A risk profile of street youth in northern California: implications for gender-specific human immunodeficiency virus prevention.

PURPOSE: To assess human immunodeficiency virus (HIV) risk behaviors of street youth and to determine whether risk behaviors differ by gender or housing status.
METHODS: Using systematic street-based sampling in four Northern California cities, we recruited 429 street youth (mean age = 19.2 years). Participants completed a structured interview which was used to assess sexual and drug HIV risk behaviors.
RESULTS: The majority of youth were heterosexual (85%), white (77%), male (68%), and currently without any type of stable housing (75%). Although 60% of the sample had had vaginal sex in the past 30 days, only 44% used a condom the last time they had sex. About one-third (32%) of the sample reported ever injecting drugs, and almost all reported lifetime use of multiple drugs including D-lysergic acid diethylamide (96%), marijuana (90%), alcohol (81%), cocaine (70%), and speed (70%). Compared to males, females were equally likely to use injection and noninjection drugs, but were more likely to be sexually active (P < .001), were more likely to have been diagnosed with a sexually transmitted disease (P = .005), and were less likely to report consistent condom use (P = .003) or intent to use condoms consistently in the future (P = .005). Compared with those with stable housing, youth who were currently without such housing reported higher rates of injection, and other drug use; females without stable housing were less likely to have used condoms the last time they had vaginal intercourse.
CONCLUSION: The high level of HIV risk behavior in this street-based sample of youth, particularly females and youth without stable housing, suggests an urgent need for gender-specific prevention efforts and an increased range of housing options.