Residential Trajectory and HIV High-Risk Behaviors among Montréal Street Youth—A Reciprocal Relationship

Abstract

Evidence has linked residential instability and engagement in high-risk behaviors. This paper longitudinally examines the relationship between changes in residential stability and changes in HIV risk behaviors among Montréal street youth (SY). Between April 2006 and May 2007, 419 SY (18-25 years old) were recruited in a cohort study. SY (using Montréal street youth agencies services) were eligible if they had had at least one 24-hour episode of homelessness in the previous 30 days. Baseline and follow-up interviews, carried out every 3 months, included completion of a questionnaire (based on Life History Calendar Technique) assessing daily sleeping arrangements since the last interview, and monthly sexual and drug use behaviors. Using mixed-effects logistic regression method, we examined the association between various risk behaviors and residential stability, reached when a youth resided in any of the following settings for a whole month: own place; friends'/partner's/parent's place; any types of housing service (excluding emergency shelters). Analyses were carried out controlling for gender, age, education level, lifetime duration of homelessness, childhood sexual trauma, and lifetime mental health disorders. This calls for more integrated services combining both individual and structural-level interventions to improve the health of street youth.

Prevalência e vulnerabilidade à infecção pelo HIV de moradores de rua em São Paulo, SP

“…It might be consequential to the extreme vulnerability that is inherent to living on the streets, 1,15,28 and such a condition overlaps with other factors typically associated with poverty and social inequality in the general population. In other words, living on the streets and insecurity related to having no housing 7,11,20,28 are per se factors that bring about situations of greater exposure to HIV such as violence and no access to services. 14,26,29 These same particularities may largely explain the study fi nding that young, female and homeless individuals engaging in homosexual sex are more vulnerable to HIV infection.…”

“…All these factors strongly affect homeless people in Brazil, 3,a,b and in other countries. 7,11,16,20 Studies assessing the impact of the HIV/AIDS epidemic on homeless people are scarce in Brazil. 2,3,b There is little information on HIV prevalence rates, risk factors associated with HIV infection, and other aspects that may guide specifi c prevention actions in this group.…”

The role of social networks and geography on risky injection behaviors of young persons who inject drugs

“…For example, residential transience (German et al, 2007; Roy et al, 2011) may impact HIV/HCV risk through increased network turnover (Costenbader et al, 2006; Hoffmann et al, 1997) by disrupting social ties, and increased frequency of injecting in semi-public places (e.g. shooting galleries) that present more opportunities for engagement in high-risk practices and with high-risk partners due to lack of safe injection spaces (German et al, 2007).…”

Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review

“…They often are victims of caretaker physical and sexual abuse [3]–[5], family disorganization [3] [6], sexual exploitation [7]–[9], hunger [10] [11], and physical and sexual assault when on the streets [3] [12] [13]. Sexual behaviors, drug use, and subsistence behaviors make them among the most susceptible to sexually transmitted infections (STIs) such as HIV/AIDS [14]–[17] and hepatitis [18]–[20], most HUHY lack conventional social support and adult mentorship [21] [22]. These combined risk factors take an enormous psychological and developmental toll.…”