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Understanding Condom Use Decision Making Among Homeless Youth Using Event-Level Data
Yashodhara Rana1, Ryan A Brown1, David P Kennedy1
1a RAND Health, RAND Corporation.
Journal of Sex Research
|November 15, 2014
Summary
Homeless youth often engage in unprotected sex due to expectations of sex and alternative pregnancy prevention. Interventions must address individual and event-level factors influencing condom use decisions.
Area of Science:
- Public Health
- Sociology
- Psychology
Background:
- Homeless youth face unique challenges influencing sexual health decisions.
- Understanding factors affecting condom use is crucial for targeted interventions.
Purpose of the Study:
- To qualitatively explore mechanisms influencing condom use decision-making among homeless youth.
- To identify event-level and nonevent factors impacting unprotected sex.
Main Methods:
- Qualitative event-based study design.
- Semi-structured interviews with 29 homeless youth about two recent sexual encounters.
- Thematic analysis of interview data.
Main Results:
- Reasons for unprotected sex included expectation of sex and alternative protection methods.
- Partnership attributes (testing, trust, risk assessment) and individual attributes (disease perception, pregnancy concerns, condom discomfort) influenced decisions.
- Decision-making involved multiple interacting event and nonevent factors.
Conclusions:
- Interventions should adopt a multilevel, individualized approach.
- Focusing on event-based determinants of risky sexual behavior is recommended for this population.
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