Skip to main content

Advertisement

SpringerLink
Log in

Substance Use and Other Risk Factors for Unprotected Sex: Results from an Event-Based Study of Homeless Youth

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

This study used an event-based approach to understand condom use in a probability sample of 309 homeless youth recruited from service and street sites in Los Angeles County. Condom use was significantly less likely when hard drug use preceded sex, the relationship was serious, the partners talked about “pulling out”, or sex occurred in a non-private place (and marginally less likely when heavier drinking preceded sex, or the partnership was monogamous or abusive). Condom use was significantly more likely when the youth held positive condom attitudes or were concerned about pregnancy, the partners talked about condom use, and the partners met up by chance. This study extends previous work by simultaneously examining a broad range of individual, relationship, and contexual factors that may play a role in condom use. Results identify a number of actionable targets for programs aimed at reducing HIV/STI transmission and pregnancy risk among homeless youth.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. Sexual and reproductive health of persons aged 10–24 years—United States, 2002–2007. Surveillance Summary (July 17, 2009): MMWR, 58 (No. SS-6); 2009.

  2. MacKellar DA, Valleroy LA, Hoffmann JP, et al. Gender differences in sexual behaviors and factors associated with nonuse of condoms among homeless and runaway youths. AIDS Educ Prev. 2000;12(6):477–91.

    PubMed  CAS  Google Scholar 

  3. Tevendale HD, Lightfoot M, Slocum SL. Individual and environmental protective factors for risky sexual behavior among homeless youth: an exploration of gender differences. AIDS Behav. 2009;13(1):154–64.

    Article  PubMed  Google Scholar 

  4. Halcón LL, Lifson AR. Prevalence and predictors of sexual risks among homeless youth. J Youth Adolesc. 2004;33(1):71–80.

    Article  Google Scholar 

  5. Ringwalt CL, Greene JM, Robertson MJ. Familial backgrounds and risk behaviors of youth with thrownaway experiences. J Adolesc. 1998;21(3):241–52.

    Article  PubMed  CAS  Google Scholar 

  6. De Rosa CJ, Montgomery SB, Hyde J, Iverson E, Kipke MD. HIV risk behavior and HIV testing: a comparison of rates and associated factors among homeless and runaway adolescents in two cities. AIDS Educ Prev. 2001;13(2):131–48.

    Article  PubMed  Google Scholar 

  7. Rice E, Milburn NG, Rotheram-Borus MJ. Pro-social and problematic social network influences on HIV/AIDS risk behaviours among newly homeless youth in Los Angeles. AIDS Care. 2007;19(5):697–704.

    Article  PubMed  CAS  Google Scholar 

  8. Baer JS, Ginzler JA, Peterson PL. DSM-IV alcohol and substance abuse and dependence in homeless youth. J Stud Alcohol. 2003;64(1):5–14.

    PubMed  Google Scholar 

  9. Johnson KD, Whitbeck LB, Hoyt DR. Substance abuse disorders among homeless and runaway adolescents. J Drug Issues (Fall). 2005;35(4):799–816.

    Article  Google Scholar 

  10. Kipke MD, Montgomery SB, Simon TR, Unger JB, Johnson CJ. Homeless youth: drug use patterns and HIV risk profiles according to peer group affiliation. AIDS Behav. 1997;1(4):247–59.

    Article  Google Scholar 

  11. Salomonsen-Sautel S, Van Leeuwen JM, Gilroy C, Boyle S, Malberg D, Hopfer C. Correlates of substance use among homeless youths in eight cities. Am J Addict. 2008;17(3):224–34.

    Article  PubMed  Google Scholar 

  12. Wenzel SL, Tucker JS, Golinelli D, Green HD Jr, Zhou A. Personal network correlates of alcohol, cigarette, and marijuana use among homeless youth. Drug Alcohol Depend. 2010;112(1–2):140–9.

    Article  PubMed  Google Scholar 

  13. Kral AH, Molnar BE, Booth RE, Watters JK. Prevalence of sexual risk behaviour and substance use among runaway and homeless adolescents in San Francisco, Denver and New York City. Int J STD AIDS. 1997;8(2):109–17.

