Patterns, predictors, and situational contexts of HIV risk behaviors among homeless men and women.
Social Work › Vol. 43 Nbr. 1, January 1998
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Patterns, predictors, and situational contexts of HIV risk behaviors among homeless men and women.
An estimated 250,000 to 3 million Americans are homeless at any given time, and a significant number of homeless people regularly live on the streets because they lack stable shelter (Robertson & Greenblatt, 1992). For many years, an extensive body of research has identified the pressing physical and mental health, substance abuse treatment, and social services needs of homeless people. During the past several years, there also has been increasing recognition that the threat of HIV infection is disproportionately high among homeless adults and adolescents and that the homeless population is extremely vulnerable to HIV infection.
Several recent HIV seroprevalence studies confirm alarming rates of infection among homeless people in large urban areas. Torres, Mani, Altholz, and Brickner (1990) found that 62 percent of injection drug users (IDUs) receiving services (predominantly men) at a New York City homeless shelter had HIV infection, and Susser, Valencia, and Conover (1990) found that 19 percent of chronically homeless men receiving services at another New York City shelter were infected. HIV seroprevalence of over 8 percent was recently reported among the homeless population in San Francisco (Zolopa et al., 1994), 5 percent has been reported among homeless adolescents in New York City (Stricoff et al., 1991), and 1 percent has been reported in a community sample of homeless African American men in Miami (Centers for Disease Control [CDC], 1991). Although HIV seroprevalence levels are likely to vary with a study's geographical location and the specific risk behaviors characteristic of the population, apparently HIV disease has become an epidemic among the United States's urban homeless population. A number of behavioral, social, and relationship factors contribute to the increased vulnerability of homeless people to HIV infection. Homeless adults are disproportionately concentrated in impoverished inner-city neighborhoods, which have high rates of drug use and greater prevalence of sexually transmitted diseases (STDs) and where HIV infection is becoming more common. As a result, people who are sexually active or those who share drug injection equipment in these neighborhoods and social networks are likely to enco...See the full content of this document
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