Youth Experiences Survey (YES): Exploring the Scope and Complexity of Sex Trafficking in a Sample of Youth Experiencing Homelessness

ABSTRACT

In the United States, sex trafficking victims have been identified at ages across the lifespan but young persons (under age 25) have been found to have unique vulnerabilities. At-risk youth, such as those who run away from home or those experiencing homelessness, are also at an increased risk of sexual exploitation. To better understand the scope and complexity of sex trafficking among these at-risk youth, a convenience sample of 131 homeless youth aged 12 to 25 years old experiencing homelessness recruited from Kentuckiana youth service providers completed an enhanced version of the Youth Experiences Survey (YES). Univariate and bivariate analyses were conducted. Results indicated that 41.2% of the homeless youth were victims of sex trafficking. The sex trafficked youth were more likely to report previous self-harm behaviors, suicide attempts, and substance use. This study not only provides support for improved service delivery, but also provides essential statistics that should inform internal policy and procedures for youth serving agencies in Kentucky and Indiana. Findings highlight a need for trauma-informed interventions designed to treat not only females but also males and LGBTQ youth. Additionally, service providers should consider partnering with victim providers and clinicians to offer therapeutic groups, individual therapy, and supportive services that increase prevention, education, and wraparound care for clients. In regards to future research, findings point towards a need to better understand the role that trauma and adverse childhood experiences may play in making young people vulnerable to sex trafficking, and encourage the need for testing prevention and early intervention practices among vulnerable youth.     

An Ecological Systems Comparison Between Homeless Sexual Minority Youths and Homeless Heterosexual Youths

ABSTRACT

This study examined risk and protective outcomes by comparing homeless sexual minority youths to heterosexual homeless youths regarding family, peer behaviors, school, mental health, stigma, discrimination, substance use, and sexual risk behaviors. Structured interviews (N = 147) were conducted with individuals aged 16 to 24 years old in Toronto. Bivariate analyses indicated statistically significant differences between homeless sexual minorities (n = 66) and their heterosexual counterparts (n = 81) regarding all variables: family, peer behaviors, stigma, discrimination, mental health, substance use, and sexual risk behaviors, with the exception of school belonging. Implications for future research are suggested.     

Social Context of Service Use Among Homeless Youth in Los Angeles,California

ABSTRACT

Little is known about rates and correlates of service use or the role that social context plays in service engagement among homeless youth. This study compares two distinct service areas and uses a social network approach to examine how environmental factors (e.g., neighborhood), social factors (e.g., social capital and network engagement) and individual level factors that relate to service use patterns among homeless youth in Los Angeles, California. A sample of 938 youth was recruited from three drop-in centers in two distinct service sites. Individuals were surveyed about their individual and social network attributes. Univariable and multivariable analyses were utilized to understand the influence of social-contextual variables on service use. Service use behaviors varied across site and service type with youth in Hollywood showing greater engagement than youth at the Beach site. Across both sites and several service types, staff emotional support was positively correlated with levels of service use. The site comparisons also point to the fact that even within a single geographic area, like Los Angeles County, client profiles and rates of service use can significantly vary. Future research needs are presented with specific emphasis on understanding the needs of non-service-seeking youth.     

Navigating Housing Instability and Substance Use: Hidden Tensions Facing Youth in Small Town America

Abstract

Recent scholarship indicates that youth homelessness is a significant problem outside urban areas. However, previous studies have not examined how local contexts shape the experiences of youth who are homeless in rural areas and small towns with high rates of poverty and epidemic drug use. To address this gap, this analysis draws from two components of a large national study of homelessness among youth, using data collected in a small non-urban setting in the Northwest including (1) a subset of 41 (out of 215 nationally) in-depth interviews with youth and (2) a subset of 16 surveys (out of 523 nationally) with service providers. We explored availability of services and how youth navigate housing instability and the service landscape in small communities. We discovered that current or prior addictions sometimes posed risks to the safety of youth and compromised their ability to rely on family supports – a support proving critical in the absence of a formal service infrastructure. Our results suggest that youth experiencing housing instability in the context of high rates of drug use and limited formal services must often choose between meeting competing needs: a place to stay versus sobriety. We discuss the implications for policy, practice, and research.     

