Research Roundup: New Information About Homeless Youth and Unprotected Sex

Photograph of a young couple standing close to each other.

Homeless youth are more likely than the general teen and young adult population to get pregnant or contract an STD. But most STD and pregnancy prevention programs are designed for youth who live at home and go to school regularly. A group of researchers in the Los Angeles area, mostly at the RAND Corporation in Santa Monica, have been studying the attitudes and behaviors that may make homeless youth more likely to have risky sex. Their work, recently published in a trio of papers, sheds light on some of things public health workers and health educators might be able to do to tailor prevention programs to this vulnerable population.

Using a combination of interviews and surveys with homeless youth in and around Los Angeles, the researchers examined the effects of young people’s drug use and drinking, their relationships with family, friends and sex partners, and their feelings about pregnancy and parenthood on their likelihood of having protected or unprotected sex.

Influences on Condom Use

The researchers found that young people were less likely to use condoms if

  • they or their partner had used hard drugs before they had sex
  • they were with someone who was their boyfriend or girlfriend or to whom they felt strongly committed
  • they had discussed “pulling out” as a contraceptive strategy before they had sex
  • they were in situations where there was no privacy

Youth were more likely to use condoms when

  • at least one of the partners regularly attended school
  • they had positive feelings about using condoms
  • they expressed high motivation to avoid pregnancy

The researchers also found that young people’s romantic partners had a strong influence on whether or not they used protection during sex, more so than friends or parents. In the study looking at attitudes toward pregnancy, youth in long-term relationships were more likely to have positive attitudes toward pregnancy and to not use contraception. In that paper the researchers write that “three-quarters of the youth thought it was very important to avoid pregnancy, but far fewer reported using effective contraceptives.”

Reducing the Risk

Based on the three papers, here are some things youth workers might consider when they create programs to reduce teen pregnancy and STDs among homeless youth:

  • Work to reduce drug use among homeless youth, and educate them on the potential impact of drugs on their ability to practice safe sex.
  • Encourage positive attitudes about condoms, which may lead to more condom use.
  • Help youth develop communication skills so they can negotiate the use of condoms with their partners.
  • Recognize the influence romantic partners have on young people’s contraceptive decisions.
  • Think of stable housing as part of the strategy for reducing young people’s likelihood of having risky sex.
  • Acknowledge and counteract the advantages homeless youth might see in getting pregnant and having children.
  • Consider using comprehensive pregnancy prevention approaches that may be able to address young people’s needs for stable housing, education and employment while also reducing pregnancy.

Read the Studies

Substance Use and Other Risk Factors for Unprotected Sex: Results from an Event-Based Study of Homeless Youth” (abstract). AIDS and Behavior, Vol. 16, No. 6 (August 2012).

Understanding Pregnancy-Related Attitudes and Behaviors: A Mixed-Methods Study of Homeless Youth.” Perspectives on Sexual and Reproductive Health, Vol. 44, No. 4 (December 2012).

Unprotected Sex of Homeless Youth: Results from a Multilevel Dyadic Analysis of Individual, Social Network, and Relationship Factors” (abstract). AIDS and Behavior, Vol. 16, No. 7 (October 2012).

9-5 pm Eastern