Predictors of HIV testing among runaway and homeless adolescents

Although runaway and homeless adolescents are at high risk for acquiring HIV infection, little is known about which of these youth obtain HIV testing or whether those considered to be at highest risk are being tested. The purpose of our study was to determine demographic characteristics and risk profiles of runaway and homeless adolescents who had obtained an HIV test and compare them to those who had not been tested.

We analyzed data collected by the State of California from a survey of 202 San Francisco Bay area runaway and homeless youth aged 13-18 years conducted in 1990-1991. Adolescents were interviewed about AIDS-related knowledge, attitudes, beliefs, and behaviors, including HIV testing experience.

Most subjects were 16 years or older (80%), white (61%), sexually active (91%) and heterosexual (82%). Twenty-three percent reported a previous sexually transmitted disease (STD); 27% had used injection drugs. Over half (54%) had been HIV antibody tested. Free/community clinics were the most common site for testing. In a logistic regression model, four variables were independent predictors of having obtained an HIV antibody test: history of an STD (p = 0.01), 5 or more years of sexual activity (p = 0.01), injection drug use (P = 0.04), and age (p = 0.04).

Our study demonstrates that many runaway and homeless adolescents have obtained an HIV antibody test and that those with known risk factors are more likely to have been tested. These data support the need for community-based expansion of HIV-related services for homeless youth. The effects of HIV antibody testing on subsequent beliefs and behaviors need further study.