Exploring the Relationship Between Foster Care Experiences and HIV Risk Behaviors Among a Sample of Homeless Former Foster Youth
Abstract
Recent research shows high rates of poor behavioral health outcomes among homeless former foster youth, including increased risk for HIV-risk behaviors. In the current study, data were collected from 184 youth at drop-in centers in Los Angeles using behavioral health questionnaires to explore the relationships between specific aspects of foster care experiences and engagement in HIV-risk behaviors. Results indicated that youth whose first homelessness experience occurred before leaving foster care were significantly more likely to engage in drug use with sex and exchange sex than those whose first homelessness experience occurred after leaving foster care. Intervention services targeting HIV-risk behaviors should consider the aspects of foster care placements that may increase the risk of these behaviors, such as long periods of placement or experiencing homelessness before exiting foster care, as well as those that may decrease the risk of these behaviors, such as exiting placement at an older age.
Keywords
Foster youth HIV risk Homeless youth Risk behaviorsNotes
Funding
This study was funded by NIMH F31MH112251.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
References
- 1.National Alliance to End Homelessness. The state of homelessness in America. 2017.Google Scholar
- 2.Reilly T. Transition from care: status and outcomes of youth who age out of foster care. Child Welf. 2003;82(6).Google Scholar
- 3.Courtney ME, Piliavin I, Grogan-Kaylor A, Nesmith A. Foster youth transitions to adulthood: Outcomes 12 to 18 months after leaving out-of-home care. Madison: School of Social Work, University of Wisconsin-Madison; 1998.Google Scholar
- 4.Roman NP, Wolfe P. Web of failure: the relationship between foster care and homelessness. Washington, DC: National Alliance to End Homelessness; 1995.Google Scholar
- 5.Dworsky A, Dillman KN, Dion R, Coffee-Borden B, Rosenau M. Housing for youth aging out of foster care: a review of the literature and program typology. Washington, DC: U.S. Department of Housing and Urban Development Office of Policy Development and Research; 2012.Google Scholar
- 6.Hudson A, Nandy K. Comparisons of substance abuse, high-risk sexual behavior and depressive symptoms among homeless youth with and without a history of foster care placement. Contemp Nurse. 2012;42(2):178–86.CrossRefGoogle Scholar
- 7.Courtney ME, Dworsky AL, Cusick GR, Havlicek J, Perez A, Keller TE. Midwest evaluation of the adult functioning of former foster youth: outcomes at age 21. Chicago: Chapin Hall Center for Children at the University of Chicago; 2007.Google Scholar
- 8.Brook J, Rifenbark GG, Boulton A, Little TD, McDonald TP. Risk and protective factors for drug use among youth living in foster care. Child Adolesc Soc Work J. 2015;32(2):155–65.CrossRefGoogle Scholar
- 9.Carpenter SC, Clyman RB, Davidson AJ, Steiner JF. The association of foster care or kinship care with adolescent sexual behavior and first pregnancy. Pediatrics. 2001;108(3):e46.CrossRefGoogle Scholar
- 10.DiClemente RJ, Crittenden CP, Rose E, Sales JM, Wingood GM, Crosby RA, Salazar LF. Psychosocial predictors of HIV-associated sexual behaviors and the efficacy of prevention interventions in adolescents at-risk for HIV infection: what works and what doesn’t work? Psychosom Med. 2008;70(5):598–605.CrossRefGoogle Scholar
- 11.Vaughn MG, Ollie MT, McMillen JC, Scott L Jr, Munson M. Substance use and abuse among older youth in foster care. Addict Behav. 2007;32(9):1929–35.CrossRefGoogle Scholar
- 12.White CR, O’Brien K, White J, Pecora PJ, Phillips CM. Alcohol and drug use among alumni of foster care: decreasing dependency through improvement of foster care experiences. J Behav Health Serv Res. 2008;35(4):419–34.CrossRefGoogle Scholar
- 13.Yoshioka-Maxwell A, Rice E, Rhoades H, Winetrobe H. Methamphetamine use among homeless former foster youth: the mediating role of social networks. J Alcohol Drug Depend. 2015;3(2):197.Google Scholar
- 14.Jones L. Measuring resiliency and its predictors in recently discharged foster youth. Child Adolesc Soc Work J. 2012;29(6):515–33.CrossRefGoogle Scholar
- 15.Ahrens KR, Richardson LP, Courtney ME, McCarty C, Simoni J, Katon W. Laboratory-diagnosed sexually transmitted infections in former foster youth compared with peers. Pediatrics. 2010;126.Google Scholar
- 16.Benjet C, Borges G, Medina-Mora ME, Méndez E. Chronic childhood adversity and stages of substance use involvement in adolescents. Drug Alcohol Depend. 2013;131(1–2):85–91.CrossRefGoogle Scholar
