Abstract
This study examined prevalence of sexual risks among homeless adolescents and described factors associated with those risks. Community-based outreach methods were used successfully to access this difficult-to-reach population. The sample included 203 homeless youth aged 15–22 recruited from community sites. Questionnaire items addressed demographics, sexual behaviors, alcohol/drug use, STI history and testing, and pregnancy history. In cross-sectional analysis, 58.7% of males and 75.6% of females reported recent sexual intercourse. Of those, one third of males and half of the females used no barrier method with at least one partner. Both gender (female) and race/ethnicity (non-Black) were associated with having intercourse without a barrier contraceptive method. Over one fifth reported a history of “survival sex” or receiving money, drugs, clothing, shelter, or food for sex. These results show disturbingly high rates of a number of sexual risks, reinforcing the need for targeted interventions with this highly vulnerable population.
Similar content being viewed by others
REFERENCES
Allen, D. M., Lehman, J. S., Green, T. A., Lou, L. M., Onorato, I. M., Forrester, W., and Branch, F. S. (1994). HIV infection among homeless adults and runaway youth, United States, 1989–1992. AIDS 8: 1593–1598.
Bailey, S. L., Camlin, C. S., and Ennett, S. T. (1998). Substance use and risky sexual behavior among homeless and runaway youth. J. Adolesc. Health 23(6): 378–388.
Blattner, W. A., O'Brien, T. R., and Mueller, N.E. (1997). Retroviruses—Human immunodeficiency virus. In Evans, A. S., and Kaslow, R. A. (eds.), Viral Infections of Humans: Epidemiology and Control (4th edn.) Plenum Medical Book Company, New York, pp. 713–783.
Chin, J. (ed.) (2000). Control of Communicable Diseases Manual (17th edn.)., Washington, D.C.: American Public Health Association.
Clatis, M. C., and Davis, W. R. (1999). A demographic and behavioral profile of homeless youth in New York City: Implications for AIDS outreach and prevention. Med. Anthropol. Q. 13(3): 365–374.
Clatts, M. C., Davis, W. R., Sotheran, J. L., and Atillasoy, A. (1998). Correlates and distribution of HIV risk behaviors among homeless youths in New York City: Implications for prevention and policy. Child Welfare 77(2): 195–207.
Clements, K., Gleghorn, A., Garcia, D., Katz, M., and Marx, R. (1997). A risk profile of street youth in northern California: Implications for gender-specific human immunodeficiency virus prevention. J. Adolesc. Health 20(5): 343–353.
DiClemente, R. J., Hansen, W. B., and Ponton, L. E. (1996). Adolescents at risk: A generation in jeopardy. In DiClemente, R. J., Hansen, W. B., and Ponton, L. E. (eds.), Handbook of Adolescent Health Risk Behavior. Plenum, New York, pp. 1–4.
Division of STD Prevention (1996). Sexually Transmitted Disease Surveillance 1995. Centers for Disease Control and Prevention, DHHS-PHS, Atlanta, GA.
Ebrahim, S. H., Peterman, T. A., Zaidi, A. A., and Kamb, M. L. (1997). Mortality related to sexually transmitted diseases in U.S. women, 1973 through 1992. Am. J. Public Health 87(6): 938–944.
Farrow, J. A., Deisher, R.W., Brown, R., Dulig, J.W., and Kipke, M. D. (1992). Health and health needs of homeless and runaway youth: A position paper of the Society for Adolescent Medicine. J. Adolesc. Health 13(8): 717–726.
Finkelhor, D., Hotaling, G., and Sedlak, A. (1990). Missing, Abducted, Runaway, and Thrownaway Children in America. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention, Washington, DC.
Fortenberry, J. D. (1995). Adolescent substance use and sexually transmitted disease risk: A review. J. Adolesc. Health 16: 304–308.
Greenblatt, M., and Robertson, M. J. (1993). Life-styles, adaptive strategies, and sexual behaviors of homeless adolescents. Hosp. Community Psychiatry 44(12): 1177–1180.
