What Leads Homeless Youth to Follow Through on Condom Use?

A young couple.

To Use or Not to Use: A Stage-Based Approach to Understanding Condom Use Among Homeless Youth,” Joan S. Tucker, Allison Ober, Gery Ryan, Daniela Golinelli, Brett Ewing, and Suzanne L. Wenzel. AIDS Care, Vol. 26, No. 5 (2014).

What it’s about: Tucker and her research team examined factors influencing three stages of condom use among homeless youth in Los Angeles: early decision-making about whether or not to use protection, the availability of condoms during sex, and actual condom use. Researchers analyzed data from 309 participants ages 13 to 24 who reported being sexually active in the past three months. Young people answered questions about their attitudes toward condoms, HIV, and pregnancy and the nature of their relationship with their last sexual partner. Thirty participants also completed qualitative interviews to provide context about their most recent sexual encounter, including whether they were recognizing a special occasion or if they had used drugs or alcohol beforehand.

Why read it: Many homeless youth encounter negative circumstances, such as violence in the home and poor family communication, that have been linked to risky sexual behaviors. Although past studies have sought to identify factors that influence homeless teens’ condom use, most overlook the potential impact of early decision-making and whether teens have condoms with them when they do have sex. Better understanding the decisions and actions that ultimately lead to protected sex can help family- and youth-serving agencies take steps to make sure young people are able to protect themselves.

Biggest takeaways from the research: Nearly three-quarters of participants did not make a decision about condom use before being with their partner in the moment. Homeless youth who identified as Hispanic and those with less education than a high school diploma were particularly unlikely to make early decisions. These groups of youth may need stronger encouragement to discuss condom use with their partners, the authors write.

Participants were also more likely to report having a condom when they were seeing their partner for the first time in a long time or knowing that one of them was going away for awhile. Even when young people had access to a condom, they were less likely to use it if they were in a monogamous relationship or used hard drugs prior to having sex.

Perhaps unsurprisingly, homeless young people with a positive attitude toward condoms were more than twice as likely to decide in advance to use condoms. Of the 30 participants who made this decision, all had a condom available during sex and 25 used it. By contrast, young people in monogamous relationships and those who reported a history of abuse with their partner were more likely to make early decisions not to use protection. Further study is needed, Tucker et al say, to better understand the importance of advanced decision-making and to help young people advocate for condom use even if their partner disagrees.

Additional references: Look for more articles on sexual and reproductive health and condom usage among homeless youth in NCFY’s research library.

We’ve also explored what makes homeless young people more and less likely to get tested for HIV or other sexually transmitted infections.

Publications discussed here do not necessarily reflect the views of the National Clearinghouse on Families & Youth, the Family & Youth Services Bureau, or the Administration for Children & Families.

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