Research and Action for Youth Health
 

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Factors medicating the relations between street youths’ experiences of trauma and their HIV risk behaviors.

Abstract

This study examined factors mediating the relations between the traumatic experiences and HIV-related risk behaviours of 430 street-involved youths (12 to 18 years) surveyed in British Columbia, Canada. High rates of trauma, mental health difficulties, alcohol and marijuana use, hard drug use and HIV-related risk behaviours were observed among these youths. Factor analyses identified 4 clusters of HIV risk behaviours: risky sex (e.g., number of sexual partners, using drugs or alcohol before intercourse), street survival behaviours (e.g., sex trade work, sharing injection equipment), drug- and alcohol-related service use (e.g., drug or alcohol counseling) and needle-related service use (e.g., use of a needle exchange). Path analyses, which accounted for 10.7 to 67.9% of the variance in the 4 types of HIV risk behaviours, revealed that trauma had indirect effects on youths’ HIV risk behaviours. Specifically, more trauma was associated with greater use of alcohol and marijuana that was, in turn, associated with more risky sex. More trauma was also associated with more mental health problems, which was then related to more street survival behavious. Trauma also had direct effects on youths’ street survival behaviours and their use of drug- and alcohol-related services, suggesting that unidentified factors also mediate the impact of trauma on these behaviours. Finally, more hard drug use was associated with both more use of alcohol- and drug-related services and less use of needle-related services. The implications of these and other findings (e.g., moderating role of gender and Aboriginal status) for future research and HIV-related interventions for street youths are discussed.