Risk evaluations and condom use decisions of homeless youth: a multi-level qualitative investigation
Identifieur interne : 000047 ( Main/Exploration ); précédent : 000046; suivant : 000048Risk evaluations and condom use decisions of homeless youth: a multi-level qualitative investigation
Auteurs : David P. Kennedy [États-Unis] ; Ryan A. Brown [États-Unis] ; Penelope Morrison [États-Unis] ; Loryana Vie [États-Unis] ; Gery W. Ryan [États-Unis] ; Joan S. Tucker [États-Unis]Source :
- BMC Public Health [ 1471-2458 ] ; 2015.
Abstract
Homeless youth are at higher risk for sexually transmitted infections and unwanted pregnancy than non-homeless youth. However, little is known about how they evaluate risk within the context of their sexual relationships. It is important to understand homeless youths' condom use decisions in light of their sexual relationships because condom use decisions are influenced by relationship dynamics in addition to individual attitudes and event circumstances. It is also important to understand how relationship level factors, sexual event circumstances, and individual characteristics compare and intersect.
To explore these issues, we conducted semi-structured interviews with 37 homeless youth in Los Angeles County in 2011 concerning their recent sexual relationships and analyzed the data using systematic methods of team-based qualitative data analysis.
We identified themes of risk-related evaluations and decisions at the relationship/partner, event, and individual level. We also identified three different risk profiles that emerged from analyzing how different levels of risk intersected across individual respondents. The three profiles included 1) Risk Takers, who consistently engage in risk and have low concern about consequences of risk behavior, 2) Risk Avoiders, who consistently show high concern about protection and consistently avoid risk, and 3) Risk Reactors, those who are inconsistent in their concerns about risk and protection and mainly take risks in reaction to relationship and event circumstances.
Interventions targeting homeless youth should reflect multiple levels of risk behavior and evaluation in order to address the diversity of risk profiles. Relationship/partner-, event-, and individual-level factors are all important but have different levels of importance for different homeless youth. Interventions should be tailored to address the most important factor contributing to homeless youth reproductive needs.
The online version of this article (doi:10.1186/s12889-015-1419-9) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s12889-015-1419-9
PubMed: 25636862
PubMed Central: 4324882
Affiliations:
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Box 2138, 1776 Main Street, Santa Monica, CA 90407 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica</wicri:cityArea></affiliation></author><author><name sortKey="Morrison, Penelope" sort="Morrison, Penelope" uniqKey="Morrison P" first="Penelope" last="Morrison">Penelope Morrison</name><affiliation wicri:level="2"><nlm:aff id="Aff2">The RAND-University of Pittsburgh Health Institute, Pittsburgh, PA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>The RAND-University of Pittsburgh Health Institute, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Vie, Loryana" sort="Vie, Loryana" uniqKey="Vie L" first="Loryana" last="Vie">Loryana Vie</name><affiliation wicri:level="2"><nlm:aff id="Aff3">The Department of Psychology, University of Pennsylvania, Philadelphia, PA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>The Department of Psychology, University of Pennsylvania, Philadelphia</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff4">The Department of Psychology, University of California, Riverside, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>The Department of Psychology, University of California, Riverside</wicri:cityArea></affiliation></author><author><name sortKey="Ryan, Gery W" sort="Ryan, Gery W" uniqKey="Ryan G" first="Gery W" last="Ryan">Gery W. 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Kennedy</name><affiliation wicri:level="2"><nlm:aff id="Aff1">RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA 90407 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica</wicri:cityArea></affiliation></author><author><name sortKey="Brown, Ryan A" sort="Brown, Ryan A" uniqKey="Brown R" first="Ryan A" last="Brown">Ryan A. Brown</name><affiliation wicri:level="2"><nlm:aff id="Aff1">RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA 90407 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica</wicri:cityArea></affiliation></author><author><name sortKey="Morrison, Penelope" sort="Morrison, Penelope" uniqKey="Morrison P" first="Penelope" last="Morrison">Penelope Morrison</name><affiliation wicri:level="2"><nlm:aff id="Aff2">The RAND-University of Pittsburgh Health Institute, Pittsburgh, PA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>The RAND-University of Pittsburgh