Examining the Impact of Relationships on Condom Use Among Homeless Youth
“Risk evaluations and condom use decisions of homeless youth: a multi-level qualitative evaluation” (abstract). David P. Kennedy, Ryan A. Brown, Penelope Morrison, Loryana Vie, Gery W. Ryan, and Joan S. Tucker. BMC Public Health, Vol. 25, No. 62 (2015).
What it’s about: Author David P. Kennedy and his colleagues wanted to explore how homeless youth evaluate the risk of sexually transmitted infections and unwanted pregnancies in their romantic relationships. To find out, the researchers interviewed 37 heterosexual homeless youth, aged 13 to 24, in Los Angeles County. They asked about the young people’s recent sexual relationships to learn how they decided whether to use a condom when having sex.
Why read it: Research has shown that young people experiencing homelessness are at greater risk for sexually transmitted infections and unwanted pregnancies than other youth. Unlike most previous studies of condom use among homeless youth, this study focuses on how relationships with sexual partners influence people’s decisions about whether to use condoms. Kennedy et al. build on previous research examining the links between stages of relationships and condom use to identify specific relationship factors that influence these decisions. They suggest that efforts to promote safer sex among homeless youth address these findings about romantic relationships, as well as individuals’ risk-taking patterns.
Biggest takeaways from the research: The researchers found that homeless youth were less likely to use a condom if they felt close to their partners, had a steady or long-term casual relationship, or felt satisfied the partner was “safe” (i.e., free from disease) based on communication and the partner’s appearance and reputation. In addition, researchers found that homeless youth were less likely to use a condom if they used alcohol or drugs or were very aroused at the time they had sex.
Homeless youth were more likely to use a condom if they were in a one-time or brand new relationship, if they did not trust that the partner was “safe,” or if the partner preferred condom use. Concern about pregnancy and sexually transmitted infections and a general pattern of avoiding risk also made youth more likely to use a condom.
The researchers assigned participants to one of three risk profiles based on what they said about their risk behaviors, namely, risk takers, avoiders, and reactors (i.e., those who did not have a consistent approach to handling risk). They found that:
- Youth categorized as consistent risk takers or avoiders based their decisions about condom use more on their general risk tendencies than on the length and seriousness of their relationships or factors like arousal and substance use.
- Risk reactors based their decisions on the length and type of relationships they had with sexual partners, as well as factors like drug or alcohol use. Risk reactors were more likely to use a condom to reduce their concern about disease or pregnancy than to reduce actual risk. Similarly, the discussions these youth had with their partners about sexually transmitted infections were aimed more toward reducing their partner's concern about risk than actually reducing risk itself.
Kennedy et al. suggest raising awareness of how relationships may increase the likelihood of risky sex among homeless youth so that safe sex interventions can take that factor into account.
Still, the researchers note that many youth are consistent in their risk behavior patterns no matter what types of relationships they have. To effectively reach these young people, the authors suggest that programs address multiple factors influencing decisions about condom use such as substance use and testing for disease.
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.