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CORK Bibliography: Adolescent Homeless and Runaways

32 citations. January 2009 to present

Prepared: March 2012

Altena AM; Brilleslijper-Kater SN; Wolf JLM. Effective interventions for homeless youth: A systematic review. American Journal of Preventive Medicine 38(6): 637-645, 2010. (53 refs.)

Context: To date, there has not been clear evidence regarding interventions that are effective in addressing the specific needs of homeless youth. A systematic and comprehensive international review on effective interventions for homeless youth is presented. This study seeks to provide an accurate and complete picture of effective interventions for homeless youth by collecting, summarizing, categorizing, and evaluating quantitative studies (i.e., those that have assessed treatment outcomes). Evidence acquistion: The following databases were searched in 2008: PsycINFO, ERIC, MEDLINE, and Cochrane were searched from 1985 through 2008 using specific key words: interventions and programs, with homeless youth (s), homeless adolescents, street youth (s), runaways and throwaways. In addition, references of key articles were searched by hand. Eleven studies met preestablished inclusion criteria. To determine study quality, a set of operational parameters was formulated to rate each study as either good, fair, or poor. Evidence synthesis: There is no compelling evidence that specific interventions are effective for homeless youth, owing to moderate study quality and the small number of intervention studies. Conclusions that can be drawn from the studies are limited by the heterogeneity of interventions, participants, methods, and outcome measures. Many interventions focused on reduction of substance abuse, whereas other important outcomes, such as quality of life, have received little attention. No study received a quality rating of good, and four studies were rated as fair. Most convincing, but still marginal, were results of interventions based on cognitive-behavioral approaches, which revealed some positive results on psychological measures. Conclusions: More methodologically sound research is needed to determine what specific interventions are beneficial for subgroups of homeless youth. Implications for future research are discussed.

Copyright 2010, Elsevier Science

Bal B; Mitra R; Mallick AH; Chakraborti S; Sarkar K. Nontobacco substance use, sexual abuse, HIV, and sexually transmitted infection among street children in Kolkata, India. Substance Use & Misuse 45(10): 1668-1682, 2010. (30 refs.)

A community-based cross-sectional study among 554 Kolkata city street children assessed nontobacco substance use and sexual abuses along with human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) during 2007, using conventional cluster sampling technique for "hard-to-reach population" with a field-tested questionnaire and the collection of a blood sample for HIV and syphilis serology testing as a composite indicator of STIs. The reported prevalence of nontobacco substance use was 30%; 9% reported having been sexually abused. Some factors (age, lack of contact with family, orphan children, night stay at public place, etc.) were documented to be associated with substance use and sexual abuses. Seroprevalence of HIV was found to be 1% and that of STIs was 4%. This 1% HIV seroprevalence in street children is a matter of concern. Community-based intervention is necessary for them. The study's limitations are noted.

Copyright 2010, Taylor & Francis

Champion JD. Context of sexual risk behaviour among abused ethnic minority adolescent women. International Nursing Review 58(1): 61-67, 2011. (37 refs.)

Background: Evidence suggests that multiple influences on sexual behaviour of adolescents exist, ranging from relationships with significant others including sexual or physical abuse and childhood molestation to substances used prior to sex and environmental circumstances such as sex work. Purpose: This study aims to describe associations between childhood molestation and sexual risk behaviour. Method: African American and Mexican American adolescent women aged 14-18 years (n = 562) with sexually transmitted infection (STI) or abuse histories and enrolled in a randomized controlled trial of behavioural interventions were interviewed via self-report concerning sexual risk behaviour, abuse and childhood molestation at study entry. Results: Sexual (59%), physical (77%) and psychological (82%) abuse and childhood molestation (25%) were self-reported without differences by ethnicity. Adolescents reporting childhood molestation experienced more forms of sexual, physical and psychological abuse than others and higher incidences of STI. Fewer attended school; however, more had arrests, convictions, incarcerations and probations. Stressors including depression, running away, thoughts of death and suicide were highest for those reporting childhood molestation. Those reporting childhood molestation engaged in higher sexual risk behaviours than adolescents experiencing other forms of sexual or physical abuse (lifetime partners, bisexual relationships, anal and group sex, sex with friends with benefits, sex for money, concurrent partners, drug use including multiple substances, alcohol use and alcohol problems). These adolescents reported 'getting high' and having sex when out of control as reasons for sex with multiple partners. Conclusion: Interventions for abused adolescent women necessitate a focus on associations between childhood molestation and a multiplicity of sexual risk behaviours for prevention of abuse, substance use and sex work, STI/human immunodeficiency virus (HIV) and sequelae.