    Article  PubMed  CAS  Google Scholar 

  14. Bryant KJ. Expanding research on the role of alcohol consumption and related risks in the prevention and treatment of HIV/AIDS. Subst Use Misuse. 2006;41(10–12):1465–507.

    Article  PubMed  Google Scholar 

  15. Leigh BC, Stall R. Substance use, risky sexual behavior for exposure to HIV. Issues in methodology, interpretation, and prevention. Am Psychol. 1993;48(10):1035–45.

    Article  PubMed  CAS  Google Scholar 

  16. Halpern-Felsher BL, Millstein SG, Ellen JM. Relationship of alcohol use and risky sexual behavior: a review and analysis of findings. J Adolesc Health. 1996;19(5):331–6.

    Article  PubMed  CAS  Google Scholar 

  17. Weinhardt LS, Carey MP. Does alcohol lead to sexual risk behavior? Findings from event-level research. Annu Rev Sex Res. 2000;11:125–57.

    PubMed  CAS  Google Scholar 

  18. Cooper ML. Alcohol use and risky sexual behavior among college students and youth: evaluating the evidence. J Stud Alcohol. 2002;14(Suppl):101–17.

    Google Scholar 

  19. Bailey SL, Gao W, Clark DB. Diary study of substance use and unsafe sex among adolescents with substance use disorders. J Adolesc Health. 2006;38(3):297. e13–20.

    Article  PubMed  Google Scholar 

  20. Bailey SL, Camlin CS, Ennett ST. Substance use and risky sexual behavior among homeless and runaway youth. J Adolesc Health. 1998;23(6):378–88.

    Article  PubMed  CAS  Google Scholar 

  21. Bryan A, Ray LA, Cooper ML. Alcohol use and protective sexual behaviors among high-risk adolescents. J Stud Alcohol Drugs. 2007;68(3):327–35.

    PubMed  Google Scholar 

  22. McMahon JM, Tortu S, Pouget ER, Hamid R, Neaigus A. Contextual determinants of condom use among female sex exchangers in East Harlem, NYC: an event analysis. AIDS Behav. 2006;10(6):731–41.

    Article  PubMed  Google Scholar 

  23. Tortu S, McMahon J, Hamid R, Neaigus A. Drug-using women’s sexual risk: an event analysis. AIDS Behav. 2000;4(4):329–40.

    Article  Google Scholar 

  24. Tucker JS, Wenzel SL, Golinelli D, et al. Is substance use a barrier to protected sex among homeless women? Results from between- and within-subjects event analyses. J Stud Alcohol Drugs. 2010;71(1):86–94.

    PubMed  Google Scholar 

  25. Gillmore MR, Morrison DM, Leigh BC, Hoppe MJ, Gaylord J, Rainey DT. Does “high = high risk”? An event-based analysis of the relationship between substance use and unprotected anal sex among gay and bisexual men. AIDS Behav. 2002;6(4):361–70.

    Article  Google Scholar 

  26. Bogart LM, Kral AH, Scott A, et al. Condom attitudes and behaviors among injection drug users participating in California syringe exchange programs. AIDS Behav. 2005;9(4):423–32.

    Article  PubMed  Google Scholar 

  27. Jemmott LS, Jemmott JB 3rd. Applying the theory of reasoned action to AIDS risk behavior: condom use among black women. Nurs Res. 1991;40(4):228–34.

    Article  PubMed  CAS  Google Scholar 

  28. Skinner CJ. Domain means, regression and multivariate analyses. In: Skinner CJ, Holt D, Smith TMF, editors. Analysis of complex surveys. New York: Wiley; 1989. p. 59–88.

    Google Scholar 

  29. Centers for Disease Control and Prevention. Youth risk behavior surveillance—United States, 2009. Surveillance Summary (July 17, 2009): MMWR, 59 (No. SS-5); 2010.

  30. Mansergh G, Purcell DW, Stall R, et al. CDC consultation on methamphetamine use and sexual risk behavior for HIV/STD infection: summary and suggestions. Public Health Rep. 2006;121(2):127–32.

