Needs Assessment and Qualitative Analysis for San Francisco’s OPT-IN Project

San Francisco Department of Public Health

The OPT-IN (Outreach, Prevention, and Treatment Initiation) Project was a four-year CDC-funded project within the San Francisco Department of Public Health, with a goal to improve HIV-related outcomes by providing services to address critical gaps in the delivery of HIV and hepatitis C care for people experiencing homelessness. According to a 2019 Point-in-Time count, there were an estimated 8,035 people experiencing homelessness in the city, a 17% increase over 2017.

Facente Consulting was hired to design and conduct a four-phase assessment to develop innovative prototypes for HIV and hepatitis C-related service delivery for people experiencing homelessness. The work included: (1) a comprehensive literature review to identify evidence-based strategies for delivering HIV and HCV-related care and outreach for people experiencing homelessness and people who inject drugs, (2) in-depth interviews with people in San Francisco who had successfully begun PrEP, HIV antiretroviral therapy, or hepatitis C treatment while unhoused, along with ethnographic observation and street intercept interviews with attendees of two “encampment health fairs,” (3) interviews with service providers focusing on HIV and hepatitis C services for this population, to determine best practices and devise a series of prototype models for HIV and hepatitis C service delivery, and (4) testing prototype models in a series of market research-style focus groups with people experiencing homelessness (using architectural drawings to enhance the experience).