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PubMed1998

Substance use and risky sexual behavior among homeless and runaway youth.

PURPOSE: To (a) characterize human immunodeficiency virus (HIV)-related risk behaviors of homeless youth; (b) determine whether substance use is associated with risky sexual behavior in this population; and, if so, (c) explore explanations for this relationship. METHODS: A purposive sample of 327 homeless youth (ages 14-21 years) in Washington, DC, were surveyed in 1995 and 1996. Survey items were adapted from items used in a national study of adult substance use and sexual behavior and measured global (lifetime) and event-specific (most recent sexual encounter) behaviors. RESULTS: Sexual activity with many partners, "survival" sex, and substance use were common. However, needle use was rare, and consistent condom use was evident in half the sample. Nearly all correlations between global measures of substance use and risky sex were statistically significant, but only a few of the event-specific correlations were significant. Marijuana use during the most recent sexual encounter was associated with nonuse of condoms, but this relationship disappeared in the multivariate model. However, crack use during the last encounter was associated with condom use; this relationship remained significant in the multivariate model. Lack of motivation to use condoms, longer histories of sexual activity and homelessness, symptoms of drug dependency, not discussing HIV risks with partner, and being female were also associated with nonuse of condoms. CONCLUSIONS: Homeless youth do use condoms, even within the context of substance use and casual sex. Results suggest that prevention and targeted intervention efforts have had some positive effect on this population, but young homeless women are in need of targeted prevention. Finally, additional research is needed to investigate the observed relationship between crack use and condom use in this sample.

Adolescent↗
PubMed1998

Pregnancy among three national samples of runaway and homeless youth.

PURPOSE: To compare estimates of the prevalence of pregnancy among runaway and homeless youth between the ages of 14 and 17 years in various settings with each other and with youth in the general population. METHODS: Comparisons used three surveys of youth: (a) the first nationally representative survey of runaway and homeless youth residing in federally and nonfederally funded shelters, (b) a multicity survey of street youth, and (c) a nationally representative household survey of youth with and without recent runaway and homeless experiences. RESULTS: Youth living on the streets had the highest lifetime rates of pregnancy (48%), followed by youth residing in shelters (33%) and household youth (<10%). CONCLUSIONS: Shelter and street youth were at much greater risk of having ever been pregnant than were youth in households, regardless of whether they had recent runaway or homeless experiences. Such youth need comprehensive services, including pregnancy prevention, family planning, and prenatal and parenting services.

Adolescent↗
PubMed1996

Sexual abuse history and associated multiple risk behavior in adolescent runaways.

Relationships between sexual abuse and sexual risk, substance use, emotional distress, and conduct problems were examined among 190 runaways. Those who had been abused were significantly more likely than nonabused peers to engage in unprotected sex, have more sexual partners, and use alcohol and drugs, but did not differ in emotional distress. Those abused after age 13 were more often engaged in sex work than nonabused peers. Males abused before age 13 had more sexual partners than those not abused, and runaway males were significantly more likely to have been sexually abused than has been reported in prior research.

Adolescent↗
PubMed2004

Restorative health: lessening the impact of previous abuse and violence in the lives of vulnerable girls.

"Restorative health" is the idea that those who have been denied access to the social determinants of health, particularly as young children, should have the right to restoration of healthy functioning. In interviewing a group of vulnerable young women, ranging in age from 15 to 22, we discovered how they experience the link between health and justice in their lives. Participants were living on the street, in extreme poverty, or both. Traumatic early childhood events continued to affect their ability to function healthy. We conclude and suggest that certain rights-based principles need to ground the development of interventions with this group.

Adolescent↗
PubMed1996

The challenge of HIV prevention among high-risk adolescents.

This article reports findings from an exploratory study of HIV knowledge and risk behaviors among 60 teenagers and young men engaged in the street life of Hollywood, California. The sample was composed largely of youths of homosexual or bisexual orientation who were substance abusers, prostitutes, or both. The data suggest that although community-based education efforts may be associated with lower-risk behavior among this population, the overall risk profiles of these socially marginalized youths remained high. Inferences are drawn about the cofactors of risk that must be addressed and the education needed to enhance the health prospects of these youths.

Adolescent↗
PubMed1993

The nutritional status of children of displaced families in Beirut.

The nutritional status of children of displaced families in Greater Beirut was investigated in 1986 (a sample of 146 households) and in 1991 (137 households). Data on demographic variables, nutrient intake (calories, protein, and iron), and anthropometric measurements were collected. Iron intake was only 50-57% of the RDA for the 1-3 age group, and 35.6% and 32.0% of all children consumed < 60% of the RDA for iron in 1986 and 1991, respectively. Main sources of protein were dairy products, milk and eggs. The lower nutrient intake in 1991 compared to 1986 was negatively related to social class. Anthropometric measurements showed an increased past and recent undernutrition of the children in 1991 as compared to both the 1986 child sample and the NCHS standard child population. Severe inflation and marked increase in food prices were reflected in dietary intake and growth of the children. Food aid programmes, government subsidy of bread, and partial wage correction were possible stabilizing factors for the most destitute groups but not for the total population of displaced children.

Anthropometry↗
PubMed1995

Ever-pregnant and never-pregnant teens in a temporary housing shelter.