Copyright 2011, Wiley-Blackwell

Crawford DM; Whitbeck LB; Hoyt DR. Propensity for violence among homeless and runaway adolescents: an event history analysis. Crime & Delinquency 57(6): 950-968, 2011. (43 refs.)

Little is known about the prevalence of violent behaviors among homeless and runaway adolescents or the specific behavioral factors that influence violent behaviors across time. In this longitudinal study of 300 homeless and runaway adolescents aged 16 to 19 at baseline, the authors use event history analysis to assess the factors associated with acts of violence over 3 years, controlling for individual propensities and time-varying behaviors. Results indicate that females, nonminorities, and nonheterosexuals were less likely to engage in violence across time. Those who met criteria for substance abuse disorders (i.e., alcohol abuse, alcohol dependence, drug abuse) were more likely to engage in violence. A history of caretaker abuse was associated with violent behaviors, as were street survival strategies such as selling drugs, participating in gang activity, and associating with deviant peers. Simply having spent time directly on the streets at any specific time point also increased the likelihood for violence.

Copyright 2011, Sage Publications

de Moura YG; Sanchez ZV; Noto AR. Diversity of contexts in drug use among street adolescents. Qualitative Health Research 20(9): 1241-1253, 2010. (32 refs.)

In this study we aimed to investigate through ethnographic methods the different contexts of drug use by street adolescents in Sao Paulo, Brazil. Participant observations and semistructured interviews were performed at 11 major points of adolescent concentration in the streets of the city and in 10 care institutions. The sample was composed of 17 adolescents between 12 and 17 years of age. Data showed diverse patterns of drug use distributed by geographic situation and street circumstances. Observations were grouped into three main contexts: (a) immersion: greater intensity of drug use associated with greater involvement in the street culture; (b) surface: less drug use associated with family closeness; and (c) alternative-migratory: greater involvement with drug trafficking and prostitution associated with less family closeness and street culture. The drug use patterns varied in accordance with the diversity of street situations. Therefore, the peculiarities of each context should be taken into consideration in the development of social/health policies.

Copyright 2010, Sage Publications

Elkoussi A; Bakheet S. Volatile substance misuse among street children in upper Egypt. Substance Use & Misuse 46(Supplement 1): 35-39, 2011. (19 refs.)

This work assessed the extent, patterns, attitudes, motivations, and impacts of volatile substance misuse (VSM) among street children in Upper Egypt. In 2009, a 36-item questionnaire was administered to a randomly selected sample of 120 street children aged 10-18 years. Nearly 91%% (n = 109) reported misusing products containing volatile substances because they are inexpensive, legal, and easy to acquire. Familial neglect and lack of supervision were the main social motivations reported by street youth for misusing volatile substances. One-third (34.2%%, n = 41) reported inhaling "Kolla," a commercial glue; this study identifies its physicochemical, neuropharmacological, and toxicological properties. The study's limitations are noted.

Copyright 2011, Informa Healthcare

Ferguson KM; Bender K; Thompson S; Xie B; Pollio D. Correlates of street-survival behaviors in homeless young adults in four US cities. American Journal of Orthopsychiatry 81(3): 401-409, 2011. (49 refs.)

This study assessed the prevalence and correlates of behaviors used by homeless young people to survive on the streets. Survival behaviors include prostitution, selling blood or plasma, dealing drugs, stealing, and panhandling. One hundred ninety-six homeless young adults from 4 metropolitan areas-Los Angeles, CA (n = 50); Austin, TX (n = 50); Denver, CO (n = 50); and St. Louis, MO (n = 46)-participated in individual, semistructured, face-to-face interviews. Researchers predicted that youth transience would be related to high rates of survival behaviors. Multivariate logistic regression was used to test a model predicting relationships between survival behaviors and transience, employment, substance use, and social support. Young adults who were transient, unemployed, drug-addicted, and reliant on peers for help were more likely to use these survival behaviors. In addition, among the transient subsample, being White, more reliant on peers for help, more transient, and having been victimized were associated with high use of these survival behaviors. Identification of the environmental and demographic factors associated with survival behaviors suggests that there may be value in combining harm-reduction strategies with efforts to reduce the transience of homeless young adults.

