Living outside the bubble: Homelessness experiences and the impact on sexual risk behaviors among Los Angeles public school students "S/A"

Introduction: Homeless youth are more likely to engage in risky sexual behaviors than domiciled youth. However, comparisons are largely made post-hoc by contrasting community-based samples of homeless youth, to school-based, probability samples of teens, such as the CDC's Youth Risk Behavior Survey (YRBS). We surveyed a random sample of Los Angeles Unified School District (LAUSD) public high school students to assess how many youth experienced homelessness in the prior 12 months, and whether the type of homelessness experience (i.e., spending the night in a shelter, a public place, or with a stranger) impacted the youths' sexual risk behavior. Methods: A supplemental survey to the YRBS containing questions regarding homelessness was administered to LAUSD high school students (N=1,823). Multivariate logistic regressions assessed the associations between types of homelessness experiences and being sexually active, and condom use at last sexual encounter. Results: LGBT and Black youth were less likely to use a shelter, and were more likely to be sexually active. Youth who spent the night with a stranger were 3.6 times more likely to be sexually active. Youth who spent the night at a shelter were 1.7 times more likely to use a condom at last sex, and youth who spent the night with a stranger were 44% less likely to use a condom. Implications: Shelters are protective for homeless youth. Certain groups of youth (e.g., LGBT youth) may be reluctant to use shelters due to perceived stigma and discrimination. Outreach should focus on reducing real or perceived barriers in shelters.