HIV Risk Behaviors of Homeless Gang Members and Gang Affiliates

Background: Homeless youth is a large and growing population with an estimated 1.6 million in America. Additionally, youth gang membership and related negative outcomes continues to be a national problem. These two social issues intersect as many homeless youth identify as being a part of a gang or closely connected to a gang member. Experiences of homelessness and gang membership are both known determinants of increased HIV risk. Yet, almost no empirical research has examined the intersection between these populations. The purpose of this current study is to determine if gang involvement- either membership or close affiliation- is related to HIV risk amongst a homeless youth population.

Method: A sample of 505 Los Angeles area drop-in service seeking homeless youth completed a self-administered questionnaire. Youth were asked if they identify as a gang member or if they are gang affiliated (i.e. have a relative, romantic partner or close friend who identified as a gang member). Youth were also asked if they had used various types HIV risk behaviors including substance use and sexual risk behaviors. Univariable logistic regression models were used to test the likelihood of HIV risk behaviors for gang members and gang affiliates compared to non-gang involved homeless youth. Variables associated at the p<0.1 level were entered into a multivariable logistic regressions controlling for age, race, gender, sexual orientation, current living situation and city or origin tested the overall effect of membership or affiliation compared to non-involved homeless youth.

Results: Within the sample, 17% identified as a gang member and 46% identified as gang affiliated. For many risk behaviors, both gang members and gang affiliates were at greater risk compared to non-gang involved youth. Multivariable logistic regressions revealed that gang membership and gang affiliation was associated with higher rates of several HIV risk behaviors compared to non-gang involved homeless youth. Gang affiliates were over two times more likely to report recent methamphetamine and cocaine use compared to non-involved youth. Gang members were 3 times more likely and gang affiliates were twice as likely to report having sex under the influence of drugs or alcohol at their last sexual encounter.

Discussion:

Our analyses reveal that gang involvement amongst homeless youth is prevalent. Rates of membership in this Los Angeles based sample were higher than previous studies and rates of affiliation are notable.  Over half of the sample had ever been gang involved.  This study is unique in that it delineates between members and gang affiliates and compares them to non-involved youth. Our analyses reveal that gang affiliates demonstrate just as much of an increased risk as gang members when compared to non-involved youth. The need for comprehensive interventions to reduce HIV risk behaviors within high-risk populations is necessary. Given the lack of knowledge on the intersection between youth homelessness and gang involvement, the results emphasize the need to prioritize future research in this field to inform policies and programs that can address the specific needs of this population.