Relationship of sexual orientation to substance use, suicidal ideation, suicide attempts, and other factors in a population of homeless adolescents

Noell, John; Ochs, Linda

doi:10.1016/s1054-139x(01)00205-1

Cited by 160 publications

(109 citation statements)

References 22 publications

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“…At a societal level, we expect that key social institutions-notably families, schools, the criminal justice system, and mental health services-serve as sources of support and protective influence in preventing exposure and accumulation of risks within the early life trajectories of youth and young adults. For example, and consistent with earlier studies of YMSM (Kruks, 1991;Remafedi, Farrow, & Deisher, 1991;Rotheram-Borus et al, 1994;Lock & Steiner, 1999;Noell & Ochs, 2001), these data show that high rates of suicide attempts and repeated suicide attempts are prevalent in YMSM, indicative of the fact that many of these young men are living with clinically significant and untreated psychological distress. Similarly, interactions with the criminal justice system and exposure to incarceration also occur frequently and early among YMSM, and yet have failed to deter progressive involvement in the street economy.…”

Section: Discussionsupporting

confidence: 87%

Homelessness and drug abuse among young men who have sex with men in New York city: A preliminary epidemiological trajectory

Clatts

Goldsamt

et al. 2005

Journal of Adolescence

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The objective of this paper is to profile the role of homelessness in drug and sexual risk in a population of young men who have sex with men (YMSM). Data are from a cross-sectional survey collected between 2001 in New York City (N = 569). With the goal of examining the import of homelessness in increased risk for the onset of drug and sexual risk, we compare and contrast three subgroups: (1) YMSM with no history of homelessness, (2) YMSM with a past history of homelessness but who were not homeless at the time of the interview, and (3) YMSM who were currently homeless. For each group, we describe the prevalence of a broad range of stressful life events (including foster care and runaway episodes, involvement in the criminal justice system, etc.), as well as selected mental health problems (including past suicide attempts, current depression, and selected help-seeking variables). Additionally, we examine the prevalence of selected drug and sexual risk, including exposure to a broad range of illegal substances, current use of illegal drugs, and prevalence of lifetime exposure to sex work. Finally, we use an event history analysis approach (time-event displays and paired t-test analysis) to examine the timing of negative life experiences and homelessness relative to the onset of drug and sexual risk. High levels of background negative life experiences and manifest mental health distress are seen in all three groups. Both a prior experience of homelessness and currently being homeless are both strongly associated with both higher levels of lifetime exposure to drug and sexual risk as well as higher levels of current drug and sexual risk. Onset of these risks occur earlier in both groups that have had an experience of housing instability (e.g., runaway, foster care, etc.) but are delayed or not present among YMSM with no history of housing instability. Few YMSM had used drug prior to becoming homeless. While causal inferences are subject to the limitations of a cross-sectional design, the findings pose an empirical challenge to the prevailing assumption that prior drug use is a dominant causal factor in YMSM becoming homeless. More broadly, the data illustrate the complexity of factors that must be accounted for, both in advancing our epidemiological understanding of the complexity of homelessness and its relationship to the onset of drug and sexual risk among high risk youth populations.

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Section: Discussionsupporting

confidence: 87%

Homelessness and drug abuse among young men who have sex with men in New York city: A preliminary epidemiological trajectory

Clatts

Goldsamt

et al. 2005

Journal of Adolescence

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“…Findings suggest that GLB youth have greater rates of depression, more suicide attempts (Fergusson et al, 1999), more risk taking behavior (Garofalo et al, 1998) (Cochran et al, 2002;Noell and Ochs, 2001;Whitbeck et al, 2004). Gender differences have also been noted by some researchers.…”

Section: Introductionmentioning

confidence: 62%

“…Emerging findings also indicate that GLB homeless youth experience greater risks in terms of victimization, substance use and abuse, rates of psychopathology, depression and suicidal ideation (Cochran et al, 2002;Noell and Ochs, 2001;Whitbeck et al, 2004). Gender differences have also been noted by some researchers.…”

mentioning

confidence: 64%

Comparison of HIV Risks among Gay, Lesbian, Bisexual and Heterosexual Homeless Youth

