Social Network Correlates of Sexual Concurrency Among Homeless Youth at Drop-in Centers: A Sociometric Network Analysis

Background and Purpose:

Sexual concurrency (have overlapping sexual relationships with more than one person) may accelerate HIV transmission. Compared to youth with stable housing, homeless youth are more likely to engage in risky sexual partnerships and practice sexual risk behaviors (e.g., unprotected sex). Consequently, homeless youth are at heightened risk of acquiring and transmitting HIV. Specifically, the HIV prevalence rate among homeless youth can be 10 times higher than that of stably housed youth. Previous research suggests that youths’ level of integration within their social networks (e.g., social network position and risk exposure) may have significant influence on their sexual behaviors. However, correlates of sexual concurrency among homeless youth, especially social network connectedness, remain uninvestigated. Understanding sexual concurrency among homeless youth and its potential social network correlates may have great implications for future HIV prevention intervention development. The present study adopted a sociometric network approach to investigate the relationship between social network position, risk exposure, and sexual concurrency among homeless youth.

Methods

The present research used the first wave of data from a longitudinal homeless youth social network study. To determine social network boundaries, an event-based approach was adopted in the parent study. Youth (N=345) aged 13 to 24 attending two drop-in centers serving homeless youth in the Los Angeles area were sampled. Youth completed a survey and a social network interview. Sociometric networks of youth at both drop-in centers were constructed. Social network structural measures regarding network risk exposure (e.g., direct connections with peers who engage in concurrency or peers who use hard drugs) and social network position (e.g., center vs. periphery) were also derived. Logistic regressions were conducted to investigate the association between homeless youths’ network risk exposure, network position, and concurrency.

Results

Over 35 percent of the respondents had engaged in sexual concurrency during the past year. Final multivariate analysis suggested that after controlling for personal characteristics (e.g., age, ethnicity, gender and sexual orientation) and risk behaviors (e.g., sex trade involvement and personal hard drug use), higher exposure to network peers who used hard drugs (OR=8.83; 95% CI=2.31-33.64) and location at periphery (e.g., being isolates or cliques vs. being at the center) in the network (OR=2.20; 95% CI=1.26-3.81) was associated with elevated risks of engaging in concurrency.

Conclusions and Implications

Sexual concurrency is prevalent among homeless youth, which may further heighten their HIV risk. Our findings suggest that homeless youths’ positionality and risk exposure within social networks influence their participation in sexual concurrency. In addition, drop-in centers are widely used by homeless youth and are where peer relationships develop. Therefore, drop-in center based interventions that adopt a social network approach to reduce engagement in concurrency may be critical in decreasing homeless youths’ HIV risks. Specifically, HIV prevention programs at drop-in center settings should focus on addressing youths’ connection with peers who use hard drugs within the same centers. In addition, such prevention programs should also identify and target youth who are not fully integrated within social networks at drop-in centers (e.g., isolates and youth in small cliques).