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Homeless youth frequently engage in high risk sex behaviors putting them at risk for Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs), and unplanned pregnancy (Edidin et al., 2012; Halcon & Lifson, 2004). Previous attempts to intervene have had limited success (Naranbhai et al., 2011). While previous research has documented high prevalence rates and risk factors for engaging in sexual risk behaviors (Halcon & Lifson, 2004; Edidin et al., 2012), less is known about homeless youths’ perceptions regarding potential benefits and consequences of their sexual risk behaviors. The current dissertation presents the results of three qualitative studies that explored homeless youths’ motivation for engaging in sexual risk behaviors and their perception of the potential risks. The studies used qualitative interviews with 30 substance using homeless youth (ages 14-24). Interviews were coded by three coders using grounded theory methods (Strauss & Corbin, 1998) and NVivo 10 software. The first study explored homeless youths’ motivation for engaging in sex and how the potential threat of HIV/STIs impacted their decisions. Youth reported similar emotional and physical benefits of having sex as housed youth. However, the stressful context of experiencing unmet needs appeared to influence youth to make impulsive decisions about sex that were often based on their immediate feelings/needs. Consequently, they rarely considered the threat of HIV/STIs when deciding to have sex. Further, youth were generally unconcerned about their risk of contracting HIV/STI because they either underestimated their level of risk or did not believe they would be significantly impacted by contracting HIV or an STI.The second study examined youths’ perception of how substance use influences their decisions to have sex and engage in sex work. Youth differed in whether they believed substance use impacted their decisions. Some youth believed their decisions about sex were not influenced by substance use, while other youth acknowledged the inhibiting effects of substance use. Behaviors youth attributed to their substance use included, having sex with someone they would not normally have sex with or being less likely to use protection. Even when youth believed their substance use influenced their decisions about sex, youth were generally unconcerned, and some youth appeared to welcome the disinhibiting effects of substance use. The final study examined youths’ perceptions of pregnancy and childrearing. Most youth had positive feelings about pregnancy but differed in how soon they wished to become pregnant. While many participants noted the importance of delaying pregnancy, most were not utilizing effective contraceptive methods. Pregnancy and childrearing appeared to provide a sense of hope for youth because they often focused on the emotional benefits of having a child and minimized the potential challenges. Further, youth typically had overly optimistic assessments of their potential parenting ability, thus they underestimated the potential challenges they may experience.

Substance abusing mothers and their children are a vulnerable, understudied, and underserved population. Mothers and their children are more likely to experience a range of social, behavioral, and psychological difficulties. Despite the significant challenges faced by these families, little is known about their experiences in treatment. The current study utilized thematic analysis to identify common themes that arose in three substance abusing mothers and their children’s discussion during family therapy. An ecological framework was used to classify themes. Themes related to each level of the families’ ecological systems were identified. Several themes related to the mothers and their children’s relational and emotional needs. Based on these findings, implications for clinicians working with these families are discussed and suggestions for future research are offered.