title: Housing and sexual health among street-involved youth.
abstract: Street-involved youth (SIY) carry a disproportionate burden of sexually transmitted diseases (STD). Studies among adults suggest that improving housing stability may be an effective primary prevention strategy for improving sexual health. Housing options available to SIY offer varying degrees of stability and adult supervision. This study investigated whether housing options offering more stability and adult supervision are associated with fewer STD and related risk behaviors among SIY. A cross-sectional study was performed using public health survey and laboratory data collected from Toronto SIY in 2010. Three exposure categories were defined a priori based on housing situation: (1) stable and supervised housing, (2) stable and unsupervised housing, and (3) unstable and unsupervised housing. Multivariate logistic regression was used to test the association between housing category and current or recent STD. Secondary analyses were performed using the following secondary outcomes: blood-borne infection, recent binge-drinking, and recent high-risk sexual behavior. The final analysis included 184 SIY. Of these, 28.8 % had a current or recent STD. Housing situation was stable and supervised for 12.5 %, stable and unsupervised for 46.2 %, and unstable and unsupervised for 41.3 %. Compared to stable and supervised housing, there was no significant association between current or recent STD among stable and unsupervised housing or unstable and unsupervised housing. There was no significant association between housing category and risk of blood-borne infection, binge-drinking, or high-risk sexual behavior. Although we did not demonstrate a significant association between stable and supervised housing and lower STD risk, our incorporation of both housing stability and adult supervision into a priori defined exposure groups may inform future studies of housing-related prevention strategies among SIY. Multi-modal interventions beyond housing alone may also be required to prevent sexual morbidity among these vulnerable youth.
authors.affiliation: Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada. maya_k@email.com.|, 4007 Alabama Street, San Diego, CA, 92104, USA. maya_k@email.com.
authors.forename: Maya M
authors.initials: MM
authors.lastname: Kumar
authors.affiliation: Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
authors.forename: Rosane
authors.initials: R
authors.lastname: Nisenbaum
authors.affiliation: Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.|Department of Pediatrics, St. Michael's Hospital, Toronto, Canada.
authors.forename: Tony
authors.initials: T
authors.lastname: Barozzino
authors.affiliation: Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.|Department of Pediatrics, St. Michael's Hospital, Toronto, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Sgro
authors.affiliation: Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.|Department of Pediatrics, St. Michael's Hospital, Toronto, Canada.
authors.forename: Herbert J
authors.initials: HJ
authors.lastname: Bonifacio
authors.affiliation: Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.|Department of Pediatrics, St. Michael's Hospital, Toronto, Canada.
authors.forename: Jonathon L
authors.initials: JL
authors.lastname: Maguire
mesh_terms: D000293:Adolescent; D063425:Binge Drinking / Q000453:epidemiology; D017848:Blood-Borne Pathogens; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D018453:Homeless Youth / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D060728:Reproductive Health / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Homeless youth; Primary prevention; Residence characteristics; Sexual behavior; Sexually transmitted diseases