The impact of an integrated treatment on HIV risk behavior among homeless youth: a randomized controlled trial

Abstract

While many studies provide useful information on the risk behaviors in which homeless youth engage, few prior studies evaluate Human Immunodeficiency Virus (HIV) risk related reduction strategies. In this study, homeless youth (n = 180) were recruited from a drop-in center and randomly assigned to one of two conditions, either an integrated individual cognitive-behavioral treatment and HIV prevention intervention that focused on skills building and education or to treatment as usual. All youth were assessed at entry into the program and at 3 and 6 month follow-up points. Findings showed an interaction between treatment condition, age and time. In the interaction, youth assigned to the integrated treatment reported greater condom usage than youth assigned to treatment as usual, with younger youth assigned to treatment as usual showing no change in condom use. The number of sexual partners reported by youth in both treatment conditions was also reduced over time. However, youth in both conditions continued to engage in other high-risk behaviors. The integrated treatment findings are promising and suggest that interventions which target both HIV risk behavior in addition to other life areas (substance use, mental health and housing) among homeless youth may be necessary in order to significantly impact high-risk behaviors among this unique group.

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

“…Indeed, such living situations are likely to obstruct the development of trust relationships and positive linkages, which increases the risks of chronicization and maintains homelessness among street-involved youth. 45 Building on others' work, 22,23,25,55,56 the present study longitudinally examined the occurrence of a variety of HIV risk behaviors in relation to changes in housing situation among street-involved youths. A major strength of this approach, based on mixed-effects regression, is that both risk behaviors and housing situations were allowed to vary not only across study participants but also among them, which controlled for unmeasured potential individual confounders.…”

“…44 Types of housing considered were those likely to favor the development of a linkage to mainstream society. 45 Emergency or short-term shelters as well as transitional facilities (residential treatment or recovery program, hospital, jail or prison, and corrections halfway house) were excluded. Mid-and long-term housing resources (resources offering housing for more than 1 month, in combination with financial support and health or social services) were included in the list of stable housing environments.…”

Interventions to modify sexual risk behaviours for preventing HIV in homeless youth

“…A total of 240 records were eliminated at screening, leaving 15 eligible reports that were examined in detail for eligibility assessment (full text obtained). Of the 15 reports, 11 reports of 10 independent studies were excluded and the remaining four reports detailed three suitable studies eligible for this review (RotheramBorus 2003, Slesnick 2005, Slesnick 2008). …”

Les interventions en matière de sexualité chez les jeunes en situation de rue à Montréal

“…Les résultats sont moins clairs quant à la modifi cation des comportements : certains travaux révèlent une diminution de comportements sexuels à risque (Auerswald, Sugano, Ellen et Klausner, 2006;Slesnick et Kang, 2008), tandis que d'autres ont montré un statu quo, voire une augmentation des comportements sexuels à risque à la suite de la consultation des interventions en matière de sexualité (Booth et coll., 1999;Gleghorn, Clements, Marx, Vittinghoff, Lee-Chu et Katz, 1997;Rew et coll., 2007;Schumann et coll., 2007).…”