Unprotected Sex of Homeless Youth: Results from a Multilevel Analysis of Individual, Social Network, and Relationship Factors

Below:  Three examples of exploratory mixed method analysis of homeless youth social networks with example quotes about their decisions to use condoms during recent sex events. The first example is a female respondent who identified her boyfriend as the person with the most influence over her decisions about sex. She said that she does not use condoms because he does not like them. The middle example is a male respondent who said the he himself has the most influence over his sexual decisions. He does not use condoms with the alter he identified and is not concerned because she is already pregnant. The final example is a female respondent who identified her mother as the most influential over her sexual decisions because she encourages abstinence. However, the respondent reported having unprotected sex with multiple partners.

Homeless youth have elevated risk of HIV through sexual behavior. This project investigates the multiple levels of influence on unprotected sex among homeless youth, including social network, individual, and partner level influences. Findings are based on analyses of an exploratory, semi-structured interview (n=40) and a structured personal network interview (n=240) with randomly selected homeless youth in Los Angeles. Previous social network studies of risky sex by homeless youth have collected limited social network data from non-random samples and have not distinguished sex partner influences from other network influences. The present analyses have identified significant associations with unprotected sex at multiple levels, including individual, partner, and, to a lesser extent, the social network. Analyses also distinguished between youth who wished they used condoms after having unprotected sex and youth who did not regret having unprotected sex. Implications for social network based HIV risk interventions with homeless youth are discussed.

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