# Policy and implementation context of an unconditional cash transfer program to address homelessness and improve HIV service uptake among marginalized youth in the United States

> **NIH NIH K01** · JOHNS HOPKINS UNIVERSITY · 2024 · $127,399

## Abstract

Rates of homelessness among youth and young adults living in the United States have more than doubled in
the last decade, and LGBTQ youth face a higher level of housing insecurity and an increased risk of
homelessness compared with their non-LGBTQ peers. Stigma and discrimination based on sexual orientation
or gender/identity expression contribute to the heightened levels of homelessness experienced by LGBTQ youth.
Housing instability among LGBTQ youth can worsen existing risk factors for HIV and give rise to new
environments that pose additional risks, including survival sex, physical and/or sexual abuse, and injection drug
use. To add to this, unstable housing may challenge already suboptimal access to and engagement with
healthcare services, including HIV prevention and treatment. Existing guidelines and strategic plans in the United
States emphasize the importance of safe and affordable housing to HIV service utilization and outcomes, but
innovative strategies that operate within the existing policy environment and effectively cater to the distinctive
needs of young people are largely unavailable and understudied. While cash transfers are not novel among the
array of existing social safety net interventions, their effective implementation has faced obstacles such as
administrative complexities, conditions linked to work or behavior change, and a lack of adaptability to evolving
needs. To address these complexities, we will first document the existing policy environment that influences
housing and HIV, and second partner with Point Source Youth (PSY), an advocacy leader in the youth
homelessness space, to refine and measure the implementation of monthly, unconditional cash disbursements
to young LGBTQ people at or about to enter the homelessness system in Baltimore City. 60 young people will
be provided with $25,000 each over two years to sustainably exit homelessness, find housing in alignment with
apartment share arrangements, and more easily access HIV services. To guide this research, we will use two
implementation science frameworks in conjunction: the Consolidated Framework for Implementation Research
(CFIR) 2.0 and Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM). The proposed
strategy is grounded in insights from community-identified needs and barriers, consideration of implementation
challenges at the individual and organizational levels, and an understanding of the ongoing evolution of the policy
context. The specific aims of this study are as follows:
Specific Aim 1 – Map existing municipal, state, and federal laws and policies that impact housing and HIV
among young people and generate a policy index to quantify their breadth and depth, 2020-2025
Specific Aim 2 – Inform and tailor the implementation of an unconditional direct cash transfer intervention for
LGBTQ youth based on stakeholder perspectives in Baltimore City
Specific Aim 3 - Measure the implementation of a direct cash transfer intervention to addr...

## Key facts

- **NIH application ID:** 11008144
- **Project number:** 1K01MD020002-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Amrita Rao
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $127,399
- **Award type:** 1
- **Project period:** 2024-08-07 → 2029-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11008144

## Citation

> US National Institutes of Health, RePORTER application 11008144, Policy and implementation context of an unconditional cash transfer program to address homelessness and improve HIV service uptake among marginalized youth in the United States (1K01MD020002-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/11008144. Licensed CC0.

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