A Qualitative Study of Factors Facilitating Access to Housing in the Context of a Sexual and Reproductive Health Program for Youth Experiencing Homelessness

Background and Purpose: Holistic sexual and reproductive health programs for youth experiencing homelessness (YEH) are rare, but necessary. Wahine (“woman”) Talk is one such holistic program, and is a multilevel intervention delivered out of a youth drop-in center in Honolulu, HI. One of Wahine Talk’s core components is addressing basic needs, which includes linkage to housing services. Given the risk associated with survival sex and other forms of sexual exploitation among YEH, often used in an attempt to meet basic needs including securing a place to stay, addressing housing as part of a holistic approach to sexual and reproductive health is critical. Little research exists on the role of linkage to housing in addressing sexual and reproductive health programs for YEH. This study aims to help fill this gap by exploring the factors that facilitate access to housing for YEH specifically in the context of an innovative holistic sexual and reproductive health program (Wahine Talk).

Methods: The study team collected in-depth qualitative data through three focus groups with interdisciplinary teams of Wahine Talk providers, four focus groups with youth participants, and 25 individual interviews with youth participants (total participants included seven Wahine Talk providers and 35 youth participants, aged 14-22 years). Transcripts were then analyzed by multiple team members using a structured, six step thematic analysis process. The team first familiarized itself with the data and generated initial codes individually. Then, the team collaborated to search for, review, define, and name themes. Study rigor was enhanced through triangulation of data sources, regular peer debriefing, and member checking with Wahine Talk providers.

Findings: Thematic analysis revealed that access to housing was facilitated for the youth participants by the following factors: (1) having staff that the youth trust, (2) one-on-one hours with staff focused on getting to know the youth and working collaboratively on addressing housing needs, and (3) if needed, the availability of additional, specialized staff support via an in-house Youth Housing Placement and Retention Specialist, who was part of the larger youth drop-in center. While the youth generally did not have suggestions to improve the housing linkage services, the providers agreed it would be beneficial to have a dedicated Housing Specialist as part of the Wahine Talk team who could help the youth navigate the often complex application processes associated with various types of public housing and housing voucher programs in Hawai’i.

Conclusions and Implications: The findings highlight the importance of staffing as it relates to facilitating access to housing through a holistic sexual and reproductive health program, especially given their role in building trust with the youth participants and allowing open, honest communication. By identifying appropriate and specialized housing staff, and allowing more one-on-one staff-participant hours, program staff can help youth get linked to housing. Further research is needed on the role housing can play in improving sexual and reproductive health among YEH.