Copyright 2011, Wiley-Blackwell

Gomez R; Thompson SJ; Barczyk AN. Factors associated with substance use among homeless young adults. Substance Abuse 31(1): 24-34, 2010. (52 refs.)

The purpose of this study was to investigate factors associated with substance use among homeless young adults. Multinomial logistic regression analyses examined the influence of social networks and economic factors among a group of homeless young adults with differing levels of alcohol and drug use. In addition, for those with an alcohol use disorder, the role of future time expectancies was examined. A sample (n = 185) of homeless young adults aged 18 to 23 were recruited from a community drop-in center and interviewed utilizing self-report instruments. Findings suggest that social networks, economic factors, and future expectancies are significant predictors of the level of substance use among homeless young adults. Being able to identify those areas that place homeless young adults at risk for substance abuse and dependence has implications for effective intervention.

Copyright 2010, Taylor & Francis

Hadland SE; Marshall BDL; Kerr T; Qi JZ; Montaner JS; Wood E. Depressive symptoms and patterns of drug use among street youth. Journal of Adolescent Health 48(6): 585- 590, 2011. (40 refs.)

Purpose: Rates of depression among street youth are poorly characterized, particularly as they pertain to concurrent drug use. We sought to assess associations between drug type and degree of depression in this population. Methods: Between October 2005 and November 2007, data were collected from a cohort of street-recruited youth aged 14-26 residing in Vancouver, Canada, for the At-Risk Youth Study. Active drug users were classified by predominant substance of use: daily marijuana use, weekly cocaine/crack use, weekly crystal methamphetamine use, or weekly heroin use. Adjusted mean number of depressive symptoms (measured by the Center for Epidemiology Studies Depression [CES-D] scale) was compared among the four groups using multiple linear regression. Logistic regression was also used to assess adjusted odds of CES-D score >= 22. Results: Among 447 youth, mean CES-D score was the highest among heroin users (adjusted mean: 22.7; standard deviation [SD]: 1.2), followed by crystal methamphetamine users (adjusted mean: 21.8; SD: 1.1), then cocaine and/or crack users (adjusted mean: 19.1; SD: 1.0), and finally, marijuana users (adjusted mean: 18.3; SD: 1.1), resulting in a difference that was significant among groups (p < .001). When compared with daily marijuana users, odds of CES-D score >= 22 were higher among heroin users (adjusted odds ratio [AOR]: 2.64; 95% confidence interval [CI]: 1.39-4.99) and crystal methamphetamine users (AOR: 1.88; 95% CI: 1.04-3.42), but not among cocaine/crack users (AOR: 1.41; 95% CI: .79-2.52). Conclusion: To our knowledge, this is the first report of drug use typologies and depression among street youth. Policymakers might heed the apparent vulnerability of heroin and crystal methamphetamine users to even greater degrees of depression than their peers.

Copyright 2011, Society for Adolescent Health and Medicine

Keeshin BR; Campbell K. Screening homeless youth for histories of abuse: Prevalence, enduring effects, and interest in treatment. Child Abuse & Neglect 35(6): 401-407, 2011. (34 refs.)

Objectives: To identify the incidence of self-reported physical and sexual child abuse among homeless youth, the self-perceived effects of past abuse, and current interest in treatment for past abuse among homeless youth with histories of abuse. Methods: Homeless and street-involved persons aged 18-23 filled out a questionnaire and participated in a structured assessment of histories of abuse, tobacco use and substance abuse. Results: Sixty-four homeless youth in Salt Lake City, Utah completed the study, 43 males and 21 females. Eighty-four percent screened positive for childhood physical and/or sexual abuse occurring before the age of 18; 42% screened positive for both physical and sexual abuse; 72% reported still being affected by their abuse. Among all abuse victims, 44% were interested in treatment for their abuse history and 62% of homeless youth who reported still being affected by their abuse were interested in treatment. Individuals were more likely to be interested in treatment if they were female, had not completed high school or had been previously asked about family dysfunction. Many victims who declined treatment offered spontaneous insight into their decision. Interest in treatment was similar to interest in treatment for other behaviors such as smoking and substance abuse. Conclusions: Histories of abuse are common among homeless youth. A majority of those reporting a history of abuse are still affected by their abuse. Interest in treatment for a history of abuse was comparable to interest in treatment for other morbidities in the homeless youth population such as tobacco use and substance abuse. Our finding that homeless youth continue to be impacted by their abuse and are interested in treatment should prompt more screening for histories of abuse.

