Bailey S L, Camlin C S, Ennett S T
Department of Psychiatry, University of Pittsburgh, Pennsylvania 15213, USA.
J Adolesc Health. 1998 Dec;23(6):378-88. doi: 10.1016/s1054-139x(98)00033-0.
To (a) characterize human immunodeficiency virus (HIV)-related risk behaviors of homeless youth; (b) determine whether substance use is associated with risky sexual behavior in this population; and, if so, (c) explore explanations for this relationship.
A purposive sample of 327 homeless youth (ages 14-21 years) in Washington, DC, were surveyed in 1995 and 1996. Survey items were adapted from items used in a national study of adult substance use and sexual behavior and measured global (lifetime) and event-specific (most recent sexual encounter) behaviors.
Sexual activity with many partners, "survival" sex, and substance use were common. However, needle use was rare, and consistent condom use was evident in half the sample. Nearly all correlations between global measures of substance use and risky sex were statistically significant, but only a few of the event-specific correlations were significant. Marijuana use during the most recent sexual encounter was associated with nonuse of condoms, but this relationship disappeared in the multivariate model. However, crack use during the last encounter was associated with condom use; this relationship remained significant in the multivariate model. Lack of motivation to use condoms, longer histories of sexual activity and homelessness, symptoms of drug dependency, not discussing HIV risks with partner, and being female were also associated with nonuse of condoms.
Homeless youth do use condoms, even within the context of substance use and casual sex. Results suggest that prevention and targeted intervention efforts have had some positive effect on this population, but young homeless women are in need of targeted prevention. Finally, additional research is needed to investigate the observed relationship between crack use and condom use in this sample.
(a) 描述无家可归青少年与人类免疫缺陷病毒 (HIV) 相关的风险行为；(b) 确定该人群中物质使用是否与危险性行为相关；如果相关，(c) 探究这种关系的原因。
1995年和1996年对华盛顿特区327名无家可归青少年（年龄在14至21岁之间）进行了一项有目的抽样调查。调查项目改编自一项关于成人物质使用和性行为的全国性研究中使用的项目，测量了总体（一生）和特定事件（最近一次性接触）行为。
与多个性伴侣发生性行为、“生存性”性行为和物质使用很常见。然而，使用针头的情况很少见，一半的样本中有明显的持续使用避孕套的情况。物质使用的总体测量指标与危险性行为之间几乎所有的相关性都具有统计学意义，但特定事件的相关性中只有少数是显著的。最近一次性接触期间使用大麻与不使用避孕套相关，但这种关系在多变量模型中消失了。然而，上次接触期间使用快克与使用避孕套相关；这种关系在多变量模型中仍然显著。缺乏使用避孕套的动机、更长的性活动和无家可归史、药物依赖症状、未与性伴侣讨论HIV风险以及女性身份也与不使用避孕套相关。
无家可归青少年即使在物质使用和随意性行为的背景下也会使用避孕套。结果表明，预防和针对性干预措施对该人群产生了一些积极影响，但年轻的无家可归女性需要针对性预防。最后，需要进一步研究调查该样本中观察到的快克使用与避孕套使用之间的关系。
