Background/introduction:
Homeless adults and street based sex workers are a highly vulnerable group of people with specific sexual and general health needs. A specialist outreach clinic was set up in 2010 to support these patients.  

Aim(s)/objectives:
To evaluate the uptake of services used including contraception, immunisation, blood-borne virus testing, cytology, STI screening and evaluation of drug use.

Methods:
Data was retrospectively collected from May 2012 until March 2015. 

Results:
82 patients seen in total (female, 53; male, 29), with an average age of 28.6 (range 17-50.)  57% of patients were symptomatic. 57% patients (n=47) were Hepatitis B immune, 26% (n=21) received either boosters or full vaccination for HBV. 34% patients (n=28) had STIs. Hepatitis C (36%) and Chlamydia (32%) were the most common infections. 57% patients (n=47) were using drugs, the majority using heroin (57%). 3 females were pregnant at baseline review; of the remaining women, 78% (n=39) were on contraception, LARCs being the most widely used. 34% of women (n=18) were working as commercial sex workers. 35 of  the  women had given birth to a total of 97 children, with 70% of them (n=68) either fostered or adopted. 33% smears taken (n=10) were abnormal with 3 colposcopy referrals.  

Discussion/conclusion:
This specialist outreach clinic facilitates sexual and reproductive healthcare for vulnerable patients who are otherwise hard to reach and often have poor experiences of healthcare. The high rate of sex work in this population emphasises the need for continued screening and treatment.  LARC uptake rates are reassuring, but could be further improved.

Working with Marginalized Groups: Homeless adults and Street Based Commercial Sex Workers