Greene, J. M., Ennett, S. T., and Ringwalt, C. L. (1997). Substance use among runaway and homeless youth in three national samples. Am. J. Public Health 87(2): 229–235.
Greene, J. M., Ennett, S. T., and Ringwalt, C. L. (1999). Prevalence and correlates of survival sex among runaway and homeless youth. Am. J. Public Health 89(9): 1406–1409.
Greene, J. M., and Ringwalt, C. L. (1998). Pregnancy among three national samples of runaway and homeless youth. J. Adolesc. Health 23(6): 370–377.
Huba, G. J., Melchior, L. A., Panter, A. T., Trevithick, L., Woods, E. R., Wrigt, E., Feudo, R., Tierney, S., Schneir, A., Tenner, A., Remafedi, G., Greenberg, B., Sturdevant, M., Goodman, E., Hodgins, A., Wallace, M., Brady, R., and Singer, B. (2000). Risk factors and characteristics of youth living with, or at high risk for, HIV. AIDS Educ. Prev. 12(6): 557–575.
Huizinga, D., Loeber, R., and Thornberry, T. P. (1993). Longitudinal study of delinquency, drug use, sexual activity, and pregnancy among children and youth in three cities. Public Health Rep. 108(Suppl. 1): 90–96.
Igra, V., and Irwin, C. E. (1996). Theories of adolescent risk-taking behavior. In DiClemente, R. J., Hansen, W. B., and Ponton, L. E. (eds.), Handbook of Adolescent Risk Behavior. Plenum, New York, pp. 35–51.
Kipke, M. D., O'Connor, S., Palmer, R., and MacKenzie, R. G. (1995). Street youth in Los Angeles: Profile of a group at high risk for human immunodeficiency virus infection. Arch. Pediatr. Adolesc. Med. 149: 513–519.
Kral, A. H., Molnar, B. E., Booth, R. E., and Watters, J. K. (1997). Prevalence of sexual risk behaviour and substance use among runaway and homeless adolescents in San Francisco, Denver and New York City. Int. J. STD AIDS 8: 109–117.
Leigh, B. C., Morrison, D. M., Trocki, K., and Temple, M. T. (1994). Sexual behavior of American adolescents: Results from a U.S. national survey. J. Adolesc. Health 15: 117–125.
Lifson, A. R., and Halcon, L. L. (2001). Substance abuse and high-risk needle-related behaviors among homeless youth in Minneapolis: Implications for prevention. J. Urban health 78(4): 690–698.
Link, B. G., Susser, E., Stueve, A., Phelan, J., Moore, R. E., and Struening, E. (1994). Lifetime and five-year prevalence of homelessness in the United States. Am. J. Public Health 84(12): 1907–1912.
Macdonald, N. E., Fisher, W. A., Wells, G. A., Doherty, J. A., and Bowie, W. R. (1994). Canadian street youth: Correlates of sexual risk-taking activity. Pediatr. Infect. Dis. J. 13: 690–697.
MacKellar, D. A., Valleroy, L. A., Hoffmann, J. P., Glebatis, D., LaLota, M., McFarland, W., Westerholm, J., and Janssen, R. S. (2000). Gender differences in sexual behaviors and factors associated with nonuse of condoms among homeless and runaway youths. AIDS Educ. Preve. 12(6): 477–491.
Martinez, T. E., Gleghorn, A., Marx, R., Clements, K., Boman, M., and Katz, M. H. (1998). Psychosocial histories, social environment, and HIV risk behaviors of injection and noninjection drug using homeless youth. J. Psychoactive Drugs 30(1): 1–10.
Minnesota Department of Human Services, Performance and Quality Improvement Division (1996). Minnesota Student Survey 1989–1992–1995: Perspectives on Youth. Department of Children, Families and Learning, St. Paul, MN.
