BACKGROUND:
There are between 0.5-2 million runaway and homeless youth in the US, of which 17% have a history of intravenous drug use (IDU). Street youth represent one of the largest proportion of new hepatitis cases. However, most hepatitis B vaccination programs target school-based youth and miss this population.

OBJECTIVE:
To provide free hepatitis vaccination, education and counseling to disenfranchised and homeless youth.

METHOD:
In May 2004, we opened a free hepatitis vaccination, counseling and education program at a homeless youth drop-in center in lower Manhattan. In addition to providing vaccination and education, we refer to a nearby hepatitis site for testing and to IDU friendly physicians for follow-up treatment. A retrospective review of interviewer administered intake forms was conducted.

RESULT:
Participants were on average 20 years old (range 17-24), male (70%) and white (57%). Most had been tested for Hepatitis C, of which 22% reported being Hepatitis C positive. Fourty-one percent of participants who received Hepatitis B vaccines returned for second doses. It is too early to assess vaccine completion rates.

CONCLUSION:
This program met with rates of return comparable to other adolescent vaccination programs that target more stable populations. The program represents an innovative and inexpensive approach to targeting an at-risk and hard-to-reach population for hepatitis vaccination.

LEARNING OBJECTIVES:
How to design and implement an effective hepatitis vaccination program for runaway and homeless youth.