HIV and Drug Use Prevention Needs Among Traveling Homeless Youth: A Qualitative Study

We investigated HIV, drug use, and health and social service needs of traveling homeless youth.We conducted in-depth, qualitative interviews with homeless youth in Portland, Oregon between 2015-17. Forty-two participants, with an average age of 23 years, agreed to interview and discuss their experiences of homelessness and traveling. Participants described experiences of trauma, parental drug and alcohol abuse in their childhood as reasons for their homelessness. Drug use among participants was common, with marijuana and alcohol being the most reported substances. High-risk sexual behaviors were also reported. Unprotected sex and needle sharing appeared to be common. Knowledge of HIV/STI prevention strategies was low. Access to, and engagement with, social and health services was minimal due to institutional barriers and the high mobility of the group. Current prevention services available for traditional (non-traveling) homeless youth may not be effectively reaching and engaging travelers. Due to the high mobility of this group, multilevel, multi-city, prevention strategies are urgently needed. In addition to behavioral risk-reduction interventions, homeless travelers need access to clean needles, condoms, and other survival services.