Abstract: Exchange Sex, Gender Identity, and Sexual Orientation Among Homeless Youth in Los Angeles (Society for Social Work and Research 23rd Annual Conference - Ending Gender Based, Family and Community Violence)

Schedule:

Friday, January 18, 2019: 11:15 AM

Union Square 17 Tower 3, 4th Floor (Hilton San Francisco)

* noted as presenting author

Ankur Srivastava, MPhil, PhD Student, University of Southern California, Los Angeles, CA

Joshua Rusow, MSW, PhD Candidate, University of Southern California, Los Angeles, CA

Monique Holguin, LCSW, PhD Student, University of Southern California, Los Angeles, CA

Sara Semborski, LCSW, Doctoral Student, University of Southern California, Los Angeles, CA

Eric Rice, PhD, Associate Professor, University of Southern California, Los Angeles, CA

Background and Purpose: In the United States, approximately 1.5 to 3 million youth experience homelessness each year. Some, because of their marginalized status and economic hardship, engage in survival sex in exchange for necessities such as food, money, shelter, or drugs. Additionally, a disproportionate number of gender minority youth (GMY) and sexual minority youth (SMY) experience homelessness each year. GMY and SMY youth experiencing homelessness also have particularly high rates of negative behavioral health problems (depression, anxiety, PTSD, suicide and substance use), and a range of HIV risk behaviors (e.g. condomless sex, sex under the influence of alcohol or drugs, exchange sex) compared to their heterosexual counterparts.

Methods: This study examined exchange and survival sex among GMY and SMY, and cisgender heterosexual homeless youth. In 2017, 253 homeless youth were interviewed from three different shelters in Los Angeles. Youth reported their demographics (age, sex, gender identity, sexual identity, race/ethnicity), engaging in exchange (for money) and survival sex (place to stay, food or meals, or anything else), number of sexual partners, having sex with someone living with HIV in last month. Multivariable regression analyses were conducted to assess the association between gender and sexual identity, and exchange sex outcomes for GSMY and heterosexual youth, adjusting for demographic characteristics.

Results: In this sample, 43.6% youth identified as sexual minority (gay, lesbian, bisexual, questioning) and 12.1% of the youth identified as gender minority (transman, transwoman, gender queer). GMY significantly differed in their reporting of ever engaging in exchange sex and survival sex compared to cisgender youth (exchange sex: 66.7% vs 33.3%; survival sex: 45.5% vs 23.3%). SMY significantly differed only in their reporting of ever engaging in exchange sex compared to their heterosexual counterparts (46.9% vs 27.3%). The multivariate model, identifying as GMY (AOR=5.00), SMY (AOR=2.60) having had sex with HIV positive person in last month (AOR=4.5), and older age (AOR=1.3) were significantly associated with engaging in exchange sex, after accounting for age, race and number of sexual partners. In the model for survival sex, GMY was only marginally associated with engaging in survival sex (p=.055), while having sex with a HIV positive person (AOR=6.9) and more number of sexual partners (AOR=1.4) were significant predictors of engaging in survival sex.

Conclusions and Implications: Programs and interventions at homeless shelters and service agencies must address higher rates of engaging in exchange and/or survival sex, and understand that the needs of GMY and SMY may be different from their cisgender and heterosexual peers. In addition, intervention among this group should focus on risk reduction strategies and crisis interventions, in relation to exchange and/or survival sex.