Health Institute, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Vie, Loryana" sort="Vie, Loryana" uniqKey="Vie L" first="Loryana" last="Vie">Loryana Vie</name><affiliation wicri:level="2"><nlm:aff id="Aff3">The Department of Psychology, University of Pennsylvania, Philadelphia, PA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>The Department of Psychology, University of Pennsylvania, Philadelphia</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff4">The Department of Psychology, University of California, Riverside, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>The Department of Psychology, University of California, Riverside</wicri:cityArea></affiliation></author><author><name sortKey="Ryan, Gery W" sort="Ryan, Gery W" uniqKey="Ryan G" first="Gery W" last="Ryan">Gery W. Ryan</name><affiliation wicri:level="2"><nlm:aff id="Aff1">RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA 90407 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica</wicri:cityArea></affiliation></author><author><name sortKey="Tucker, Joan S" sort="Tucker, Joan S" uniqKey="Tucker J" first="Joan S" last="Tucker">Joan S. Tucker</name><affiliation wicri:level="2"><nlm:aff id="Aff1">RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA 90407 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica</wicri:cityArea></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Homeless youth are at higher risk for sexually transmitted infections and unwanted pregnancy than non-homeless youth. However, little is known about how they evaluate risk within the context of their sexual relationships. It is important to understand homeless youths' condom use decisions in light of their sexual relationships because condom use decisions are influenced by relationship dynamics in addition to individual attitudes and event circumstances. It is also important to understand how relationship level factors, sexual event circumstances, and individual characteristics compare and intersect.</p></sec><sec><title>Methods</title><p>To explore these issues, we conducted semi-structured interviews with 37 homeless youth in Los Angeles County in 2011 concerning their recent sexual relationships and analyzed the data using systematic methods of team-based qualitative data analysis.</p></sec><sec><title>Results</title><p>We identified themes of risk-related evaluations and decisions at the relationship/partner, event, and individual level. We also identified three different risk profiles that emerged from analyzing how different levels of risk intersected across individual respondents. The three profiles included 1) Risk Takers, who consistently engage in risk and have low concern about consequences of risk behavior, 2) Risk Avoiders, who consistently show high concern about protection and consistently avoid risk, and 3) Risk Reactors, those who are inconsistent in their concerns about risk and protection and mainly take risks in reaction to relationship and event circumstances.</p></sec><sec><title>Conclusions</title><p>Interventions targeting homeless youth should reflect multiple levels of risk behavior and evaluation in order to address the diversity of risk profiles. Relationship/partner-, event-, and individual-level factors are all important but have different levels of importance for different homeless youth. Interventions should be tailored to address the most important factor contributing to homeless youth reproductive needs.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12889-015-1419-9) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Rotheram Borus, Mj" uniqKey="Rotheram Borus M">MJ Rotheram-Borus</name></author><author><name sortKey="Song, M" uniqKey="Song M">M Song</name></author><author><name sortKey="Gwadz, Mv" uniqKey="Gwadz M">MV Gwadz</name></author><author><name sortKey="Lee, M" uniqKey="Lee M">M Lee</name></author><author><name sortKey="Vanrossem, R" uniqKey="Vanrossem R">R VanRossem</name></author><author><name sortKey="Koopman, C" uniqKey="Koopman C">C Koopman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rotheram Borus, Mj" 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Kennedy</name></region><name sortKey="Brown, Ryan A" sort="Brown, Ryan A" uniqKey="Brown R" first="Ryan A" last="Brown">Ryan A. Brown</name><name sortKey="Morrison, Penelope" sort="Morrison, Penelope" uniqKey="Morrison P" first="Penelope" last="Morrison">Penelope Morrison</name><name sortKey="Ryan, Gery W" sort="Ryan, Gery W" uniqKey="Ryan G" first="Gery W" last="Ryan">Gery W. Ryan</name><name sortKey="Tucker, Joan S" sort="Tucker, Joan S" uniqKey="Tucker J" first="Joan S" last="Tucker">Joan S. Tucker</name><name sortKey="Vie, Loryana" sort="Vie, Loryana" uniqKey="Vie L" first="Loryana" last="Vie">Loryana Vie</name><name sortKey="Vie, Loryana" sort="Vie, Loryana" uniqKey="Vie L" first="Loryana" last="Vie">Loryana Vie</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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