Methods: Individuals ages 16-24 were recruited from three drop-in programs serving homeless youths in downtown Toronto (N=147). Inclusion criteria required participants to have not had a stable place to live for at least seven days in the past month. Structured survey interviews were conducted with each participant. Dependent variables substance use, mental health (suicide and depression) and sexual risk were modeled by sexual orientation identity. The contextual variables included school engagement, family, peers, stigma related to homelessness and discrimination based on sexual orientation.
Results: Bivariate analyses indicated that homeless sexual minority youths (n=66) fared more poorly than their homeless heterosexual counterparts (n=81) overall, with statistically significant differences on mental health, substance use and sexual risk behaviors, as well as contextual factors such as peers, family communication, stigma, and discrimination. Results of multiple regression analyses indicated that sexual identity moderated the relationship between negative peers and three psychosocial behaviors: sexual risk behaviors (b=-0.11,t=-2.07,p=0.04), condom use (b—0.07,t=-2.92, p<0.005) and substance use (b=-0.06,t=-3.19, p=0.002). Among sexual minority youths, having peers who engaged in negative behaviors was associated with increased risky behaviors, but for homeless heterosexual youths, there was no effect between negative peers and their sexual risk behaviors, condom use, and substance use. Results also indicated that sexual identity did not moderate the relationship between other contextual factors (i.e., family communication, stigma, or discrimination) and psychosocial outcomes such as mental health, substance use, and sexual risk behaviors.
Conclusion and Implications: Study findings suggest several ways to move the field forward including developing peer based interventions for substance use and condom use among homeless sexual minority youths. Preliminary results regarding individuals involved in Q-Block, an innovative transitional living program for homeless sexual minority youths in Milwaukee, will be discussed.