Living with nonfamily members and drug use appear to be the most salient in explaining sexual risk among newly homeless youth. Our findings indicate that interventions aimed at reducing sexual risk behaviors, and thereby reducing sexually transmitted diseases and HIV among newly homeless youth, need to help youth in finding housing associated with supervision and social support (family and institutional settings) as well as aim to reduce drug use.
The Expanded Behavioral Model for Vulnerable Populations was used to examine the predisposing, enabling, and need factors associated with mental health service use in a homeless adolescent sample (N = 688). Among all youth, 32% perceived a need for help with mental health problems and 15% met Brief-Symptom Inventory (BSI) criteria for emotional distress. The rate of mental health service use in our sample was 32%. One enabling factor, having a case manager/discussed mental health concerns, and one need factor, which met criteria for BSI, were found to be associated with mental health service use in the past 3 months. The majority of youth who used mental health services had obtained services from crisis centers. Among those who perceived a need for help with mental health problems but who did not use services, the most common barrier was not knowing where to go or what service to use (57%). These findings suggest that due to the high prevalence of mental health problems among homeless youth, it would be helpful for service providers coming into contact with youth to make them aware of existing community resources for mental health services; making youth aware of these resources may in turn decrease the rate of crisis center use and instead allow youth to receive mental health services in outpatient settings that provide continuity of care.
This article reviews the literature on HIV/AIDS health care services for Mexican migrants in the United States. Because so little research has been conducted on Mexican migrants per se, we include literature on Latinos/Hispanics in the United States, because some characteristics may be shared. Furthermore, we focus special attention on data from California because it is on the front line of issues regarding health care for Mexican migrants. The types of health care services needed to improve on the quality of care provided to Mexican migrants living with HIV are highlighted, and recommendations are made for future interventions, research, and binational collaborations.
To ensure equitable comparison of CHC performance on patient experience measures, reports and ratings should be adjusted for adult self-reported health status or parent-reported child health status, adult age, education, race/ethnicity, and survey language. Because of the differential impact of case-mix adjusters for child and adult surveys, initiatives should consider measuring and reporting adult and child scores separately.
We examined the association between sexual risk behaviors and sexually transmitted infection (STI) testing in a sample of homeless youth. Of 261 youth interviewed, 50% had been sexually active in the past 3 months. Gender variation in sexual behaviors and risk were found. Boys were more likely than girls to engage in anal sex (46% vs. 15%), to have 3 or more sexual partners (46% vs. 17%) and to engage in anonymous sex (38% vs. 21%). Girls were less likely to use condoms consistently and more likely to engage in sex with a partner suspected of having an STI (20% vs. 4%). In the past 3 months, the STI testing rates were similar for boys and girls (46%). However, girls were more likely to have positive STI results (46% vs. 9%). In a multivariate logistic regression analysis, the only variable that was an independent predictor of STI testing was having either gotten someone or having become pregnant in the past 3 months. High-risk sexual behaviors did not predict STI testing in our sample. Outreach programs are needed that target sexually active homeless youth for early STI testing and treatment.
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