Copyright 2011, Elsevier Science

Kulahci Y; Sever C; Noyan N; Uygur F; Ates A; Evinc R et al. Burn assault with paint thinner ignition: An unexpected burn injury caused by street children addicted to paint thinner. Journal of Burn Care & Research 32(3): 399- 404, 2011. (15 refs.)

The frequency of assault by burning among all burn patients varies from country to country. Assault by burning, although uncommon, is a serious form of trauma and a significant source of morbidity and mortality. The aim of this retrospective study was to identify the epidemiologic features, current etiological factors, and the mortality of nine patients admitted to our burn unit between January 1999 and January 2009 after unexpected burn assault by paint thinner ignition caused by street children addicted to paint thinner. The circumstances of this injury and preventive measures are discussed.

Copyright 2011, Lippincott, Williams & Wilkins

Marshall BDL; Kerr T; Qi JZ; Montaner JSG; Wood E. Public injecting and HIV risk behaviour among street-involved youth. Drug and Alcohol Dependence 110(3): 254-258, 2010. (33 refs.)

Background: Although street-involved youth who inject illicit drugs are known to be at an increased risk of HIV and other adverse health outcomes, little is known about public injecting among this population and how injecting in public environments may impact HIV risk behaviour. Methods: We used data derived from a study of 560 street-involved youth in Vancouver, Canada to examine the factors associated with injecting in public environments among youth who reported injecting drugs in the past 6 months. Results: At baseline, 162 (28.9%) reported injecting drugs in the past 6 months. Among injectors, the 124 (76.5%) participants who reported injecting in public were more likely to be homeless (odds ratio [OR] = 6.39, p < 0.001), engage in unprotected intercourse (OR = 3.09, p = 0.004), deal drugs (OR = 2.26, p = 0.032), smoke crack cocaine (OR = 3.00, p = 0.005), inject heroin (OR = 3.48, p = 0.001), drop used syringes outdoors (OR = 8.44, p < 0.001), share syringes (OR = 4.43, p = 0.004), and were less likely to clean injection sites >75% of the time (OR = 0.36, p = 0.008). The majority (62.1%) reported feeling rushed while injecting in public. Conclusions: Youth who inject in public are significantly more likely to engage in sexual and injection-related risk behaviour. Given the known elevated rates of HIV infection and other harms among this population, youth-focused interventions that target both sexual and drug-related risks associated with public drug-using environments are in urgent need of evaluation.

Copyright 2010, Elsevier Science

Nada KH; Suliman ED. Violence, abuse, alcohol and drug use, and sexual behaviors in street children of Greater Cairo and Alexandria, Egypt. AIDS 24(Supplement 2): S39-S44, 2010. (15 refs.)

Objectives: To measure the prevalence of HIV/AIDS risk behaviors and related factors in a large, probability-based sample of boys and girls aged 12-17 years living on the streets of Egypt's largest urban centers of Greater Cairo and Alexandria. Methods: Time-location sampling (TLS) was used to recruit a cross-sectional sample of street children. Procedures entailed using key informants and field observation to create a sampling frame of locations at predetermined time intervals of the day, where street children congregate in the two cities, selecting a random sample of time-locations from the complete list, and intercepting children in the selected time-locations to assess eligibility and conduct interviews. Interviews gathered basic demographic information, life events on the street (including violence, abuse, forced sex), sexual and drug use behaviors, and HIV/AIDS knowledge. Results: A total of 857 street children were enrolled in the two cities, with an age, sex, and time-location composition matching the sampling frame. The majority of these children had faced harassment or abuse (93%) typically by police and other street children, had used drugs (62%), and, among the older adolescents, were sexually active (67%). Among the sexually active 15-17-year-olds, most reported multiple partners (54%) and never using condoms (52%). Most girls (53% in Greater Cairo and 90% in Alexandria) had experienced sexual abuse. The majority of street children experienced more than one of these risks. Overlaps with populations at highest risk for HIV were substantial, namely men who have sex with men, commercial sex workers, and injection drug users. Conclusion: Our study using a randomized TLS approach produced a rigorous, diverse, probability-based sample of street children and documented very high levels of multiple concurrent risks. Our findings strongly advocate for multiple services including those addressing HIV and STI prevention and care, substance use, shelters, and sensitization of authorities to the plight of street children in Egypt.