Serving Former Foster Youth and Homeless Students in College

ABSTRACT

Many universities have developed campus support programs for former foster youth and homeless college students; however, there are no studies focusing on long-term programs in the college-setting with a mentoring component that focuses on developing relationships with supportive adults. To address the gap, this study examined both mentors' and program staff's experience with providing services to students in a campus support program. The authors collected qualitative data from one success coach (i.e. program staff) and eight mentors through focus group meetings and interviews. Results indicated that the success coach reported the students in the program improved their overall academic performance, while most mentors did not know their mentees' grades. The success coach coordinated most services of the program, assigned financial and academic support, and made service referrals. Mentors helped their mentees to improve academic and independent living skills. However, mentors reported that they received limited support, especially when working with mentees with mental health problems. Recommendations to improve the program include: using a multidisciplinary team for students with mental health problems and adopting systematic approaches to better support mentors' services. Future studies should go beyond program staff and mentors to include students' perspectives regarding their experiences with receiving mentoring services.     

Contexts of Mother–Child Separations in Homeless Families

Families that contend with the losses, disruptions, and hardships occasioned by homelessness often experience dispersal of children as well. Although a federal initiative on homeless families identified family preservation as a focus of intervention development, there is little research to guide service efforts. This qualitative study of mother–child separations in homeless families with maternal mental health and/or substance use problems identifies precursors of separations (precarious housing, turbulent relationships, substance abuse by mothers and others, institutional confinement, and children's needs) and examines how mothers' responses to these events and conditions interact with social and institutional contexts to shape variations in the course and outcome of separations. Implications for research, services, and policies affecting homeless families are discussed.     

Home Street Home: The Interpersonal Dimensions of Adolescent Homelessness

This paper draws on the available literature, as well as unpublished data, to reconstruct the often chaotic early childhood experiences of homeless adolescents and to describe the problematic ways of relating that may result from these troubled life histories. We also examine the processes by which homeless youth become separated from their families, and we make connections between socio-emotional problems on the street and early neglect and abuse at home. The risk-amplification model is offered as a theoretically compelling explanation of the adolescent homeless experience, high rates of victimization on the streets, and mental health problems that arise out of these circumstances. Finally, we present a promising approach for intervening with homeless youth, one that explicitly targets this cycle of ineffective interpersonal relationships.     

Dual experiences of teenage parenting and homelessness among Native Hawaiian youth: A critical interpretative phenomenological analysis

Teenage parenting is a challenging venture—particularly when parenting while homeless. The present study explores in‐depth through case‐based analysis the lived experiences of three young homeless and parenting teens (one mother and two fathers). It is the first known study of teenage parenting and homelessness among Native Hawaiian youth, a key affected population. Interpretative phenomenological analysis of participants' individual interviews revealed three themes that characterize the experience of parenting as a teen while homeless: (a) They never raised me up (childhood experiences); (b) becoming mommy and daddy (early experiences of teen pregnancy and parenting while homeless); and (c) finding our place (current experiences of teen parenting and perspectives on teen pregnancy and homelessness). Implications for direct practice, social policy, and future research are discussed in the context of this complex reality.     

Living on the margins: older homeless adults in Toronto

A handful of scholars have acknowledged that, along side the traditional homeless, there are now older people who become homeless for the first time in old age. Few researchers, however, have systematically compared the recent older homeless with the chronic or traditional homeless. In the research presented here, we compare recent older homeless with long-term older homeless adults in Toronto according to their health and wealth, their housing history, and their use of health and social services. Findings indicate that people who become homeless for the first time at older ages have needs that are different from the lifetime elderly homeless and require different approaches to intervention.     

Mental health care for youth: Predictors of use are not always the same as predictors of volume

This study identifies determinants of adolescents’ propensity to use outpatient mental care as well as factors predicting number of visits after contact with a provider was made. We examined three types of treatment outlets: day treatment program (DTP), mental health clinic (MHC), and private specialty services (PSS). Among youth, 1.6% visited DTP, 2.3% visited MHC, and 11.1% had PSS, with overlaps in services utilization. Results from multivariable logistic regressions indicate that most of the individual characteristics differentiated youth on odds of using MHC and PSS, but not DTP. Health status, alcohol dependence, drug dependence, and problematic conduct behaviors and having Medicaid increased the odds of using all three services. Censored regressions used to model number of visits among service users found that girls consistently used more visits than boys. The results suggest that policies that encourage seeking help to a mental care provider may be in instances different from those aimed at motivating retention in treatment.     

