TY - JOUR
T1 - Risk evaluations and condom use decisions of homeless youth
T2 - A multi-level qualitative investigation
AU - Kennedy, David P.
AU - Brown, Ryan A.
AU - Morrison, Penelope
AU - Vie, Loryana
AU - Ryan, Gery W.
AU - Tucker, Joan S.
N1 - Funding Information:
This research was supported by Grant R01DA020351 from the National Institute on Drug Abuse and Grant R24MD008818-01 from the National Institute on Minority Health and Health Disparities. We thank the youth who shared their experiences with us, the service agencies that collaborated in the study, Rick Garvey, Fred Mills, Dynette Streich, and Meghan Treese for their assistance in data collection and Andy Parker for assistance in developing the interview protocol.
Publisher Copyright:
©2015 Kennedy et al.; licensee BioMed Central.
PY - 2015/1
Y1 - 2015/1
N2 - Background: Homeless youth are at higher risk for sexually transmitted infections and unwanted pregnancy than non-homeless youth. However, little is known about how they evaluate risk within the context of their sexual relationships. It is important to understand homeless youths' condom use decisions in light of their sexual relationships because condom use decisions are influenced by relationship dynamics in addition to individual attitudes and event circumstances. It is also important to understand how relationship level factors, sexual event circumstances, and individual characteristics compare and intersect. Methods: To explore these issues, we conducted semi-structured interviews with 37 homeless youth in Los Angeles County in 2011 concerning their recent sexual relationships and analyzed the data using systematic methods of team-based qualitative data analysis. Results: We identified themes of risk-related evaluations and decisions at the relationship/partner, event, and individual level. We also identified three different risk profiles that emerged from analyzing how different levels of risk intersected across individual respondents. The three profiles included 1) Risk Takers, who consistently engage in risk and have low concern about consequences of risk behavior, 2) Risk Avoiders, who consistently show high concern about protection and consistently avoid risk, and 3) Risk Reactors, those who are inconsistent in their concerns about risk and protection and mainly take risks in reaction to relationship and event circumstances. Conclusions: Interventions targeting homeless youth should reflect multiple levels of risk behavior and evaluation in order to address the diversity of risk profiles. Relationship/partner-, event-, and individual-level factors are all important but have different levels of importance for different homeless youth. Interventions should be tailored to address the most important factor contributing to homeless youth reproductive needs.
AB - Background: Homeless youth are at higher risk for sexually transmitted infections and unwanted pregnancy than non-homeless youth. However, little is known about how they evaluate risk within the context of their sexual relationships. It is important to understand homeless youths' condom use decisions in light of their sexual relationships because condom use decisions are influenced by relationship dynamics in addition to individual attitudes and event circumstances. It is also important to understand how relationship level factors, sexual event circumstances, and individual characteristics compare and intersect. Methods: To explore these issues, we conducted semi-structured interviews with 37 homeless youth in Los Angeles County in 2011 concerning their recent sexual relationships and analyzed the data using systematic methods of team-based qualitative data analysis. Results: We identified themes of risk-related evaluations and decisions at the relationship/partner, event, and individual level. We also identified three different risk profiles that emerged from analyzing how different levels of risk intersected across individual respondents. The three profiles included 1) Risk Takers, who consistently engage in risk and have low concern about consequences of risk behavior, 2) Risk Avoiders, who consistently show high concern about protection and consistently avoid risk, and 3) Risk Reactors, those who are inconsistent in their concerns about risk and protection and mainly take risks in reaction to relationship and event circumstances. Conclusions: Interventions targeting homeless youth should reflect multiple levels of risk behavior and evaluation in order to address the diversity of risk profiles. Relationship/partner-, event-, and individual-level factors are all important but have different levels of importance for different homeless youth. Interventions should be tailored to address the most important factor contributing to homeless youth reproductive needs.
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U2 - 10.1186/s12889-015-1419-9
DO - 10.1186/s12889-015-1419-9
M3 - Article
C2 - 25636862
AN - SCOPUS:84924078199
SN - 1471-2458
VL - 15
JO - BMC Public Health
JF - BMC Public Health
IS - 1
M1 - 62
ER -