Noell, J., Rohde, P., Ochs, L., Yovanoff, P., Alter, M. J., Schmid, S., Blullard, J., and Black, C. (2001). Incidence and prevalence of chlamydia, herpes, and viral hepatitis in a homeless adolescent population. Sex. Transm. Dis. 28(1): 4–10.
Pennbridge, J. N., Freese, T. E., and MacKenzie, R. G. (1992, Fall). High-risk behaviors among male street youth in Hollywood, California. AIDS Educ. Prev. (Suppl.) 24–33.
Pharris, M. D. (1998). Consent and Confidentiality: Providing Medical and Mental Health Services to Minors in Minnesota. Hennepin County Medical Center, Sexual Assault Resource Services, Minneapolis, MN.
Rew, L., Fouladi, R. T., and Yockey, R. D. (2002). Sexual health practices of homeless youth. J. Nurs. Scholarsh. 34(2): 139–145.
Rew, L., Taylor-Seehafer, M., and Fitzgerald, M. L. (2001). Sexual abuse, alcohol and other drug use, and suicidal behaviors in homeless adolescents. Issues in Compr. Pediatr. Nurs. 24: 225–240.
Rew, L., Taylor-Seehafer, M., and Thomas, N. (2000). Without parental consent: Conducting research with homeless adolescents. JSPN 5(3): 131–138.
Ringwalt, C. L., Greene, J. M., Robertsoln, M., and McPheeters, M. (1998). The prevalence of homelessness among adolescents in the United States. Am. J. Public Health 88(9): 1325–1329.
Rotheram-Borus, M. J., and Koopman, C. (1991). Sexual risk behaviors, AIDS knowledge, and beliefs about AIDS among runaways. Am. J. Public Health 81(2): 208–210.
Sherman, D. J. (1992). The neglected health care needs of street youth. Public Health Rep. 107(4): 433–440.
Shew, M. L., Remafedi, G. J., Bearinger, L. H., Faulkner, P. L., Taylor, B. A., Potthoff, S. J., and Resnick, M. D. (1997). The validity of self-reported condom use among adolescents. Sex. Transm. Dis. 24(9): 503–510.
Stricof, R. L., Kennedy, J. T., Nattell, T. C., Weisfuse, I. B., and Novick, L. F. (1991). HIV seroprevalence in a facility for runaway and homeless adolescents. Am. J. Public Health 81(Suppl.): 50–53.
Taylor, V. E. (1993). Analysis of the differences and similarities between homeless people seen at on-site health clinics in soup kitchens and shelters. In Hunter, J. K. (ed.), Nursing and Health Care for the Homeless State University of New York Press, New York, pp. 65–70.
Wagner, L. S., Carlin, L., Cauce, A. M., and Tenner, A. (2001). A snapshot of homeless youth in Seattle: Their characteristics, behaviors and beliefs about HIV protective strategies. J. Community Health 26(3): 219–232.
Wenzel, S. L., Andersen, R. M., Gifford, D. S., and Gelberg, L. (1999). Homeless women's gynecological symptoms and use of medical care. J. Health Care Poor Underserved 12(3): 323–341.
Wilder Research Center (1998). Minnesota Statewide Survey of Persons Without Permanent Shelter, Vol. 2: Unaccompanied youth. St. Paul, MN: Amherst H. Wilder Foundation.
World Health Organization, Task Force on the Prevention and Management of Infertility (1995). Tubal infertility: Serologic relationship to past chlamydial and gonococcal infections. Sex. Transm. Dis. 22(2): 71–77.
Yates, G. R., MacKenzie, J., Pennbridge, and Cohen, E. (1988). A risk profile comparison of runaway and non-runaway youth. Am. J. Public Health 78: 820–821.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Halcón, L.L., Lifson, A.R. Prevalence and Predictors of Sexual Risks Among Homeless Youth. Journal of Youth and Adolescence 33, 71–80 (2004). https://doi.org/10.1023/A:1027338514930
Issue Date:
DOI: https://doi.org/10.1023/A:1027338514930