A risk profile of street youth in Northern California: Implications for gender-specific human immunodeficiency virus prevention

Abstract

To assess human immunodeficiency virus (HIV) risk behaviors of street youth and to determine whether risk behaviors differ by gender or housing status. Using systematic street-based sampling in four Northern California cities, we recruited 429 street youth (mean age = 19.2 years). Participants completed a structured interview which was used to assess sexual and drug HIV risk behaviors. The majority of youth were heterosexual (85%), white (77%), male (68%), and currently without any type of stable housing (75%). Although 60% of the sample had had vaginal sex in the past 30 days, only 44% used a condom the last time they had sex. About one-third (32%) of the sample reported ever injecting drugs, and almost all reported lifetime use of multiple drugs including D-lysergic acid diethylamide (96%), marijuana (90%), alcohol (81%), cocaine (70%), and speed (70%). Compared to males, females were equally likely to use injection and noninjection drugs, but were more likely to be sexually active (P < .001), were more likely to have been diagnosed with a sexually transmitted disease (P = .005), and were less likely to report consistent condom use (P = .003) or intent to use condoms consistently in the future (P = .005). Compared with those with stable housing, youth who were currently without such housing reported higher rates of injection, and other drug use; females without stable housing were less likely to have used condoms the last time they had vaginal intercourse. The high level of HIV risk behavior in this street-based sample of youth, particularly females and youth without stable housing, suggests an urgent need for gender-specific prevention efforts and an increased range of housing options.