Sexual Health Practices of Homeless Youth

PURPOSE: To describe the sexual health practices of homeless adolescents, examine relationships among variables in a conceptual model of sexual health practices, and determine direct and indirect effects of population characteristics, cognitive-perceptual factors, and behavioral factors on sexual health practices among homeless adolescents. DESIGN AND METHODS: Descriptive exploratory design. A survey was administered to a convenience sample of 414 homeless young men (244) and young women (170) aged 16-20 years, the majority of whom were Anglo American. FINDINGS: Thirty-five percent reported homosexual or bisexual orientation, and sexual orientation was reported as a reason for leaving home. Over half reported a history of sexual abuse and nearly one in four had been treated for gonorrhea. Safe-sex behaviors were related to age, time away from home, assertive communication, social support, future time perspective, connectedness, perceived health status, intentions to use condoms, and condom self-efficacy. A parsimonious model with good fit indicated that the only direct paths to safe-sex behaviors were future time perspective, intentions to use condoms, and self-efficacy to use condoms, and the direct paths to sexual self-care behaviors were from assertive communication, social support, and self-efficacy to use condoms. CONCLUSIONS: As in other studies of homeless youth, respondents reported a high incidence of sexual abuse and homosexual and bisexual orientation. Their safe-sex behaviors were surprisingly similar to those of university students, were modestly related to cognitive-perceptual variables in the sexual health model, and might be amenable to brief culturally relevant interventions.