The impact of an integrated treatment on HIV risk behavior among homeless youth: a randomized controlled trial

Abstract

While many studies provide useful information on the risk behaviors in which homeless youth engage, few prior studies evaluate Human Immunodeficiency Virus (HIV) risk related reduction strategies. In this study, homeless youth (n = 180) were recruited from a drop-in center and randomly assigned to one of two conditions, either an integrated individual cognitive-behavioral treatment and HIV prevention intervention that focused on skills building and education or to treatment as usual. All youth were assessed at entry into the program and at 3 and 6 month follow-up points. Findings showed an interaction between treatment condition, age and time. In the interaction, youth assigned to the integrated treatment reported greater condom usage than youth assigned to treatment as usual, with younger youth assigned to treatment as usual showing no change in condom use. The number of sexual partners reported by youth in both treatment conditions was also reduced over time. However, youth in both conditions continued to engage in other high-risk behaviors. The integrated treatment findings are promising and suggest that interventions which target both HIV risk behavior in addition to other life areas (substance use, mental health and housing) among homeless youth may be necessary in order to significantly impact high-risk behaviors among this unique group.

Fig. 1

Research design

Fig. 2

Interaction effect between time, age, and treatment types for frequency of condom use reported. Note. ^aFrequency of Condom Use = Mean scores; 1 = Never; 2 = Rarely; 3 = Sometimes; 4 = Usually; 5 = Always

Fig. 3

Group centroids plot from discriminant function analysis. Note. Group 1 = T1 > T3 (significant reduction of HIV risk behaviors at post-treatment) Group 2 = T1 = T3 (nonsignificant change from pre- to post-treatment) Group 3 = T1 < T3 (significant increase of HIV risk behaviors at post-treatment)