Shared Risk: Who Engages in Substance Use with American Homeless Youth?

Aims

To identify characteristics of social network members with whom homeless youth engage in drinking and drug use.

Design

A multi-stage probability sample of homeless youth completed a social network survey.

Setting

41 shelters, drop-in centers, and known street hangouts in Los Angeles County.

Participants

419 homeless youth, 13 to 24 years old (M age = 20.09, S.D. = 2.80).

Measurements

Respondents described 20 individuals in their networks, including their substance use and demographics, and the characteristics of the relationships they shared, including with whom they drank and used drugs. Dyadic, multilevel regressions identified predictors of shared substance use.

Findings

Shared drinking was more likely to occur with recent sex partners, drug users, sexual risk takers, opinion leaders, support providers, and popular people. Shared drug use was more likely to occur with recent sex partners, drinkers, sexual risk takers, opinion leaders, support providers, and popular people.

Conclusions

Homeless youth in the United States were more likely to drink or use drugs with those who engaged in multiple risk behaviors and who occupied influential social roles (popular, opinion leaders, support providers, sex partners). Understanding these social networks may be helpful in designing interventions to combat substance misuse.

...Results from this study emphasize the importance of accounting for social networks in efforts to reduce homeless youths' substance use. Homeless youth reported recent shared alcohol or drug use with approximately 25% of the members of their social networks. Although research has associated certain characteristics of social networks with increased substance use in homeless young people [9,11,12], the identity of network members that engage in or abstain from substance use remained unclear. This is the first study to identify attributes of social network members and characteristics of relationships that youth have with these network members associated with shared substance use.

Homeless youth were found to use alcohol and drugs with members of their network who engaged in a range of risky behaviors: they were likely to drink with network members who engaged in drug use and risky sex, and they were likely to use drugs with network members who drank to intoxication and engaged in risky sex. Thus, they used alcohol and drugs with network partners who were likely to promote numerous risky behaviors. Alcohol and drug use was also likely to occur with social network members who were also homeless, whom they had met on the street, and who were male, whereas they were unlikely to engage in these behaviors with family members and individuals who were employed. While these findings identify the most “risky” members of these youths' social networks, they also highlight the potentially protective influences of family members and employed individuals. This lends support to microenterprise interventions [19], that assist homeless youth in building relationships with positive roles models who do not endorse risk behaviors.

Additionally, homeless youth were likely to use substances with peers who occupied influential roles within their social networks. Shared drinking or drug use was more prevalent in relationships that entailed frequent contact, a sexual partnership, or that provided social support, emphasizing multifaceted relationship dynamics that may be both protective and risky. Respondents were also more likely to use substances with alters who occupied multiple opinion leader roles (as core group members, personal opinion leaders, and community role models), and were popular within their network. Overall, the likelihood of shared substance with a particular network partner increased incrementally for each of these support, opinion leader, and structurally popular roles. Recruiting peer leaders for interventions based on these potentially “influential” social roles may not be as clear-cut in homeless populations, given the tendency for these individuals to endorse the behaviors we hope they will prevent...

Table 2

Characteristic	Percent (N)	M (SD)	Range
Alter attributes (level 1) (N = 8380)
Gender (male)	57.7 (4835)
Attends school	21.4 (1793)
Employed part-time or full time	32.0 (2682)
Homeless	31.3 (2623)
Drinks to intoxication	44.0 (3687)
Uses drugs	50.0 (4190)
Engages in risky sex	21.4 (1793)
Provides social support	43.8 (3670)
Core group member	36.0 (3017)
Personal opinion leader	32.3 (2707)
Community leader	19.2 (1609)
Sum of functional roles (0–3)		0.88 (0.94)	0–3
Degree		3.06 (3.98)	0–19
Network isolate	32.2 (2698)
Dyadic attributes (level 1) (N = 8380)
Family members	18.3 (1534)
Met on the street	23.5 (1969)
Frequency of contacta		2.51 (1.42)	0–4
Current sex partner	5.0 (419)
Shared drinking	24.6 (2061)
Shared drug use	26.7 (2237)
Personal network attributes (level 2) (N = 419)
Density		0.16 (0.17)	0–1
Number of isolates		6.43 (5.26)	0–20
Number of alters:
Family members		3.66 (3.41)	0–20
Met on the street		4.70 (5.82)	0–20
Drank to intoxication		8.79 (6.74)	0–20
Used drugs		9.99 (6.93)	0–20
Engaged in risky sex		4.52 (5.34)	0–20
Provided social support		8.76 (5.93)	0–20
Core group members		7.19 (4.97)	0–20
Personal opinion leader		6.46 (5.12)	0–20
Community role model		3.85 (4.06)	0–20
Density of alcohol use (ingroup density)		0.17 (0.21)	0–0.95

Characteristics of Dyadic Relationships and Personal Networks of Homeless Youth (N = 149)

a0=Almost never, 1=Less than 1 time a month, 2=One to three times a month, 3=1 to 3 times a week, 4=Daily or almost daily

Full article at:   http://goo.gl/Ktcgi0

By:   Harold D. Green, Jr., Kayla de la Haye, Joan S. Tucker, and Daniela Golinelli

RAND Corporation 1776 Main St. Santa Monica, CA 90401 310-393-0411

 

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