Risk Behaviors and Sexual Health in The Context of Homelessness Discrimination in an Urban Sample of Youth Experiencing Homelessness

Homelessness among youth in urban areas carries specific challenges because so many come from different geographic regions hoping for opportunities, but instead encounter added problems. Discrimination based on homelessness is a problem that has only recently been explored in youth experiencing homelessness (YEH). Discrimination based on different facets of one’s identity, including homelessness, is associated with health disparities, like sexually transmitted infections (STIs), including HIV. Our study explores the relationship between homelessness discrimination and risky sexual health behaviors among 147 urban YEH. Primarily non-white, YEH in our sample were an average age of 21 years old. We defined risky sexual behaviors as lack of contraceptive use and substance use. There was a significant direct path between discrimination and risky sexual behavior, with those reporting more discrimination also reporting being less likely to use contraception. There was also an indirect effect of discrimination on contraceptive use through depressive symptoms, suggesting that discrimination is associated with more risky sexual behavior by way of depressive symptoms. Higher levels of discrimination were directly associated with lower levels of risky substance use, as were higher levels of depressive symptoms. The direct path between discrimination and risky substance was moderated by age. In light of these findings, we argue that urban communities should be focused on reducing acts of discrimination and stigma around homelessness and improving access to housing. Resolving these urban social problems may go a long way in reducing large public health problems like STIs and the HIV epidemic.