Sex Risk Among a Probability Sample of Homeless Youth in Los Angeles

Background: Los Angeles County has the largest number of homeless children and youth in the United States. There were approximately 226 homeless students in Los Angeles county school districts in the year of 2015 who potentially fall under the HUD definition of homeless. While studies have examined outcomes among homeless youth in schools, few studies have examined the impact of homeless status on sex risks among homeless high school students in a probability sample. This study examines instances of youth homelessness within a school setting, assessing rates of sex risk utilizing a probability sample of high school students in the Los Angeles Unified School District (LAUSD) who have experiences homelessness.

Methods: A supplemental questionnaire was distributed in conjunction with the 2015 administration of the Centers for Disease Control and Prevention’s (CDC) Youth Risk Behavior Survey (YRBS) in Los Angeles Unified School District (LAUSD) high schools. 2,326 students were selected through probability sampling of schools and students completed both general and supplemental questionnaires. Logistic regressions were run to examine the impact of homelessness on sex risk behaviors.

Results: Our results indicate that approximately 10% of the entire school sample experienced homelessness, with nearly half of the sample reporting being sexually active, but with low rates of STI testing and condom use. Results of the multivariate models indicated that any homeless experience was significantly associated with ever having had sex (OR=2.15, 95%CI=1.50,3.08), as well as an increased likelihood of having been tested for an STI (2.93, 95%CI=1.82, 4.70) and a decreased likelihood of having used a condom in the last 3 months (OR=.50, 95% CI=.29,.89).

Discussion: This study indicates while homeless youth were more likely to have been tested in the last 3 months, they were also more likely to have had sex at all, and less likely to have used a condom in the last 3 months. Interventions targeting sex education for homeless youth may need to account to their decreased use of condoms, while supporting their use of STI testing. Schools teaching sex education may need to take added measures to ensure that homeless students may have specific risk and resiliency factors where their sexual health is concerned compared to other students who are not experiencing homelessness.