    PubMed  Google Scholar 

  31. Leigh BC, Ames SL, Stacy AW. Alcohol, drugs, and condom use among drug offenders: an event-based analysis. Drug Alcohol Depend. 2008;93(1–2):38–42.

    Article  PubMed  Google Scholar 

  32. Wilson PA, Diaz RM, Yoshikawa H, Shrout PE. Drug use, interpersonal attraction, and communication: situational factors as predictors of episodes of unprotected anal intercourse among Latino gay men. AIDS Behav. 2009;13(4):691–9.

    Article  PubMed  Google Scholar 

  33. Fortenberry JD, Orr DP, Katz BP, Brizendine EJ, Blythe MJ. Sex under the influence. A diary self-report study of substance use and sexual behavior among adolescent women. Sex Transm Dis. 1997;24(6):313–9.

    Article  PubMed  CAS  Google Scholar 

  34. Morrison DM, Gillmore MR, Hoppe MJ, Gaylord J, Leigh BC, Rainey D. Adolescent drinking and sex: findings from a daily diary study. Perspect Sex Reprod H. 2003;35(4):162–8.

    Article  Google Scholar 

  35. Crosby R, Salazar LF, Diclemente RJ. Lack of recent condom use among detained adolescent males: a multilevel investigation. Sex Transm Infect. 2004;80(6):425–9.

    Article  PubMed  CAS  Google Scholar 

  36. Thompson SJ, Bender KA, Lewis CM, Watkins R. Runaway and pregnant: risk factors associated with pregnancy in a national sample of runaway/homeless female adolescents. J Adolesc Health. 2008;43(2):125–32.

    Article  PubMed  Google Scholar 

  37. Kiene SM, Barta WD, Tennen H, Armeli S. Alcohol, helping young adults to have unprotected sex with casual partners: findings from a daily diary study of alcohol use and sexual behavior. J Adolesc Health. 2009;44(1):73–80.

    Article  PubMed  Google Scholar 

  38. Drumright LN, Gorbach PM, Holmes KK. Do people really know their sex partners? Concurrency, knowledge of partner behavior, and sexually transmitted infections within partnerships. Sex Transm Dis. 2004;31(7):437–42.

    Article  PubMed  Google Scholar 

  39. Kennedy DP, Wenzel SL, Tucker JS, et al. Unprotected sex of homeless women living in Los Angeles county: an investigation of the multiple levels of risk. AIDS Behav. 2010;14(4):960–73.

    Article  PubMed  Google Scholar 

  40. Kalichman SC, Williams EA, Cherry C, Belcher L, Nachimson D. Sexual coercion, domestic violence, and negotiating condom use among low-income African American women. J Women’s Health. 1998;7(3):371–8.

    Article  CAS  Google Scholar 

  41. Sheeran P, Abraham C, Orbell S. Psychosocial correlates of heterosexual condom use: a meta-analysis. Psychol Bull. 1999;125(1):90–132.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This research was supported by Grant R01DA020351 from the National Institute on Drug Abuse. We thank the youth who shared their experiences with us, the service agencies that collaborated in the study, and the RAND Survey Research Group for their assistance in data collection.

Author information

Authors and Affiliations

  1. RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA

    Joan S. Tucker, Gery W. Ryan, Daniela Golinelli, Brett Ewing, David P. Kennedy, Harold D. Green Jr. & Annie Zhou

  2. School of Social Work, University of Southern California, Los Angeles, CA, USA

    Suzanne L. Wenzel

Authors
  1. Joan S. Tucker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gery W. Ryan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniela Golinelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brett Ewing
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Suzanne L. Wenzel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David P. Kennedy
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Harold D. Green Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Annie Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joan S. Tucker.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tucker, J.S., Ryan, G.W., Golinelli, D. et al. Substance Use and Other Risk Factors for Unprotected Sex: Results from an Event-Based Study of Homeless Youth. AIDS Behav 16, 1699–1707 (2012). https://doi.org/10.1007/s10461-011-0017-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-011-0017-9

Keywords

Search

Navigation