Street youth: adaptation and survival in the AIDS decade

Abstract

This article discusses adaptational and survival strategies of homeless youth and describes how pilot research, begun in 1982 on these strategies in the western United States, led to additional research and activity focused upon the related international street youth problem. The results of this research suggest that a critical relationship exists between survival strategies and the AIDS pandemic. The impact of this pandemic on street youth can be mitigated only by immediate and comprehensive preventive actions at both national and international levels.

PIP: This paper describes adaptational and survival strategies of homeless youths as observed from pilot research started in 1982 in the western US and 1988 in Rio de Janeiro, Brazil. Strong correlation was found between both survival strategies and the AIDS pandemic, and the life styles of youths in the 2 regions. The 1982 ethnographic study on homeless youths was conducted over a 2-year period in San Francisco, Los Angeles, and Seattle. Interviews and participant observations were conducted with a group of 250 males and females aged 15-19, with contact maintained with 27. Interviews were conducted with 100 "kept" youths aged 16-19, and a pilot study of HIV infection in teens was undertaken in 1986. This latter study lasted over 4 months, and tested and interviewed 19 and 31 sexually active males and females, respectively, of which 11 were homeless. Finally, 103 street youths were studies in Rio in 1988. The youths expressed an urgent need to secure personal and immediate survival, with money seen as central to providing for this security. Many therefore sold goods, used clothing, panhandled dealt drugs, stole, and provided sex in return for money. Kept youths were often ensconced within the world of pornography and organized prostitution, and virtually invisible to most health care professionals; 28 of 52 interviewed who spoke about sex did not use condoms. Significant incidents of HIV exist in these communities, with 10.5% of youths in Covenant House New York in 1988 and 68.6% of males aged 11-23 prostituting in downtown Rio being HIV+. Moreover, these youths face physical violence and sexual abuse from family members, police, drug dealers and addicts, mentally disturbed and homeless adults, service providers, tourists, and peers. Without families, jobs, and education. they suffer low self-esteem, and therefore have additional psychological reasons for high-risk sexual activity beyond basic economic necessity Strong commonalities exist between these and the estimated 100 million street youths worldwide; social inequality and familial disruptions are common to all countries. The Society for Adolescent Medicine, UNICEF, PAHO, and WHO address the problems of these youths. The authors call for immediate and massive preventive action at national and international levels, including but not limited to the development of large-scale long term housing, and an informational exchange network supportive of collaborative research initiatives.