Influence of “Traveling” Youth and Substance Use Behaviors in the Social Networks of Homeless Youth

Background: Travelers are a sub-population of homeless youth who constantly migrate from city to city, staying several days to a few months in a given city. These travelers exhibit particularly higher levels of risky substance use behaviors than non-travelers. However, to date, no study has examined how travelers are impacting substance use behaviors of their peers within a bounded network of homeless youth. The current study filled this gap by using sociometric (population-level network) data, which allowed us to examine how travelers are connected to other travelers and non-travelers, and how connections to travelers are associated with substance use behaviors of traveling and non-traveling youth.

Methods: 386 homeless youth at two drop-in centers in Los Angeles, CA, participated in a self-administered survey and a social network interview between October 2011 and February 2012. Past month binge drinking (5 or more drinks within 2 hours), marijuana use, hard drug use, multiple drug use (marijuana and at least one hard drug) and injection drug use were measured based on participants’ self-reports. Chi-square tests compared substance use behavior by traveler status and by networks with travelers. Multivariable logistic regressions indicated the correlates of risky behaviors for each substance.

Results: Homeless youth in this study were 16 to 29 years old, 71.0% males, 35.8% White, and 30.4% travelers. Travelers engaged in significantly more binge drinking (χ²=16.44, p<.001) marijuana (χ²=21.85, p<.001), hard drug (χ²=6.87, p<.01), multiple drug (χ²=9.40, p<.01), and injection drug (χ²=8.37, p<.01) use than non-travelers during the past month. Likewise, youth connected to travelers were more likely to use all substances than those who were not connected to travelers. Only connections to substance-using travelers, not ties with all travelers, were significantly associated with one’s binge drinking (OR=3.13, 95% CI=1.79, 5.47), marijuana (OR=2.70, 95% CI=1.40, 5.19), and injection drug use (OR=4.34, 95% CI=1.90, 9.93).

Discussion: Findings of this study highlight the need for harm-reduction based, substance use prevention services using network-level interventions that target travelers. One effective strategy is to focus particularly on substance-using travelers, as they are a potential source of negative influence to their peers. Thus, we propose training non-travelers who are not substance users to build a bridge to services to high-risk traveling youth. To prevent these low-risk non-travelers from using substances, we will need to consistently provide support and other services to them.