Differences in Social Support and Normative Network Characteristics Between Heterosexual and LGBQ Cisgender Homeless Youth: Does It Explain Differential Engagement in Sexual Risk Behaviors?

Background:

Studies have found that approximately 40% of homeless youth are lesbian, gay, bisexual or queer (LGBQ). Additionally, research also suggests that cisgender (gender identity aligns with sex assigned at birth) LGBQ homeless youth are more likely to engage in greater risk behaviors compared to cisgender heterosexual homeless youth. These disparities have often been assumed to be linked to differences in access to supportive resources and exposure to risk-networks among these different sub-groups. There is little extant literature focusing on the differences in the social networks of homeless youth who identify as heterosexual or LGBQ. This study explores differences between the social networks of heterosexual and LGBQ cisgender homeless youth, focusing specifically on sexual risk factors, in order to expand current knowledge on these populations experiencing multiple levels of marginalization.

Methods:

A sample of 1,046 homeless youth was recruited from two Los Angeles, California youth drop-in centers during October 2011 to November 2013.  Participants completed a self-administered computerized survey assessing demographic, homelessness background and risk behavior variables. A social network interview assessed network norms (i.e. what kind of sex-risk behaviors these network members engage in), network communication (i.e. whether network members talk about safe sex) and network function (i.e. whether youth received any supports from these networks).  Chi-square and t-tests of independence were run to analyze differences in demographics, background experiences and social networks between these different sub-groups. Logistic-regressions were used to examine whether differences in norms and functions of social networks had different kinds of relationships with engagement in unprotected sex and concurrent sex. These multivariate-models were stratified by sexual orientation.

Results:

Approximately 24% (n=242) of youth in our study identified as LGBQ. LGBQ youth were more likely to report engaging in hard-drug use (chi-sq.=7.14, p<.01), unprotected sex (chi-sq.=9.01, p<.01) and concurrent sex (chi-sq.=3.41, p<.05). Surprisingly, there were no differences in social support networks between heterosexual and LGBQ youth. However, as hypothesized, there were differences in risk-networks of LGBQ homeless youth. LGBQ homeless youth were more likely to report having network members who engage in unprotected sex (chi-sq.=4.24, p<.01) and concurrent sex (chi-sq.=8.51, p<.01) and contrarily also more likely to report having network members who engage in safe-sex communication (chi-sq.=3.36, p<.05). The stratified multivariate models suggest that while network norms were significantly related to unprotected sex for both heterosexual (AOR=3.89, 95%; CI= 2.81-5.39) and LGBQ homeless youth (AOR=3.14, 95%; CI= 1.74-5.67), talking about safe-sex was associated with lower rates of unprotected sex only among heterosexual youth (AOR=. 62, 95%; CI= 0.44-0.89) but not among LGBQ youth (AOR=0.82, 95%; CI= .42-1.61).

 

Conclusions/Implications:

Results suggest that while there are no significant differences in the social support networks of heterosexual and LGBQ cisgender homeless youth, there are differences in the risk factors between these groups’ network norms. On a macro-level, these findings provide support for sexual risk-reduction or HIV preventive interventions that are tailored for LGBQ homeless youth.  On a micro-level, social work practitioners should consider these differences when engaging in conversations and interventions with cisgender LGBQ homeless youth regarding sexual-risk factors.