Exploring the Relationship between Foster Care Experiences and HIV- Risk Behaviors Among a Sample of Homeless Former Foster Youth

Background: Reports estimate nearly 2 million unaccompanied homeless youth aged 13-24 in the United States each year. Nearly 40% of these youth were formerly a part of the foster care system. A body of research has reported elevated risk for HIV among foster and former foster youth. The accumulation of risk factors common to both homeless youth and former foster youth place this large population of homeless former foster youth in the nexus of life experiences that position them at extreme risk for engaging in a number of HIV risk behaviors, and necessitating an increase in intervention research to address the unique needs of this population. While interventions targeting HIV prevention efforts have focused on homeless youth, little research has focused on the impact of unique foster care experiences on HIV risk behaviors. Current studies have examined some HIV risk behaviors by foster care status, but limitations in the current data do not reflect the heterogeneity of foster care experiences. This analysis seeks to determine the relationship between foster care experiences on HIV risk behaviors among a sample of homeless former foster youth.

Methods: A sample of 184 homeless former foster youth living in Los Angeles participated in surveys exploring their foster care experiences, HIV risk behaviors, and social network experiences. Descriptive statistics were run to determine basic frequencies and means of foster care experiences and engagement in HIV-risk behaviors, while a series of logistic regressions were run to determine the nature of the relationship between foster care experiences and HIV risk behaviors.

Results: Results from the analysis indicated that long periods of time spent in care negatively impacted condom use. Conversely, older age of exit from foster care was related to reduced injection drug use. Finally, timing of homeless experiences provided some insight into risk factors for this population, in that, both drug use with sex and engagement in exchange sex were negatively impacted when homelessness was experienced before the youth exited foster care.

Discussion: This examination led to a number of new conclusions within the field of research on homeless former foster youth. A high number of youth reported extremely long periods of placement, and many youths reported homelessness upon transition out of foster care, whereas others reported their first experience of homelessness while still in foster care. Results also indicated that a number of foster care experiences directly impact HIV-risk behaviors. Those services targeting HIV-risk behaviors should consider the impact that foster care placements have on these behaviors, such as the risk factors associated with long placement periods or experiencing homelessness before exiting foster care, and the protective factors associated with exiting placement at an older age. On a policy level, these results indicate that a number of experiences during foster care should be addressed to reduce risk behaviors at a later time.