(P179) BARRIERS AND NEEDS TO URBAN INDIAN SEXUAL HEALTH SERVICES PROVISION: A MIXED-METHODS APPROACH

Background:
Over 70% of American Indians and Alaska Native (AI/AN) people live in urban areas. There are 41 Urban Indian Organizations (UIOs), which currently operate 86 healthcare facilities in 38 urban areas across 22 states. This study sought to improve the limited knowledge of current sexual health services offered at UIOs, as well as to enhance understanding of barriers/challenges to sexual health service provision at UIOs.

Methods:
UIOs were invited via NCUIH’s communication methods to complete an online survey June – September 2023. Each UIO that submitted a complete response received $250 for their participation. Survey topics included STI/HIV testing, treatment, vaccines, programs offered, and barriers and facilitators to offering STI services. Descriptive statistics were used to analyze data.

Results:
Fifteen UIOs (37%) completed the survey.  Nine UIOs (60%) reported offering on-site screening/testing for chlamydia, gonorrhea, syphilis, herpes simplex virus, and bacterial vaginosis. Seven UIOs (46.7%) offer on-site prenatal STI screenings. Eight UIOs (53.3%) offer partner services, four UIOs (26.7%) offer on-site expedited partner therapy (EPT).  More than half (53.3%) of UIO respondents do not use the 340B Drug Pricing Program. The greatest barrier/challenge to STI service provision was insufficient STI treatment tools/resources (53.3%). The greatest area of interest for developing/enhancing STI services was partner STI services (86.7%).

Conclusion:
Increased funding to support screening/treatment, staffing/staff trainings, preventative services, etc., to enhance STI services at UIOs is needed. Increased UIO access to programs like 340B Drug Pricing, interventions like EPT, extragenital screening, and self-collection test kits may help improve Urban Indian sexual healthcare access and quality. UIOs are uniquely positioned to provide culturally tailored care to Urban Indians and serve as a point of healthcare access and intervention. Further research on the needs of UIOs and the communities they serve is needed to improve Urban AI/AN sexual health outcomes and care.