6: Differences in Adolescents’ Perceived Health Status and Sexual Behavior by Duration of Homelessness and Gender

Abstract

Homeless adolescents experience various adverse health outcomes, particularly related to risky sexual behavior. The purpose of this study was to investigate the interaction effects of duration of homelessness and gender on baseline measures of perceived health status, safe sex behavior, and sexual risk-taking behavior. Data for this analysis were collected at baseline from 476 homeless youth who participated in a street-based sexual health intervention. Laptop computers were used with audio (optional) computer-assisted self-interviewing technology. Duration of homelessness was created as a dichotomous variable with 2 extreme levels: those who had been homeless < 6 months (n = 230) and those who had been homeless > 1 year (n = 246). The sample was primarily male (60.5%) and White (58.8%). Analysis of covariance was conducted to test the interaction of duration of homelessness by gender, as well as the main effects of duration of homelessness and gender. For each analysis, age was entered as a covariate. A significant interaction effect was found for duration of homelessness by gender, F (1,448) = 8.09, p < 0.05, on perceived health status. For women homeless > 1 year, perceived health status was significantly lower than in women homeless < 6 months, t (169) = -2.23, p < 0.05. For men who were homeless > 1 year, perceived health status was slightly higher than in men who were homeless < 6 months, although the difference was not statistically significant. Additionally, there was a significant main effect for gender, with women reporting lower levels of perceived health status than men, F (1,448) = 12.36, p < 0.05. A significant main effect for duration of homelessness was found, F (1,439) = 6.48, p < 0.05, with participants homeless < 6 months reporting higher levels of safe sex behavior than participants homeless > 1 year. A significant main effect was also found for gender, F (1,439) = 11.42, p < 0.01, with females reporting higher levels of safe sex behavior than males. Although both main effects were significant, there was no significant interaction effect. A main effect for duration of homelessness was also found for sexual risk-taking behavior, F (1,427) = 15.60, p < 0.01, with those homeless < 6 months reporting less sexual risk-taking behaviors than those homeless > 1 year. Clearly, the longer adolescents remain homeless, the more likely they are to engage in sexual behaviors that place them at risk for adverse health outcomes. Their perceptions of health status vary by gender as well as by duration of homelessness and support the need for gender-specific sexual health interventions.