Newly homeless youth are likelier to engage in risky sexual behavior if they stay in nonfamily settings — such as friends' homes, abandoned buildings or the streets — because they lack supervision and social support, a new UCLA AIDS Institute study has found.
Drug use also factored into this behavior, according to the study, which is currently available in the online edition of the peer-reviewed Journal of Adolescent Health.
This is the first time that researchers have followed newly homeless youth — those who have been away from home for a period between one day and six months — for any length of time to track how their behavior changes. The researchers examined how individual factors, such as sociodemographics, depression and substance abuse, and structural factors, such as living situations, can influence sexual behavior.
"The reason these findings are so important is that interventions in the past have focused on addressing individual risk behavior and not on addressing structural factors, such as living situations, that might have an impact on their behavior," said lead author Dr. M. Rosa Solorio, assistant professor of family medicine at the David Geffen School of Medicine at UCLA and a member of the UCLA AIDS Institute. "When we look at homeless youth, we want to consider these structural factors if we want them to reduce their risky behavior and thereby prevent sexually transmitted diseases such as HIV."
The researchers identified 261 newly homeless young people in Los Angeles County between the ages of 12 and 20 and tracked them over two-year period, interviewing them six times at baseline and again at three, six, 12, 18 and 24 months about symptoms of depression, substance use, living situations, number of sexual partners and condom use.
At the beginning of the two years, 77 percent said they were sexually active, but that percentage increased to 85 percent by the end of the period. Males were found to be more likely to have multiple sex partners if they lived in settings without family members and abused drugs. For females, drug abuse was the primary predictor of risky sexual behavior. As for condom use, females were less likely to use them if they lived in a nonfamily situation or abused drugs; neither of these factors predicted condom use among males.
The researchers also found that, in general, U.S.-born or foreign-born Latinas were less likely to engage in sex with multiple partners than were females of other races and ethnicities.
"While gender and some racial/ethnic differences in predictors of sexual risk were found in this study, living with nonfamily members and drug use appear to be the most salient in explaining sexual risk," the researchers wrote. "Our findings indicate that interventions aimed at reducing sexual risk behaviors, and thereby reducing STDs and HIV among newly homeless youth, need to help youth find housing associated with supervision and social support (family and institutional settings) as well as aim to reduce drug use."
The full study is available by visiting www.sciencedirect.com/science/journal/1054139X and clicking on the the link for Volume 42.
Other researchers on this study were Norweeta G. Milburn, Robert Weiss, Philip J. Batterham, Marla Gandara and Mary Jane Rotheram-Borus of UCLA, and Doreen Rosenthal of the University of Melbourne.
Grants from the National Institute of Mental Health and the Robert Wood Johnson Foundation funded this study.
The UCLA AIDS Institute, established in 1992, is a multidisciplinary think tank drawing on the skills of top-flight researchers in the worldwide fight against HIV and AIDS, the first cases of which were reported in 1981 by UCLA physicians. Institute members include researchers in virology and immunology, genetics, cancer, neurology, ophthalmology, epidemiology, social science, public health, nursing, and disease prevention. Their findings have led to advances in treating HIV, as well as other diseases, such as hepatitis B and C, influenza and cancer.
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