Tailoring Family-Based HIV Prevention Interventions for African American and Latino Homeless Youth
“Are Parental Relationships Always Protective? A Social Network Analysis of Black, Latino, and White Homeless Youth and Sexual Risk-Taking Behaviors” (abstract). Jaih B. Craddock, Eric Rice, Harmony Rhoades, and Hailey Winetrobe. Forthcoming from Prevention Science, published online July 20, 2016.
What it’s about: Homeless youth are at high risk for HIV, particularly African American and Latino youth. Craddock, Rice, Rhoades, and Winetrobe note that research with housed Hispanic and African American youth has shown that positive parental relationships are linked to lower intentions among young people to have sex in the next three months. The authors also write that many homeless youth still have some connection to their families. To examine parental relationships and sexual risk behaviors among these youth populations, the researchers interviewed 754 homeless youth ages 14 to 25 at three Los Angeles drop-in centers between October 2011 and June 2013. Participants also completed a computerized, self-administered questionnaire that analyzed their risk and protective factors and behaviors. Participants identified as African American, Latino, or white; 338 (45 percent of the sample) included a parent in their social network.
Why read it: Most family-based HIV prevention interventions are geared toward newly homeless, or runaway, youth. However, youth who have been homeless for a longer period are at higher risk for HIV and other sexually transmitted infections than runaway youth or homeless youth accompanied by family, Craddock et al. write. Moreover, no family-based interventions have been tailored for African American and Latino unaccompanied youth who have experienced homelessness for an extended time. This study seeks to inform culturally-tailored interventions to fill these gaps.
Biggest takeaways from the research: Overall, the authors found that among youth who reported parental relationships, most (95 percent) described them as close relationships. Fifty-seven percent said their parent(s) provided emotional support, and 64 percent said they provided sexual health information. Eighty-eight percent said their parent(s) had a positive influence, while only 5 percent said their parent(s) had a negative influence.
Among those with a parent in their networks, African American and white youth were less likely to have used condoms during their most recent sexual encounter. However, African American youth who reported having a parent who is a positive influence were three times more likely to report recent condom use, and nearly five times more likely to report having been recently tested for HIV. Craddock et al. suggest that whether parental relationships are protective against HIV may depend more on the content of these relationships than on their existence.
In contrast, Latino youth who reported talking to their parents about sex were less likely to have recently been tested for HIV. On the other hand, parental emotional support among Latino youth was linked to lower odds of having multiple sex partners. To explain these differences, Craddock et al. point to research examining cultural influences on sexual risk behaviors in Latino communities. This research reveals discomfort with discussions of sexuality, and culturally ingrained religious beliefs and messages about remaining sexually abstinent until marriage.
Craddock et al. recommend three existing evidence- and family-based HIV prevention interventions that could be tailored for these groups:
- For homeless African American youth: Create a culturally-tailored intervention featuring content from interventions such as Strong African American Families-Teen (SAAF-T), which was developed for housed youth. This content could be combined with the parental communications tools in Support to Reunite, Involve and Value Each Other (STRIVE), which was developed for homeless youth, or other similar interventions.
- For homeless Latino youth: Start with interventions such as STRIVE and Familias Unidas, “a highly effective family-based HIV intervention designed to meet the culture-specific needs of Latino families” with a “focus on Latino parent–child communication.” The authors caution that Familias Unidas would need some modifications for older adolescents and young adults.
- For homeless white youth: Provide an intervention similar to STRIVE. The authors note the need for further qualitative study of this population’s parental relationships, and of ways that family communication can be improved to prevent HIV risk behaviors.
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.