Using Youth Participatory Research to Address Health Disparities

Sexually transmitted infections (STIs), including HIV, among homeless youth are a significant public health issue with STI rates among homeless youth being more than twice that of nonhomeless youth. Despite known risk factors, effective interventions for STI prevention and treatment for this population remain elusive. Evidence-based STI interventions targeted at adolescents typically encompass community or school-based, behavioral approaches; such approaches are a poor fit with a highly mobile population and do not address underlying social conditions that contribute to unsafe sexual behaviors such as survival needs, social norms, and access to health education.

This project is an exploratory study using a youth-participatory approach to determine the most effective methods in STI research with homeless youth as well as identifying key social and structural characteristics that will inform programs targeting this population in developing culturally-specific interventions that will increase protective sexual behavior and improve access to care. Four current and former homeless youths (2 males, 2 females, ages 19-21) were recruited as co-researchers and cultural informants and co-designed the study’s methodologies and instruments.

Preliminary data from focus groups (1^st phase) revealed several key themes: 1) mistrust of the healthcare system; 2) stigma and shame related to STIs; 3) concerns about confidentiality; and 4) lack of knowledge about insurance coverage. These findings support the need for more in-depth qualitative interviews with homeless youth to illuminate processes related to these concerns (2^ndphase). As a youth-participatory project, the research team also identified systems issues that posed challenges to a full academic-youth partnership.