Copyright 2010, Lippincott, Williams & Wilkins

Njord L; Merrill RM; Njord R; Lindsay R; Pachano JDR. Drug use among street children and non-street children in the Philippines. Asia-Pacific Journal of Public Health 22(2): 203-211, 2010. (40 refs.)

This study characterizes the prevalence of drug use among Filipino street children compared with Filipino non street children. A cross-sectional survey was administered to 311 street children and 528 non street children aged 13 to 17 years. Participants were enrolled through 4 nonprofit organizations and 3 high schools located in Manila, Philippines. After adjustment for age and sex, street children with little or no contact with their families were 2.0 (95% confidence interval [CI] = 1.7-2.3) times more likely to smoke tobacco, 1.3 (95% Cl = 1.2-1.5) times more likely to use alcohol, 36.7 (95% CI = 16.4-82.0) times more likely to use inhalants, and 5.5 (95% Cl = 3.6-8.2) times more likely to use illegal drugs than their non street counterparts. Street children who maintained contact with their families, compared with non street children, were 8.7 (95% CI = 3.9-19.4) times more likely to use inhalants and 2.8 (95% Cl = 1.7-4.6) times more likely to use illegal drugs. There was no significant difference in tobacco or alcohol use between street children who maintained contact with their families and non street children. All street children were significantly more likely to have been given or sold a drug in the past 30 days and to have received drug education compared with non street children. Filipino street children are at greater risk of abusing drugs than are non street children, with street children who do not maintain family contact being at greatest risk.

Copyright 2010, Sage Publications

Office of Applied Studies, Substance Abuse and Mental Health Administration. The TEDS Report: Homeless Young Adult Treatment Admissions. (July 2010). Rockville MD: Substance Abuse and Mental Health Administration, 2010. (6 refs.)

Data from the Treatment Episode Data Set (TEDS) for 2008 can be used to examine homelessness among admissions to substance abuse treatment. This report compares the characteristics of homeless admissions aged 18 to 25 to those who are not homeless. Of the approximately 377,000 young adult admissions to substance abuse treatment, 7% were homeless. Among the homeless, heroin (30%) and alcohol (25%) were the primary substances of abuse. Homeless young adults were more likely than non-homeless young adult admissions to have had five or more treatment episodes (17.3 vs. 6.2%.) Among homeless young adults entering treatment, individual/self referrals were the most common referral source, (41.5%), whereas the criminal justice system was the most common source of referral, 50.6% for those with a residence.

Public Domain

Reid JA. An exploratory model of girl's vulnerability to commercial sexual exploitation in prostitution. Child Maltreatment 16(2): 146- 157, 2011. (68 refs.)

Due to inaccessibility of child victims of commercial sexual exploitation, the majority of emergent research on the problem lacks theoretical framing or sufficient data for quantitative analysis. Drawing from Agnew's general strain theory, this study utilized structural equation modeling to explore: whether caregiver strain is linked to child maltreatment, if experiencing maltreatment is associated with risk-inflating behaviors or sexual denigration of self/others, and if these behavioral and psychosocial dysfunctions are related to vulnerability to commercial sexual exploitation. The proposed model was tested with data from 174 predominately African American women, 12% of whom indicated involvement in prostitution while a minor. Findings revealed child maltreatment worsened with increased caregiver strain. Experiencing child maltreatment was linked to running away, initiating substance use at earlier ages, and higher levels of sexual denigration of self/others. Sexual denigration of self/others was significantly related to the likelihood of prostitution as a minor. The network of variables in the model accounted for 34% of the variance in prostitution as a minor.

Copyright 2011, Sage Publications

Rice E. The positive role of social networks and social networking technology in the condom-using behaviors of homeless young people. Public Health Reports 125(4): 588-595, 2010. (41 refs.)

