Abstract
BackgroundResearch on street children and youth has shown that this population is at high risk for substance use. Though risky sexual behaviours have been investigated and widely reported among street youth in resource constrained-settings, few studies have explored the relationship between substance use and other risk behaviours. This study was therefore conducted to examine the association between substance use and risky sexual behaviours among homeless youth in Ghana.MethodA cross-sectional survey of a convenient sample of 227 (122 male and 105 female) street connected children and youth was conducted in Ghana in 2012. Using self-report measures, the relationship between substance use and risky sexual behaviours was examined using logistic regression.ResultsSubstance use was relatively high as 12% and 16.2% reported daily use of alcohol and marijuana respectively. There were age and sex differences in substance use among the sample. As compared to males, more females had smoked cigarettes, used alcohol and marijuana. While alcohol use decrease with age, marijuana use on the other hand increases with age. Results from multivariate analysis revealed that having ever drunk alcohol and alcohol use in the past one month were independently associated with all the four indices of risky sexual behaviour (ever had sex, non-condom use, multiple sexual partners and survival sex). Both marijuana use and smoking of cigarettes were associated with having ever had sex, multiple sexual partners and survival sex. Other drug use was independently associated with non-condom use.ConclusionSubstance use seems to serve as a possible risk factor for sexual risk behaviours among homeless youth. Harm reduction interventions are needed to prevent street children and youth from engaging in substance use and risky sexual behaviours. Such programmes should pay special attention to females and younger children who are highly susceptible to the adverse conditions on the street.
Highlights
Research on street children and youth has shown that this population is at high risk for substance use
Substance use seems to serve as a possible risk factor for sexual risk behaviours among homeless youth
Health compromising behaviours among homeless youth in this study shows their vulnerability for HIV infection as a result of their high levels of sexual risk behaviours i.e. multiple sexual partners, engagement in survival sex and inconsistent condom use in contexts of considerably high alcohol and drug use
Summary
Research on street children and youth has shown that this population is at high risk for substance use. Though risky sexual behaviours have been investigated and widely reported among street youth in resource constrained-settings, few studies have explored the relationship between substance use and other risk behaviours. Circumstances on the street render children and youth vulnerable to various kinds of psychological problems and health risks [2]. Their lifestyles are characterized by a high rate of sex trade [3,4,5] and. In a comprehensive review, [10] reported that street youth in high income countries usually use injecting drugs and other substances that are not commonly used by homeless adolescents from low and middle resourced countries (LMIC). A similar pattern of substance use was reported among street youth in Kenya, where lifetime and current substance use was 74% and 83% respectively [12]
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