What Impacts Condom Use in Homeless Youth?
“Understanding Condom Use Decision Making Among Homeless Youth Using Event-Level Data” (abstract). Yashodhara Rana, Ryan A. Brown, David P. Kennedy, Gery W. Ryan, Stefanie Stern, and Joan S. Tucker. The Journal of Sex Research (published online November 2014).
What it’s about: Rana and her colleagues wanted to explore what individual, interpersonal, and environmental factors influence whether homeless youth use condoms. The researchers interviewed 29 homeless young adults in Los Angeles to ask about their condom-related behaviors and decision-making at two points in time: the last time they had sex and another time that was somehow “different” from the first. All participants were between the ages of 13 and 23, had stayed in emergency shelters or received services, and reported having heterosexual sex at least once in the past six months.
Why read it: We know that homeless youth in the United States are more likely to contract sexually transmitted infections or to get pregnant (or get someone else pregnant) than their peers. Although some researchers have begun to explore different stages of decision-making behind condom use, few studies consider the role of personal, relationship-based, and event-specific factors that simultaneously impact young people’s decisions about sex. Most studies also collect data using surveys, which don’t give youth a chance to explain the multiple reasons for their decisions. By addressing that gap, this study can help agencies move away from a one-sized-fits-all approach to preventing risky sexual behaviors to better meet the needs of individual youth.
Biggest takeaways from the research: Researchers organized their findings into three main categories: circumstances related to the “event” of having sex, factors related to participants’ partners, and young people’s individual characteristics. At the event level, for example, homeless youth spoke about their challenges finding a place to have sex without fear of arrest. For two young people, this obstacle led them to make plans with their partner far in advance so they could have sex in private. Yet two other participants said their circumstances led them to have sex more spontaneously, a trend the authors say could reduce their odds of having (and using) condoms.
Interestingly, participants said they were less likely to use condoms when they anticipated having sex with a partner when compared to having sex unexpectedly. Upon further exploration, researchers noticed that many of these youth also pointed to individual and partnership-related factors such as being in love or feeling confident about their partners’ sexual health as factors influencing their decision. Indeed, more than half of respondents mentioned a partner-related characteristic such as their “healthy” appearance as reasons for overlooking risks posed by disease and pregnancy. By contrast, only four females and two males said they had a firm rule about always using condoms.
Two female participants said they stopped using condoms because they felt a child would help them access housing. Expanding existing housing programs, they authors say, may improve homeless young people’s sexual health as fewer young women turn to pregnancy to connect with resources.
Rana et al. also shared some recommendations for improving sexual health interventions for homeless youth, including:
- Acknowledge the importance of romantic partnership and young people’s environment in addition to individual factors.
- Supplement peer-based interventions with information on how trust, love, and other feelings complicate youth’s decision to use condoms.
You can also read this roundup summarizing three articles on homeless youth and unprotected sex.
Publications discussed here do not necessarily reflect the views of the National Clearinghouse on Families and Youth, the Family and Youth Services Bureau, or the Administration for Children and Families.