Nurse Case Management HIV Prevention and Care Intervention among Homeless Youth,”  the five-year project will study whether nurse case management, enhanced with motivational interviewing strategies and behavioral feedback, may increase adoption of and adherence to behavioral and biomedical HIV prevention methods. Prevalence estimates of HIV among homeless youth are as high as 13 percent.

Santa Maria, Cizik School of Nursing at UTHealth interim dean and the Dorothy T. Nicholson Distinguished Professor, is an expert known for her work with underserved adolescent and young adult populations, particularly youth experiencing homelessness. The grant award (R01NR017837) will span a five-year period.

“We are very proud of Dr. Santa Maria for obtaining R01 funding from the NIH. Cizik School of Nursing has not had funding at this level since 2013,” said Associate Dean for Research Constance M. Johnson, PhD, RN, the Maria C. and Christopher J. Pappas Family Distinguished Chair in Nursing. “This accomplishment, and other funding that research faculty members are pursuing, are critical to the school in many ways and will boost our efforts to recruit top faculty and students.”

Santa Maria will conduct a randomized controlled trial of the intervention, which will be delivered in the community to youth aged 16-25 years old who are experiencing homelessness. Her team includes national leaders in HIV prevention, healthcare for the homeless and behavioral sciences.

This intervention model builds on the “come as you are” approach promoted by the National Healthcare for the Homeless Council.  One of the study’s aims is to determine whether the intervention increases uptake of HIV prevention strategies when compared with usual care.

“The intervention is innovative because it uses nurses to directly deliver enhanced case management and can be applied to improve any existing HIV prevention program for youth experiencing homelessness,” said Santa Maria, who also is the John P. McGovern Distinguished Professor in Nursing. “This grant is significant because it has the ability to improve uptake of HIV prevention strategies and reduce new HIV cases in a high-prevalence, marginalized group.”

Santa Maria’s project also seeks to find out whether the intervention improves young people’s mental health, substance use, and housing status when compared with youth from the control group.

“If the intervention is efficacious, we will work with NHCHC to scale it across the 300 programs and 3,300 homeless clinics that serve youth experiencing homelessness,” Santa Maria said.

In May 2015, as co-principal investigator, Santa Maria completed a study of homeless youth in the Houston community called YouthCount 2.0!  She conducted this collaborative, community-based research study in partnership with the University of Houston and with support from the University of Houston-Downtown. 

As part of a national, interdisciplinary group of homelessness researchers, Santa Maria’s work contributes to improvements in HIV prevention methods and strategies including barriers and facilitators to HIV pre-exposure prophylaxis and post-sexual assault HIV prevention care. Her work has contributed to two recent Texas legislative policies: to establish a clear statewide enumeration of homelessness among youth, and to prevent the pipeline from foster care to homelessness among youth who age out of the foster care system.

In August 2018, UTHealth President Giuseppe N. Colasurdo, MD, appointed Santa Maria to serve as interim dean of the nursing school while a national search is conducted for a permanent dean.

– David R. Bates, School Communications Director

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