Metrics details. Rates of sexually transmitted infections STI and unplanned pregnancy are high among youth. While the intersection between drug and alcohol use and unprotected sex is well recognized, few studies have examined the relationship between substance use patterns and unprotected sex among high risk-populations such as street-involved youth.
Generalized estimating equations GEE were used to examine substance use patterns that were independently associated with unprotected sex, defined as vaginal or anal sexual intercourse without consistent condom use. Unprotected sex was prevalent among street-involved youth in this setting, and independently associated with female gender and a wide range of substance use patterns.
Evidence-based and gender-informed sexual health interventions are needed in addition to increased access to youth-centered addiction treatment services. STI testing and linkages to healthcare professionals remain important priorities for street-involved youth, and should be integrated across all health and social services.
Youth are at a critical stage of development as they initiate sexual and substance use behaviours that shape their health throughout adulthood [ 1 ]. The evidence suggests, however, that this crucial transition period is often overlooked and not adequately addressed by healthcare providers in many settings [ 2 ]. This is especially important for street-involved youth, who commonly experience trauma and abuse before entering street life [ 3 ], and adverse childhood events have been linked with an increased risk of illicit drug use [ 4 ] and, among women, sexual risk taking [ 5 ].
Despite efforts to increase safer sex practices among youth [ 6 ], in nearly half of all new sexually transmitted infections STI in the United States occurred among those aged 15β24 [ 7 ].
