If You Provide the Test, They Will Take It: Factors Associated with HIV/STI Testing in a Representative Sample of Homeless Youth in Los Angeles

Abstract

Homeless youth are at high risk for human immunodeficiency virus (HIV) and other sexually transmitted infections (STI), yet those at greatest risk may never have been tested for HIV or STI. In a probability sample of sexually active homeless youth in Los Angeles (n =305), this study identifies factors associated with HIV/STI testing status. Most youth (85%) had ever been tested and 47% had tested in the past 3 months. Recent testing was significantly more likely among youth who self-identified as gay, were Hispanic, injected drugs, and used drop-in centers, and marginally more likely among youth with more depressive symptoms. Drop-in center use mediated the association of injection drug use with HIV/STI testing. HIV/STI testing was unrelated to sexual risk behavior. Drop-in centers can play an important role in facilitating testing, including among injection drug users, but more outreach is needed to encourage testing in other at-risk subgroups.

Predictors of Intention to Use HIV Testing Service Among Sexually Experienced Youth in Thailand

“…This suggests a group of youth who want to be certain that their sexual practices are safe. This is in contrast with those in our study who used condoms inconsistently, the highest risk group, who had lesser intention to use HCT, suggesting they may be aware of their risk and afraid or in denial of becoming infected, knowing their status, or having AIDS, which may interfere with HCT seeking (Longmore, Johnson, Manning, & Giordano, 2012;Ober, Martino, Ewing, & Tucker, 2012).…”

Facilitators and Barriers of Drop-In Center Use Among Homeless Youth

“…Although there is less evidence that gender is associated with drop-in center use, some research suggests that females are more satisfied than males with services for homeless youth in general (including drop-in centers) [45]. In terms of racial/ethnic differences, one study conducted in Los Angeles found that minority youth were more likely than Whites to use drop-in center services [46], yet there is some evidence that racial minority youth are generally less satisfied with services overall [45]. …”

“…For example, one study found that only those youth who reported use of drop-in centers and/or shelters (as compared to those who do not) reported use of any medical, dental, or other services such as mental health or employment services, crisis hotlines, or substance use treatment [30]. Use of drop-in centers in the past month also emerged as a predictor of ever receiving HIV/STI testing among 305 homeless youth in Los Angeles, an effect seen when other factors such as number of sex partners and depression symptoms were not significant predictors [46]. Lastly, although the study did not specify where the STI/HIV testing occurred, Tyler and colleagues [43] found that youth who were older, female, LGBT, more highly educated, victims of sexual abuse, and had group home/foster care placement were more likely to report receiving testing in the past year.…”

The Adolescent and Young Adult HIV Cascade of Care in the United States: Exaggerated Health Disparities

“…18 Demographic factors suggest that among adolescents and young adults, HIV testing is higher among females, 18,19 African American, 7,8,[18][19][20][21][22][23] and Latino/a 19,20,24 youth. Sexual factors associated with increased HIV testing among youth include having three or more sexual partners in the last three months, 21 ever having a sexually transmitted infection (STI), 21,25 inconsistent condom use, 21 substance use, 21 being a MSM or a female who had sex with a MSM, 7,8,19,[21][22][23][24] or having had sex with an HIV-infected partner. 21 Healthcarerelated factors associated with increased HIV testing among youth include those receiving Medicaid with a primary care physician who were recommended testing 20 or had any healthcare in the past year.…”