Comparison of HIV Risks among Gay, Lesbian, Bisexual and Heterosexual Homeless Youth

Department of Human Development and Family Science, The Ohio State University, 135 Campbell Hall, 1787 Neil Ave, Columbus, OH 43210, USA.
Journal of Youth and Adolescence (Impact Factor: 2.72). 02/2008; 37(4):456-464. DOI: 10.1007/s10964-007-9171-9
Source: PubMed


Youth who are homeless and gay, lesbian or bisexual (GLB) are one of the most disenfranchised and marginalized groups in our society. The purpose of this study is to examine and compare HIV in GLB homeless youth with their heterosexual counterparts. Participants for this study included 268 youth involved in treatment outcome studies with substance abusing homeless youth. Results suggest that GLB youth have greater HIV risks and that these risks are greater among bisexual females. In examining the predictors of sexual health risks, survival sex emerged as the most significant. Survival sex was high among females regardless of their sexual orientation and also among gay males. Implications of these findings suggest that a greater emphasis needs to be paid to preventive interventions among this population.

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    • "Childhood sexual abuse has been particularly emphasized as a risk factor for poor sexual health outcomes, including unprotected sex, high numbers of sexual partners, early age of first intercourse and sex trading (Johnson, Rew and Sternglanz 2006; Rotheram-Borus et al. 1996; Senn, Carey and Vanable 2008; Simons and Whitbeck 1991). lgb homeless youth, who report even higher rates of childhood sexual abuse compared to heterosexual homeless youth (Tyler and Cauce 2002), have been found to engage in sex trading at the same rate as heterosexual female homeless youth and at a higher rate than heterosexual male homeless youth (Gangamma et al. 2008). Childhood physical and emotional abuse are also correlates of sexual risk behaviours and poor sexual health among homeless youth, including sex trading (Greene, Ennett and Ringwalt 1999) and unintended pregnancy (Thompson et al. 2008). "

    Full-text · Chapter · Jan 2014
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    • "Homeless young men who have sex with men (YMSM) deserve particular attention, as living on the streets or being marginally housed may further increase their vulnerability to HIV/AIDS [5] [6]. Studies generally find greater sexual risk behavior among homeless gay, lesbian, and bisexual youth compared with their heterosexual counterparts [7] [8]. Further, homeless gay and lesbian youth are more likely to report being diagnosed and treated for HIV compared with homeless bisexual and heterosexual youth [9]. "
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    ABSTRACT: Purpose: There is growing interest in network-based interventions to reduce HIV sexual risk behavior among both homeless youth and men who have sex with men. The goal of this study was to better understand the social network and individual correlates of sexual risk behavior among homeless young men who have sex with men (YMSM) to inform these HIV prevention efforts. Methods: A multistage sampling design was used to recruit a probability sample of 121 homeless YMSM (ages: 16-24 years) from shelters, drop-in centers, and street venues in Los Angeles County. Face-to-face interviews were conducted. Because of the different distributions of the three outcome variables, three distinct regression models were needed: ordinal logistic regression for unprotected sex, zero-truncated Poisson regression for number of sex partners, and logistic regression for any sex trade. Results: Homeless YMSM were less likely to engage in unprotected sex and had fewer sex partners if their networks included platonic ties to peers who regularly attended school, and had fewer sex partners if most of their network members were not heavy drinkers. Most other aspects of network composition were unrelated to sexual risk behavior. Individual predictors of sexual risk behavior included older age, Hispanic ethnicity, lower education, depressive symptoms, less positive condom attitudes, and sleeping outdoors because of nowhere else to stay. Conclusions: HIV prevention programs for homeless YMSM may warrant a multipronged approach that helps these youth strengthen their ties to prosocial peers, develop more positive condom attitudes, and access needed mental health and housing services.
    Full-text · Article · Oct 2012 · Journal of Adolescent Health
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    • "Shelters and other programs serving homeless LGBT youth [6] [7] provide condoms and HIV education tailored to their specific needs. The content of this socialization depends on assumptions about their condom use beliefs and norms, e.g., that their elevated risk comes from greater involvement in survival sex [8] and substance use [9]. This study is a " member check " of those assumptions, open-endedly inquiring into homeless LGBT youths' decision processes in hopes of identifying risky beliefs and norms not already addressed. "
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    ABSTRACT: Health behavior interventions based on Theory of Planned Behavior address participants' personally-held beliefs, perceived social norms, and control over the behavior. New data are always needed to "member check" participants' decision processes and inform interventions. This qualitative study investigates decision processes around condom use among 81 homeless LGBT youth ages 18-26. Findings indicated considerable endorsement of the conventional policy of always using condoms, promulgated in HIV prevention education targeting this population. Although some participants reported risk behavior in contexts of sex work, survival sex, casual encounters, open relationships, and substance use, most were aware of these risks and consistently safe in those situations. Condoms use boundaries became vulnerable in states of emotional need and negative mood. The only effect participants acknowledged of homelessness on condom use was indirect, through negative mood states. The most prevalent context of condom non-use was with long-term primary partners, a potential area of vulnerability because, of 13 participants for HIV or HCV, nine mentioned how they had been infected, and all nine believed they had acquired it from a primary partner. Findings imply programs should emphasize HIV risk potential within long-term romantic partnerships and mental health services to remediate negative mood states.
    Full-text · Article · May 2012 · AIDS research and treatment
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