RESEARCH TOPICS

RESEARCH BY TOPIC

Considerable research has occurred in this area over the last two decades. One of the major focuses of the literature highlights the need for service providers to tailor intervention strategies to the diverse needs of specific sub-groups of street youths. For instance, in one study, the authors caution service providers against treating gay, lesbian or bisexual youth as an aggregate. They state that sexual health prevention programs must address the unique differences within these sub-groups of street youth.¹ Another study advocates the need for tailoring intervention strategies based on the age of the street youth population. According to the authors, "...early adolescent street youth have unique situations and needs that differ from those of older street youth," which can result in these adolescents lacking the skills necessary to survive street life. Accordingly, the authors recommend that special public health services be targeted to early adolescent street youth.² Another similar focus of research has related to the need for service providers to focus on gender-specific interventions.³

As a result of the dire consequences of HIV/AIDS and other illnesses such as hepatitis, much of the research has focused on prevention strategies. Knowledge and beliefs about HIV/AIDS varies amongst street youth and interventions must be considerate of this reality.⁴

Pregnancy prevention is also a focus of the literature in this area. According to one study, pregnancy prevention efforts should include specific strategies geared toward changing unsafe sexual behaviors, including condom distribution. As well, the authors suggest that as a result of the high rate of pregnancy in street youth, shelters and outreach programs should provide prenatal care or develop ties with community agencies that specialize in such services.⁵

"Survival sex" is a term often referred to in this area of research. Youth engaged in this behavior make them vulnerable to acquiring STDs and/or unintended pregnancies. One author advocates holistic nursing as an effective intervention with this population. Another study stresses the "...need to develop intensive and long-term services that provide alternatives to the sex trade as a means of meeting economic needs, as well as comprehensive counseling and treatment services to assist youths with drug addictions, mental health problems, and family problems."⁶ Independent living programs, which assist with employment and housing, are also recommended. Moreover, it is suggested that drop-in centers and outreach programs are more effective than traditional programs for youth who engage in survival sex.

Other sexual health interventions cited in the literature include peer based strategies, which have been reported to increase street youths' HIV knowledge.⁷ One study reported that intensive case management with youth is effective with HIV+ youth as well as with some youth whose behavior puts them at risk for HIV infection.⁸ The same study cautions that such intensive case management can take time, and as a result, the service provider in that study chose to keep its caseload numbers low and increase the time the case managers spent providing direct services to youth. The study also advocated for a flexible and responsive service system which responds to both the medical and other social service needs of its clients. Finally, a recent study has shown that cognitive behavioral intervention that focuses on skill building and education was more effective than treatment as usual in increasing condom use⁹.

_{¹L. Rew et. al, "Sexual Health Risks and Protective Resources in Gay, Lesbian, Bisexual , and Heterosexual Homeless Youth," Journal for Specialists in Pediatric Nursing, Vol. 10(1), pp. 11-19, March 2005.
²J. B. Unger, et. al, "Early Adolescent Street Youth: An Overlooked Population With Unique Problems and Service Needs," Journal of Early Adolescence, Vol. 18, No. 4, pp. 325-348, November 1998.
³L. Rew, et. al, "Outcomes of a Brief Sexual Health Intervention for Homeless Youth," Journal of Health Psychology, Vol. 12(5), pp. 818-832, 2007.
⁴L. Smith Wagner et. al, "A Snapshot of Homeless Youth in Seattle: Their Characteristics, Behaviors and Beliefs about HIV Protective Strategies," Journal of Community Health, Vol. 26, No. 3, pp. 219-232, June 2001. ⁵J. M. Greene and C.L. Ringwalt, "Pregnancy Among Three National Samples of Runaway and Homeless Youth," Journal of Adolescent Health, Vol. 23, No. 6, pp. 370-377, 1998.
⁶J.M. Greene et. al, "Prevalence and Correlates of Survival Sex Among Runaway and Homeless Youth," American Journal of Public Health, Vol. 89, No. 9, pp. 1406-1409, September 1999.
⁷R.E. Booth, et. al, "The Challenges of Changing Drug and Sex Risk Behaviors of Runaway and Homeless Adolescents," Child Abuse and Neglect, Vol. 23, No. 12, pp. 1295-1306, December 1999.
⁸A.D. Tenner, et. al, "Seattle YouthCare's prevention, intervention, and education program: A model of care for HIV-positive, homeless, and at-risk youth," Journal of Adolescent Health, Vol. 23, Issue 2, Supplement 1, pp. 96-106, August 1998.
⁹N. Slesnick et al., "The impact of an integrated treatment on HIV risk behavior among homeless youth: : A randomized controlled trial," Journal of Behavioral Medicine, 31(1), pp. 45-59, 2008.}