- 17.Black MM, Oberlander SE, Lewis T, Knight ED, Zolotor AJ, Litrownik AJ, Thompson R, Dubowitz H, English DE. Sexual intercourse among adolescents maltreated before age 12: a prospective investigation. Pediatrics. 2009;124(3):941–9.CrossRefGoogle Scholar
- 18.Kerr T, Stoltz JA, Marshall BD, Lai C, Strathdee SA, Wood E. Childhood trauma and injection drug use among high-risk youth. J Adolesc Health. 2009;45(3):300–2.CrossRefGoogle Scholar
- 19.Schilling EA, Aseltine RH, Gore S. Adverse childhood experiences and mental health in young adults: a longitudinal survey. BMC public health. 2007;7(1):30.CrossRefGoogle Scholar
- 20.Barman-Adhikari A, Hsu HT, Begun S, Portillo AP, Rice E. Condomless sex among homeless youth: the role of multidimensional social norms and gender. AIDS Behav. 2017;21(3):688–702.CrossRefGoogle Scholar
- 21.Rew L, Taylor-Seehafer M, Thomas N. Without parental consent: conducting research with homeless adolescents. J Spec Pediatr Nurs. 2000;5(3):131–8.CrossRefGoogle Scholar
- 22.Boyer CB, Greenberg L, Chutuape K, Walker B, Monte D, Kirk J, Ellen JM. Adolescent Medicine Trials Network Exchange of sex for drugs or money in adolescents and young adults: an examination of sociodemographic factors, HIV-related risk, and community context. J Community Health. 2017;42(1):90–100.CrossRefGoogle Scholar
- 23.Nyamathi A, Hudson A, Greengold B, Leake B. Characteristics of homeless youth who use cocaine and methamphetamine. Am J Addict. 2012;21(3):243–9.CrossRefGoogle Scholar
- 24.Collins ME, Spencer R, Ward R. Supporting youth in the transition fromfoster care: formal and informal connections. Child Welf. 2010;89(1):125–43.Google Scholar
- 25.Courtney ME, Dworsky A. Early outcomes for young adults transitioning from out-of-home care in the USA. Child Fam Soc Work. 2006;11(3):209–19.CrossRefGoogle Scholar
- 26.Newton RR, Litrownik AJ, Landsverk JA. Children and youth in foster care: disentangling the relationship between problem behaviors and number of placements. Child Abuse Negl. 2000;24(10):1363–74.CrossRefGoogle Scholar
- 27.Rice E. HIV risks in large social networks of homeless youth [data file]. Los Angeles: University of Southern California, School of Social Work; 2012.Google Scholar
- 28.Yoshioka-Maxwell A. Former foster youth typology of risk: pre-existing risk factors and homelessness. St. Paul, MN: CW360°:The Impact of Housing and Homelessness on Child Well-Being; 2017.Google Scholar
- 29.Yoshioka-Maxwell AC, Rhoades H, Rice E, Winetrobe H. Homeless Young adults with and without a history of foster care: correlates of sexual risk behavior. J Sex Reprod Med, in press.Google Scholar
- 30.Barman-Adhikari A, Hsu HT, Begun S, Portillo AP, Rice E. Condomless sex among homeless youth: the role of multidimensional social norms and gender. AIDS Behav. 2017;21(3):688–702.CrossRefGoogle Scholar
- 31.Brener ND, Collins JL, Kann L, Warren CW, Williams BI. Reliability of the youth risk behavior survey questionnaire. Am J Epidemiol. 1995;141(6):575–80.CrossRefGoogle Scholar
- 32.SAS Institute Inc. Base SAS® 9.3 procedures guide. Version 9. Cary, NC: SAS; 2017.Google Scholar
- 33.Courtney ME, Terao S, Bost N. Midwest evaluation of the adult functioning of former foster youth: conditions of youth preparing to leave state care. Chicago: Chapin Hall Center for Children at the University of Chicago; 2004.Google Scholar
- 34.Haley N, Roy É, Leclerc P, Boudreau JF, Boivin JF. HIV risk profile of male street youth involved in survival sex. Sex Transm Infect. 2004;80(6):526–30.CrossRefGoogle Scholar
- 35.Solorio MR, Rosenthal D, Milburn NG, Weiss RE, Batterham PJ, Gandara M, Rotheram-Borus MJ. Predictors of sexual risk behaviors among newly homeless youth: a longitudinal study. J Adolesc Health. 2008;42(4):401–9.CrossRefGoogle Scholar
- 36.Tucker JS, Wenzel SL, Golinelli D, Kennedy DP, Ewing B, Wertheimer S. Understanding heterosexual condom use among homeless men. AIDS Behav. 2013;17(5):1637–44.CrossRefGoogle Scholar
- 37.Young SD, Rice E. Online social networking technologies, HIV knowledge, and sexual risk and testing behaviors among homeless youth. AIDS Behav. 2011;15(2):253–60.CrossRefGoogle Scholar
- 38.Yoshioka-Maxwell A, Rice E. Exploring the impact of network characteristics on substance use outcomes among homeless former foster youth. Int J Public Health. 2017;62(3):371–8.CrossRefGoogle Scholar
- 39.Braciszewski JM, Wernette GK, Moore RS, Bock BC, Stout RL, Chamberlain P. A pilot randomized controlled trial of a technology-based substance use intervention for youth exiting foster care. Child Youth Serv Rev. 2018;94:466–76.CrossRefGoogle Scholar
- 40.Rana Y, Brown RA, Kennedy DP, Ryan GW, Stern S, Tucker JS. Understanding condom use decision making among homeless youth using event-level data. j Sex Res. 2015;52(9):1064–74.CrossRefGoogle Scholar