Experiences of service providers delivering care for street involved and homeless pregnant and early parenting women

Service delivery and care of street-involved pregnant women is recognized as a complex issue, and as such comorbidities, addictions, and risky behaviors can result in significantly higher risks of contracting HIV. We inquired into the experiences of service providers who work in community-based supportive intervention programs for vulnerable street-involved, pregnant, and early parenting women in precarious housing situations who are living with HIV or are at risk of contracting HIV, across the continuum of care. We used a qualitative descriptive design and interviewed 22 service providers from local government and non-governmental community agencies about their experiences delivering services to this population. Four key themes emerged from the data: focus on outcomes and success, understanding tensions in service delivery, challenges in accessing appropriate services and resources, and attention to moving forward. We highlight the complex tensions experienced by service providers in a health and social care system that centers on measurable and quantifiable outcomes while overlooking larger issues that shape equitable care. Our study highlights the need for alternative approaches to service delivery that are focused on the lives of women.