Sexual Risk Behavior and Condom Use Among Street Youth in Hollywood.(Statistical Data Included)

A study of 610 street youth aged 13--23 who attended drop-in centers in Hollywood, Calif., reveals that 96% are sexually experienced. One-half of the young men and one-third of the young women have engaged in sex for food, money, shelter, drugs or other items needed. Twenty-five percent of the men and 15% of the women have injected drugs at some time in their life. Some 45% of the men and 30% of the women used condoms at last intercourse. A logistic regression analysis found that among men, those who have completed 10th grade or higher are nearly three times as likely to use condoms as are those who have less education. Young men who have been tested for the human immunodeficiency virus are nearly twice as likely to use condoms as are those who have not been tested. Among women, condom use declines with age, and young women who have engaged in sex for food, money or lodging are more likely to use condoms than those who have not.

(Family Planning Perspectives, 26:22-25,1994)

Because much sexual risk-taking occurs during adolescence and young adulthood, (1) many programs designed to prevent the spread of the human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) are oriented toward teenagers and adults in their early 20s. Prevention programs have specifically targeted youth in high-risk situations, including homeless youth, runaways and youth supporting themselves through the street economy of drugs, prostitution and crime.

Although street youth are a priority for HIV prevention programs, in part because of concern that these youth may link the general population to the HIV epidemic, reliable data about the characteristics and behavior of high-risk youth are scarce. Representative surveys, such as the National Survey of Family Growth and the National Survey of Adolescent Males, provide information about youth living in households, and the Youth Risk Behavior Survey contains data about those attending high school. However, representative data on high-risk youth are more difficult to obtain because their lifestyle excludes them from sampling frames usually used to obtain probability samples.

Surveys conducted of this population are usually drawn from homeless shelters or clinics. (2) Obtaining meaningful data from interviews with these youth requires special sensitivity. Research in Los Angeles has shown that runaway youth who become acculturated to the streets generally adopt one of three dominant street subcultures-- hustlers, druggies and rebels. (3) Members within these groups share common values, attitudes and beliefs, use distinctive language, have unique dress codes and dearly defined hang-outs, and use different survival strategies. These factors, as well as the emotional responses to life on the streets, must be considered when studying the behaviors of these youth.

The data reported in this article are from a survey of youth who attended drop-in centers in Hollywood, Calif., in 1990-1991. The survey was conducted by the Department of Adolescent Medicine at Children's Hospital of Los Angeles, with the collaboration of a coalition of agencies that provide services to street youth in the area. These services include overnight shelter, day programs and street outreach. This study examines the prevalence of sexual risk behavior and correlates of condom use in this population. The data can be used in planning interventions to provide more effective support services and reduce risky behavior among street youth.

Methodology