Homelessness Experiences Among Lausd High School Students-Associations with Sexual Risk Behaviors

Introduction: An estimated 1.5 million youth experience homelessness in the U.S. each year. Homeless youth engage in higher rates of sexual risk taking than their housed-peers, however, these comparisons are largely made post-hoc by contrasting community-based samples of homeless youth, to school-based, probability samples of teens, like the CDC’s Youth Risk Behavior Survey (YRBS). We surveyed a random sample of Los Angeles Unified School District (LAUSD) high school students to assess how many youth experienced homelessness in the prior year, and whether the type of homelessness experience (i.e., spending the night in a shelter, a public-place, or  a stranger) impacted the youths’ sexual-risk behavior.  

Methods: A supplemental survey to the YRBS containing questions regarding homelessness was administered to LAUSD high school students (N=1,839). Multivariate logistic-regressions assessed the associations between demographic characteristics and types of homelessness. Subsequent models assessed sexual risk behaviors, comparing housed youth with youth who experienced each of three types of homelessness:  spending the night in a shelter, a public place, or with a stranger. In addition, among those youth who experienced homelessness (n=406), the associations between type of homelessness-experience and sexual-risks were examined.

Results: Over 10% (n=192) of the respondents indicated they had spent the night in a shelter, and more than 10% (n=199) reported staying in a public place. Nearly 5.6% of youth (n=89) indicated they spent the night with a stranger. Males were 2.7 times more likely and lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth were 4 times more likely to spend the night with a stranger. Similarly, males were 1.5 times and LGBTQ youth were 2 times more likely to spend the night at a public place. On the other hand, females and Hispanic youth were less likely to report spending the night at a shelter. When we limited our analyses to include only youth who had reported any kind of homelessness, it was found that LGBTQ youth were 2.4 times more likely to spend the night with stranger, and 56% less likely to spend the night at a shelter. When comparing sexual behaviors among housed youth and youth who reported any kind of homelessness, it was found that youth who spent the night with a stranger were 3.7 times more likely to be sexually active and 1.8 times more likely to engage in unprotected sex. Among youth who reported any kind of homelessness, youth who spent the night with a stranger were 3.36 times more likely to be sexually active, and 3.1 times more likely to engage in unprotected sex at last sex.

Implications: Certain groups of youth (e.g., LGBTQ youth) may be reluctant to use shelters due to perceived stigma and discrimination. Outreach should focus on reducing real or perceived barriers in shelters. Homelessness in the form of staying with strangers is particularly risky with respect to sexual health, especially for LGBTQ adolescents who are more likely to experience this form of homelessness. School-based sexual health programs should be sensitive to the intersections of sexual orientation and homelessness.