Sexual Health Risk Among Gang-Involved Youth: Ensuring Services Are Sensitive to Marginality and Adversity Experiences

Background/Purpose: Many gang-involved youth experience social and economic marginalization, fueling greater health risk conditions and behaviors. Sexual health risk in particular may be heightened for gang-involved youth, placing them in vulnerable positions for other adverse health outcomes (Nydegger et al., 2017; Wesche & Dickson-Gomez, 2019). Little is known about how sexual orientation, sexual behavior and decision-making varies among gang-involved youth, including factors that influence vulnerability to sexual health risk. As youth gang involvement continues to grow (Pyrooz & Sweeten, 2015), so do the health disparities faced by this population. Service approaches may benefit from more systematic assessment of sexual variability and contextual influences. Accordingly, this study tests for patterns of sexual risk among gang-involved youth, and how profiles vary according to sexual orientation diversity and factors theorized to increase sexual health vulnerability. Findings hold important implications for aligning services to address sexual health risk while also aimed at reducing vulnerability to adverse health outcomes.

Methods: Data come from a state-wide survey of self-identified gang-involved students in the 8^th, 10^th, and 12^th grades (N=2,052). The sample was racially/ethnically diverse, 61% male, 79% heterosexual, and on average 15.13 (SD=1.63) years old. Latent class analysis using indicators of age of first sex, number of sexual partners, condom use, and receiving sexual photos tested for classes of gang-involved youth respective to their sexual behavior profiles. Guided by a sexual health vulnerabilities framework (Miller et al., 2011) chi-square tests examined group differences across vulnerabilities linked to adolescent sexual health (e.g., socioeconomic adversity, substance use, victimization) and demographic characteristics.

Results: Based on model fit (AIC, BIC), a 4-class solution emerged: Non-Sexually Active (54%); Single Partner with Condom Use (23%); Multiple Partner with Sexting (9%); and Sexual Risk-Taking (13%). The Non-Sexually Active youth were younger, had more youth identifying as female and heterosexual, had fewer vulnerabilities, and the most sex education. Comparatively, Single Partner youth were higher than Non-Sexually Active in vulnerability indicators but consistently lower than the remaining sexually active classes. The Sexual Risk-Taking and Multiple Partners youth were older, had more youth identifying as bisexual, and consistently highest in other vulnerabilities. Although similar in substance use and victimization experiences, Multiple Partners youth experienced higher family/housing instability.

Conclusions/Implications: Findings provide valuable insight into the sexual health risks faced by gang-involved youth, highlighting the need for services sensitive to the intersecting experiences of marginality and adversity faced by this population. Particularly striking were very high levels of multi-form risk exposure across the sexually active classes, including housing instability, substance use and partner victimization. Further, this is one of the first studies to examine the diversity and patterning of sexual orientation among gang-involved youth. Contrary to prevailing perceptions, heterosexuality within the gang subculture is not universal, and those who identify otherwise may be at particularly heightened vulnerability for sexual health risk. Addressing health disparities for gang-involved youth requires research and practice to expand current conventional approaches. Focusing on developmental features of adolescence and the marginalizing experiences that make these youth vulnerable to health risks will be discussed.