Street youth in Los Angeles. Profile of a group at high risk for human immunodeficiency virus infection.

OBJECTIVE: To characterize an urban street youth population, their self-reported rates of drug use, and their involvement in behaviors that put them at risk for infection with the human immunodeficiency virus.
DESIGN: A brief structured interview was administered to 409 youths who had been living on the streets for 2 or more consecutive months, or who were fully integrated into the "street economy."
SETTING: Thirty percent of the sample were recruited from community-based service sites and 70% were recruited from street locations and at natural hangouts. PARTICIPANTS: Youths were aged 12 to 23 years; 74% were male, 48% were ethnic minorities, 72% were homeless, 14% were gang affiliated, 20% were involved in drug dealing, 43% were engaged in survival sex (ie, the exchange of a sexual favor for money, food, a place to stay, clothes, and/or drugs), and 40% were homosexual or bisexual.
RESULTS: Seventy percent of the youths were sexually active, with an average of 11.7 sexual partners (past 30 days). Youths with multiple sexual partners were more likely to have had a previous sexually transmitted disease (P < .01), to use drugs during sex (P < .001), and to be involved in survival sex (P < .001). Marijuana (55%), methamphetamine (62%), and crack (38%) were the drugs of choice, with 30% of the sample reporting injecting drug use (58% of this subset reported injecting drug use within the past 30 days). Substance-abusing youth were 3.6 times more likely to use drugs during sex, 2.2 times more likely to engage in survival sex, and 2.5 times more likely to have been diagnosed as having a sexually transmitted disease.
CONCLUSIONS: High-risk sexual and drug use behaviors were prevalent and interrelated in this urban street youth sample. This suggests the need for new and innovative educational promotions and prevention interventions targeted to this population.