Street youth in Los Angeles. Profile of a group at high risk for human immunodeficiency virus infection
M. D. Kipke, S. O'Connor, R. Palmer and R. G. MacKenzie
Division of Adolescent Medicine, Childrens Hospital, Los Angeles, Calif, USA.
OBJECTIVE: To characterize an urban street youth population, their
self-reported rates of drug use, and their involvement in behaviors that
put them at risk for infection with the human immunodeficiency virus.
DESIGN: A brief structured interview was administered to 409 youths who had
been living on the streets for 2 or more consecutive months, or who were
fully integrated into the "street economy." SETTING: Thirty percent of the
sample were recruited from community-based service sites and 70% were
recruited from street locations and at natural hangouts. PARTICIPANTS:
Youths were aged 12 to 23 years; 74% were male, 48% were ethnic minorities,
72% were homeless, 14% were gang affiliated, 20% were involved in drug
dealing, 43% were engaged in survival sex (ie, the exchange of a sexual
favor for money, food, a place to stay, clothes, and/or drugs), and 40%
were homosexual or bisexual. RESULTS: Seventy percent of the youths were
sexually active, with an average of 11.7 sexual partners (past 30 days).
Youths with multiple sexual partners were more likely to have had a
previous sexually transmitted disease (P < .01), to use drugs during sex
(P < .001), and to be involved in survival sex (P < .001). Marijuana
(55%), methamphetamine (62%), and crack (38%) were the drugs of choice,
with 30% of the sample reporting injecting drug use (58% of this subset
reported injecting drug use within the past 30 days). Substance-abusing
youth were 3.6 times more likely to use drugs during sex, 2.2 times more
likely to engage in survival sex, and 2.5 times more likely to have been
diagnosed as having a sexually transmitted disease. CONCLUSIONS: High-risk
sexual and drug use behaviors were prevalent and interrelated in this urban
street youth sample. This suggests the need for new and innovative
educational promotions and prevention interventions targeted to this
population.
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