Objective. To examine the impact of condom-using peers in the social networks of homeless young people, differences in behaviors were assessed based on the social location of ties (home-based vs. street-based) and how those ties are maintained (face-to-face vs. via social networking technology). Methods. "Ego-centric" social network data were collected from 103 currently sexually active homeless young people aged 16-26 years in Los Angeles, California. Associations between condom use and the condom-using behaviors of social network influences were assessed using standard logistic regression. Results. About 52% of respondents had a street-based peer who was a condom user. Having such a peer was associated with a 70% reduction in the odds of having unprotected sex at last intercourse. About 22% of respondents had a condom-using, home-based peer with whom they communicated only via social networking technology. Having such a peer was associated with a 90% reduction in risky sexual behavior and a 3.5 times increase in safer sex behavior. Conclusion. The study revealed several implications for new human immunodeficiency virus-prevention interventions that mobilize these networks and social networking technologies.

Copyright 2010, Association of Schools of Public Health

Rice E; Milburn NG; Monro W. Social networking technology, social network composition, and reductions in substance use among homeless adolescents. Prevention Science 12(1): 80-88, 2011. (51 refs.)

Peer-based prevention programs for homeless youth are complicated by the potential for reinforcing high-risk behaviors among participants. The goal of this study is to understand how homeless youth could be linked to positive peers in prevention programming by understanding where in social and physical space positive peers for homeless youth are located, how these ties are associated with substance use, and the role of social networking technologies (e.g., internet and cell phones) in this process. Personal social network data were collected from 136 homeless adolescents in Los Angeles, CA. Respondents reported on composition of their social networks with respect to: home-based peers and parents (accessed via social networking technology; e.g., the internet, cell phone, texting), homeless peers and agency staff (accessed face-to-face) and whether or not network members were substance-using or non-substance-using. Associations between respondent's lifetime cocaine, heroin, and methamphetamine use and recent (previous 30 days) alcohol and marijuana use were assessed by the number of non-substance-using versus substance-using ties in multivariate linear regression models. 43% of adolescents reported a non-substance-using home-based tie. More of these ties were associated with less recent alcohol use. 62% of adolescents reported a substance-using homeless tie. More of these ties were associated with more recent marijuana use as well as more lifetime heroin and methamphetamine use. For homeless youth, who are physically disconnected from positive peers, social networking technologies can be used to facilitate the sorts of positive social ties that effective peer-based prevention programs require.

Copyright 2011, Springer

Tevendale HD; Comulada WS; Lightfoot MA. Finding shelter: Two-year housing trajectories among homeless youth. Journal of Adolescent Health 49(6): 615-620, 2011. (39 refs.)

Purpose: The aim of this study was to (1) identify trajectories of homeless youth remaining sheltered or returning to shelter over a period of 2 years, and (2) to identify predictors of these trajectories. Method: A sample of 426 individuals aged 14-24 years receiving services at homeless youth serving agencies completed six assessments over 2 years. Latent class growth analysis was applied to the reports of whether youth had been inconsistently sheltered (i.e., living on the street or in a squat, abandoned building, or automobile) or consistently sheltered (i.e., not living in any of those settings) during the past 3 months. Results: Three trajectories of homeless youth remaining sheltered or returning to shelter were identified: consistently sheltered (approximately 41% of the sample); inconsistently sheltered, short-term (approximately 20%); and inconsistently sheltered, long-term (approximately 39%). Being able to go home and having not left of one's own accord predicted greater likelihood of membership in the short-term versus the long-term inconsistently sheltered trajectory. Younger age, not using drugs other than alcohol or marijuana, less involvement in informal sector activities, being able to go home, and having been homeless for <1 year predicted membership in the consistently sheltered groups versus the long-term inconsistently sheltered groups in the multivariate analyses. Conclusions: Findings suggest that being able to return home is more important than the degree of individual impairment (e. g., substance use or mental health problems) when determining the likelihood that a homeless youth follows a more or a less chronically homeless pathway.

Copyright 2011, Society for Adolescent Health and Medicine

Thompson S; Jun J; Bender K; Ferguson KM; Pollio DE. Estrangement factors associated with addiction to alcohol and drugs among homeless youth in three US cities. Evaluation and Program Planning 33(4): 418-427, 2010. (59 refs.)