Adolescent pregnancy and childbearing are of national concern; documented sequelae are numerous and varied. The primary purpose of this cross-sectional study is to describe the differences in selected demographic, sociocultural, physiological, psychological, and cognitive variables among 136 ever-pregnant and never-pregnant teens residing in a temporary housing shelter. Teens who experienced a pregnancy had significantly higher chronological age, gynecological age, and school grade level in addition to reporting significantly greater histories of both rape and voluntary sexual activity than did never-pregnant teens. This study indicates that teen pregnancy is a major problem among adolescents in temporary housing shelters. Our findings provide guidance for clinical interventions and further research with this at-risk population.

Adolescent↗
PubMed1997

Prevalence of sexual risk behaviour and substance use among runaway and homeless adolescents in San Francisco, Denver and New York City.

We aim to assess the prevalence of HIV sexual risk behaviours and substance use among runaway and homeless adolescents in San Francisco, Denver and New York City. Survey data were examined from 775 runaway and homeless adolescents recruited from street settings and youth agencies during 1992/1993. Nearly all (98%) reported having engaged in sexual intercourse, of whom 49% first had intercourse by the age of 13. Condom use during all vaginal intercourse in the previous 3 months was reported by 42%. Among males, 23% indicated that they had exchanged sex for money, as did 14% of the females. Ninety-seven per cent had used alcohol or drugs and 21% had injected drugs. Overall, 75% reported having had sex while under the influence of alcohol or drugs. Systematic epidemiological studies of this population and the development of innovative interventions are essential to reduce the threat of HIV among runaway and homeless youth.

Adolescent↗
PubMed1997

Drug use in Nepal: the view from the street.

This study uses qualitative research techniques to examine heroin use in Nepal. It explores the life histories of 16 heroin users in Kathmandu, the country's capital, emphasizing those who are street children or who are otherwise displaced. The cases document that the initiation of use in Nepal is a complex process which includes: certain personality traits; an early history of culturally acceptable use of alcohol, tobacco, marijuana, or hashish; peer influence; and the specific social setting of users. Outside (i.e., foreign) influences are included in the mix, but never as a single determinant of drug use. Factors specific to the Nepali scene include the traditional association of forms of marijuana with certain religious contexts and the availability of heroin. An additional factor is the poverty of the urban setting. The approach in Nepal to dealing with drugs primarily involves a realization of the role played by the interaction between personality and social setting in the fullest meaning of that term.

Adolescent↗
PubMed1999

Primary multidrug-resistant tuberculosis--Ivanovo Oblast, Russia, 1999.

The incidence of tuberculosis (TB) in the Russian Federation has increased steadily from 34 per 100,000 population in 1991 to 78 per 100,000 in 1998 (Central Tuberculosis Research Institute, unpublished data, 1999). To reverse this trend, in 1995, federal and local governments, with assistance from the World Health Organization (WHO), implemented a pilot project using the WHO TB-control strategy of directly observed therapy, short-course (DOTS) in Ivanovo oblast (1998 population: approximately 1.3 million), a district 165 miles (280 km) northeast of Moscow. This report documents a substantial increase in primary multidrug-resistant TB (P-MDRTB) in the civilian population of Ivanovo from January 1996 through October 1998 and a high prevalence of alcoholism, previous incarceration, unemployment, and history of homelessness among persons infected with both drug-susceptible and drug-resistant Mycobacterium tuberculosis strains.

Adolescent↗
PubMedDate not supplied

Nutritional status of pavement dweller children of Calcutta City.

Pavement dwelling is likely to aggravate malnutrition among its residents due to extreme poverty, lack of dwelling and access to food and their exposure to polluted environment. Paucity of information about nutritional status of street children compared to that among urban slum dwellers, squatters or rural/tribal population is quite evident. The present study revealed the magnitude of Protein Energy Malnutrition (PEM) and few associated factors among a sample of 435 underfives belonging to pavement dweller families and selected randomly from clusters of such families, from each of the five geographical sectors of Calcutta city. Overall prevalence of PEM was found almost similar (about 70%) to that among other 'urban poor' children viz. slum dwellers etc., but about 16% of them were found severely undernourished (Grade III & V of IAP classification of PEM). About 35% and 70% of street dweller children had wasting and stunting respectively. Severe PEM (Grade III & IV) was more prevalent among 12-23 months old, girl child, those belonged to illiterate parents and housewife mothers rather than wage earners. It also did increase with increase of birth rate of decrease of birth interval.

Child, Preschool↗
PubMedDate not supplied

[Street children and AIDS in Haiti].

This study is a qualitative inquiry KAP about sexuality, and adoption and preservation of safe sexual behaviors, among the children of the street in Port-au-Prince, Haiti. Three groups of participating children of the street were observed in Port-au-Prince for three months, during June through August 1991. The information was collected with the use of pre-tested charts for each theme chosen. Then, individual interviews were conducted with leaders identified among the educators and children of the street. One of the main goals of Aids educational programs of street children should be to make them believe in the existence of the disease, and the real risk it poses for death. The strategies that we will use to convince them should deal with the different social, psychological, economical, and environmental factors that characterized the children as follows: 1) their adherence to a peer group and the relationship of power between the older and younger children; 2) the fundamental importance of money in their life, and that all relationships that they have are based on the capacity of people to give them something, such as money; 3) the role of their social appearance and their need to behave like other children for even one day; 4) their low self-esteem; 5) their feeling of powerlessness and resignation related to their living conditions; 6) the influence of the street culture; and 7) their understanding of sexuality as an immediate pleasure.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