Gangamma

Slesnick

Toviessi

et al. 2007

J Youth Adolescence

121

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Youth who are homeless and gay, lesbian or bisexual (GLB) are one of the most disenfranchised and marginalized groups in our society. The purpose of this study is to examine and compare HIV in GLB homeless youth with their heterosexual counterparts. Participants for this study included 268 youth involved in treatment outcome studies with substance abusing homeless youth. Results suggest that GLB youth have greater HIV risks and that these risks are greater among bisexual females. In examining the predictors of sexual health risks, survival sex emerged as the most significant. Survival sex was high among females regardless of their sexual orientation and also among gay males. Implications of these findings suggest that a greater emphasis needs to be paid to preventive interventions among this population. KeywordsYouth; Gay; HIV; Homeless One particularly disturbing consequence of being homeless is engaging in behaviors that put oneself at risk for HIV infection. Overall, the homeless population has a disproportionately higher risk of HIV transmission (Ebner and Laviage, 2003) and substance use (Kipke et al., 1997). Substance abuse has been associated as a risk factor for HIV, both in terms of drug and sexual related risk (Rotheram-Borus et al., 2003). In a recent study designed to explore the differences in sexual health risks and protective factors Rew et al. (2005) found that gay and lesbian homeless youth reported being tested and treated for HIV more than the bisexual or heterosexual youth. This was partially supported by a later study (Solorio et al., 2006) that found that gay and bisexual males were more likely to report being tested for sexually transmitted infections (STIs) when compared to heterosexual males and lesbian and bisexual females. While this could imply that gay and lesbian homeless youth are at a greater risk for STIs, there is currently little empirical evidence to show whether differences in HIV risks among heterosexual and gay, lesbian, and bisexual (GLB) youth exist. Such evidence would be helpful in better understanding the needs of these youth and also to better inform intervention strategies. Thus, the purpose of this study was to bridge this gap by comparing the HIV risks among heterosexual and GLB youth in a population of homeless youth.Historically, studies comparing GLB and heterosexual non-homeless youth have been primarily conducted with school-based and community-based samples (Bontempo and D'Augelli, 2002;Faulkner and Cranston, 1998;Lock and Steiner, 1999). Findings suggest that GLB youth have greater rates of depression, more suicide attempts (Fergusson et al., 1999), more risk taking behavior (Garofalo et al., 1998) (Cochran et al., 2002;Noell and Ochs, 2001;Whitbeck et al., 2004). Gender differences have also been noted by some researchers. For instance, Whitbeck and colleagues (2004) in a longitudinal study of homeless and runaway adolescents found that gay males were more likely to have symptoms of internalization when compared to heterosexual males. Lesbian adole...

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“…Regardless of race/ethnicity, MSM and men who have sex with men and women (MSMW) are much less likely to have ever been or recently been arrested and to have ever been charged with a criminal offense than heterosexual men. 16,23,24 Even among MSM, men who have sex with men and women are more likely to report incarceration history than men who have sex only with men. 25 Men who reported using non-injection and injection drugs and exchange sex activity were more likely to report arrest history.…”

Section: Discussionmentioning

confidence: 99%

History of Arrest and Associated Factors among Men Who Have Sex with Men

et al. 2011

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Incarceration has been proposed to be a driving factor in the disproportionate impact of HIV in African-American communities. However, few data have been reported on disparities in criminal justice involvement by race among men who have sex with men (MSM). To describe history of arrest and associated factors among, we used data from CDC's National HIV Behavioral Surveillance system. Respondents were recruited by time-space sampling in venues frequented by MSM in 15 US cities from 2003 to 2005. Data on recent arrest (in the 12 months before the interview), risk behaviors, and demographic information were collected by face-to-face interview for MSM who did not report being HIV-positive. Six hundred seventy-nine (6.8%) of 10,030 respondents reported recent arrest. Compared with white MSM, black MSM were more likely to report recent arrest history (odds ratio (OR), 1.6; 95% confidence interval (CI), 1.3-2.1). Men who were less gay-identified (bisexual [OR, 1.5; 95% CI, 1.1-1.9] or heterosexual [OR, 2.0; 95% CI, 1.2-3.5]) were more likely to report recent arrest than homosexually identified men. In addition, men who reported arrest history were more likely to have used non-injection (OR, 3.0; 95% CI, 2.4-3.6) and injection (OR, 4.7; 95%, 3.3-6.7) drugs, exchanged sex (OR, 2.7; 95% CI, 2.1-3.4), and had a female partner (OR, 1.5; 95% CI, 1.2-2.0) in the 12 months before interview. Recent arrest was associated with insertive unprotected anal intercourse in the 12 months before interview (OR, 1.4; 95% CI, 1.2-1.7). Racial differences in arrest seen in the general US population are also present among MSM, and history of arrest was associated with high-risk sex. Future research and interventions should focus on clarifying the relationship between criminal justice involvement and sexual risk among MSM, particularly black MSM.

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Relationship of sexual orientation to substance use, suicidal ideation, suicide attempts, and other factors in a population of homeless adolescents

Cited by 160 publications

References 22 publications

Homelessness and drug abuse among young men who have sex with men in New York city: A preliminary epidemiological trajectory

Homelessness and drug abuse among young men who have sex with men in New York city: A preliminary epidemiological trajectory

Comparison of HIV Risks among Gay, Lesbian, Bisexual and Heterosexual Homeless Youth

History of Arrest and Associated Factors among Men Who Have Sex with Men

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