Substance use is highly prevalent among homeless, street-involved young people. Societal estrangement is often associated with substance use, particularly among this population. The current study sought to identify four domains of social estrangement (disaffiliation, human capital, identification with homeless culture, and psychological dysfunction) in relation to alcohol and drug addiction. Homeless young adults were recruited from three disparate urban areas: Los Angeles, CA (n = 50), Austin, TX (n = 50) and St. Louis, MO (n = 46) using comparable research methods and measurement instruments. Findings demonstrated that variables measuring psychological dysfunction and homeless culture predicted alcohol addiction, while institutional disaffiliation and homeless culture predicted drug addiction. Findings affirm distinct patterns of estrangement related to alcohol compared to drug addiction. Understanding these features and the heterogeneity of this population has strong potential for assisting development of programs targeting substance use among this underserved population.

Copyright 2010, Elsevier Science

Thrane LE; Yoder KA; Chen XJ. The influence of running away on the risk of female sexual assault in the subsequent year. Violence and Victims 26(6): 816-829, 2011. (46 refs.)

This study explores the sexual risk trajectories of female youths and sheds light on the long-term effects of running away. It evaluates whether running away increases the risk of sexual assault in the following year, which is after runaways return home. The sample consists of 5,387 heterosexual females between the ages of 11 and 18 years from the Longitudinal Study of Adolescent Health. Nearly one quarter (23%) of runaways report a previous sexual assault in contrast to 5% of nonrunaways. In a logistic regression model, childhood neglect increases the risk of sexual assault between Waves 1 and 2 by nearly two times. Poor mental health is statistically significant. Alcohol use doubles the odds of sexual assault. The risk of sexual assault is approximately three-fold for girls with a history of sexual onset and sexual touching in a romantic relationship. Running away increases the risk by nearly two and a half times. There is evidence that alcohol use and sexual onset partially mediates the relationship between running away and sexual assault.

Copyright 2011, Springer

Walsh SM; Donaldson RE. Invited Commentary. National Safe Place: meeting the immediate needs of runaway and homeless youth. (editorial). Journal of Youth and Adolescence 39(5): 437-445, 2010. (23 refs.)

An estimated 1.6 million youth run away from home each year. While on the run, these youth are vulnerable to exploitation, victimization, increased dangers and perpetration of criminal behavior. Runaway and homeless youth are far more likely to engage in substance use and delinquent behavior, drop out of school and suffer from sexually transmitted diseases and mental illness at greater rates than the norm. Timely and direct intervention in runaway and throwaway cases is imperative to protect youth from the high risks of living on the streets. National Safe Place is an outreach and prevention program that is uniquely designed to provide immediate safety and access to services for any youth in need. In partnership with over 360 youth serving agencies and over 10,000 businesses and community organizations across the United States, the Safe Place program educates youth about alternatives to running away and homelessness and provides easily accessible links to service providers. Ongoing data collection indicates that National Safe Place has been successful in reaching endangered youth at risk of abuse, neglect or serious family problems but that expanded program models remain needed. The challenges and successes of current programming and the future of National Safe Place program expansion are discussed.

Copyright 2010, Springer

Werb D; Kerr T; Fast D; Qi JZ; Montaner JSG; Wood E. Drug-related risks among street youth in two neighborhoods in a Canadian setting. Health & Place 16(5): 1061-1067, 2010. (49 refs.)

We compared drug-related behaviors, including initiation of drug use, among street youth residing in two adjacent neighborhoods in Vancouver. One neighborhood, the Downtown Eastside (DIES), features a large open-air illicit drug market. In multivariate analysis, having a primary illicit income source (adjusted odds ratio [AOR]=2.64, 95% confidence interval [CI] 1.16-6 02) and recent injection heroin use (AOR=4.25, 95% CI 1.26-14 29) were positively associated with DIES residence, while recent non-injection crystal methamphetamine use (AOR, 039, 95% CI: 0 16-0 94) was negatively associated with DIES residence. In univariate analysis, dealing drugs (odds ratio [OR]=5 43, 95% CI: 1 24-23.82) was positively associated with initiating methamphetamine use in the DTS compared to the DTES. These results demonstrate the importance of considering neighborhood variation when developing interventions aimed at reducing drug-related harms among street-involved youth at various levels of street entrenchment.

Copyright 2010, Elsevier Science