The Safe and Sexy Project: The sexual-health needs and knowledge of street involved and homeless youth living in Hamilton, Ontario.
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BACKGROUND: Youth continue to be at high risk for STI and HIV transmission and unplanned pregnancies because of their liberal approach to sexual-health and their susceptibility toward engaging in risky activities. Youth who are street involved face greater risks than their peers because they occasionally participate in behaviours that places them at increased risk; for instance injection drug use, multiples sex partners, low condom use and considerable substance use. However, while street youth are predisposed to engage in many of the situations they do, some street youth are also making decisions to limit risk. OBJECTIVES: To 1) determine the basic level of HIV and STI knowledge of street youth; 2) to understand youth’s knowledge of, access to, and use of sexual-health information; 3) to explore where and from youth would like to get accurate sexual-health information and appropriate care; 4) to determine whether peer education is a useful method of transmitting sexual-health information to youth; 5) to assess the sexual risk level of youth; and 6) to develop an understanding of the proactive sexual-health behaviours and decisions youth have established for themselves. METHODS: Street-involved and homeless youth living in Hamilton, Ontario (n=97) who were between the ages of 14 and 24 were interviewed using a 112 questions interview tool. Topics covered in the interview included demographics, personal safety, health behaviour, accessing sexual-health information, accessing sexual-health services, HIV/AIDS knowledge and services use and peer education. Descriptive, bivariate, and multivariate analyses were conducted using SAS. RESULTS: Youth had high rates of STI and HIV testing and good HIV knowledge when compared to the general youth population. However, the sample also had increased rates of unplanned pregnancies and young women were not well-informed about what gets tested for in pap smears. Some youth are also not accessing sexual-health services at all. CONCLUSIONS: Youth are making attempts to protect themselves, however there are areas for improvement; specifically increased condom-use, knowledge of HIV and pap smears. Youth who were found to have increased risk were youth who were under the age of 19, and youth who had experienced unstable housing before the age of 15. The findings suggest that sexual-health harm reduction needs to start at a younger age and the basics of sexual-health should not be overlooked.