‘Sex is violence’: African‐American parents' perceptions of the link between exposure to community violence and youth sexual behaviours

In Chicago, African‐American youth experience disproportionately high rates of exposure to community violence. Growing evidence documents that such exposures are related to youth sexual behaviours. This qualitative study seeks to illuminate the various ways in which violence and sex are intertwined in the lives of African‐American youth. Analysing data from four focus groups (N = 54), major themes indicated that parents linked community violence with: (i) influencing youth sexual interests and opportunities for having sex; (ii) specific notions of youth sexual identities and social status; (iii) increased gang involvement and sexual initiations; and (iv) girls' grudges and their sexual concurrency with boys. These findings suggest that addressing these specific issues is important in parent‐centred and community‐grounded interventions aimed at reducing risky sexual behaviours among African‐American youth.     

A family support service for homeless children and parents: user and staff perspectives

Children and their parents who become homeless constitute a group of families with a complex range of social care and health needs, including mental health difficulties. In response to this, a local authority housing department established a family support team (FST) that provides assessment and detection of a range of problems, support to parents and children, parenting interventions for child behavioural problems, liaison with other agencies, and referral to specialist services when appropriate. The aim of this study was to establish the perceptions of parents and staff on their experience of the service, and ways of improving it in the future. The study adopted a developmental evaluation approach and used multiple methods, including in‐depth interviews with families; diaries; reflective activities; participatory learning and action; and observation of the FST. The study mapped the innovative service and captured the range of skills in the team and the complexity of agencies the team interacted with. It also identified areas for further development in terms of the mental health needs of children and parents who have become homeless.     

Assessing Health Care Needs Among Street Homeless and Transitionally Housed Adults

ABSTRACT

This study examined the health services received and needed among homeless persons in Hillsborough County, FL (N = 823). Lifetime and current need and receipt of health services were assessed with a cross-sectional survey. Participants reported extensive lifetime and current needs for physical and behavioral health care services. Nearly a third of participants reported current unaddressed health problem(s); an inability to obtain needed health care; and feelings of unaddressed mental health issue(s) as well as substance abuse problem(s) in the past year. Future research on homelessness and health should focus on identifying different pathways to health and mental health services for this vulnerable population and the outcomes of these interventions.     

AIDS Risk Behaviors among American and Australian Homeless Youth

We examined HIV/AIDS risk behaviors among homeless youth in cross-national data collected in Melbourne, Australia ( n = 398), and Los Angeles, California ( n = 498). Using structural equation modeling, we found that the Australian youth reported greater involvement in AIDS risk behaviors than the American youth and the Australian youth were more involved in intervening risk factors that promote risk behaviors and less involved with protective factors that reduce risk behaviors. Youth reporting the highest rates of delinquent behaviors also had peers engaging in delinquent acts, used alcohol and marijuana, and were more likely to utilize social services. These findings underscore the importance of having a service sector that is able to adequately address the needs of homeless youth .     

Caregiver‐endorsed strategies to improving sexual health outcomes among foster youth

Foster youth are at an increased risk of unintended pregnancies and sexually transmitted infections (STIs) compared with peers. We conducted 11 semistructured focus groups with 86 foster and kinship caregivers in three child welfare jurisdictions to understand their strategies for monitoring and communicating with youth in foster care around sexual health topics, with the overall goal of developing a training for caregivers to reduce STI and unintended pregnancies among youth in foster care. We used thematic analysis to analyse the data. Three main themes emerged: (1) strategies to communicate with youth about sexual health (trust‐building, open/direct communication, tailoring information to each individual youth, creative conversation‐starters, and self‐education), (2) strategies for monitoring youth (e.g., tailoring monitoring to youth development/characteristics, clearly communicating rules, co‐development of rules, spending time with youth/friends/friends' parents, using technology, using a social support system), and (3) other strategies to promote positive youth development (advocating for youth, engaging youth in goal‐setting). Trainings that provide caregivers with (1) information on sexual health and normal adolescent development and (2) strategies and skills to help caregivers engage in open, evidence‐informed communication, and monitor youth in a tailored, developmentally‐informed manner are likely to improve reproductive health and other outcomes among youth in foster care.     

Risk for a Price: Sexual Activity Solicitations in Online Male Sex Worker Profiles

ABSTRACT

The use of social- and sexual networking-based Web sites designed to provide easy and more anonymous access to sexual partners is rising. The popularity of the use of Web sites by male sex workers to promote their services and find clients is also rising. To date, very little inquiry has been devoted to studying the sexual behaviors solicited within online advertisement profiles of male sex workers and men who have sex with men. This study utilized a widely used popular Internet site designed to advertise to clients and gathered demographic, advertised sexual and nonsexual behaviors, pricing, and safety risk category data from profiles within the state of Florida (n = 163). Pearson chi-square analyses indicated that location and several sexual behaviors were significantly related to how often the men reported the degree to which they had safer sex with clients. These findings suggest some male sex workers do not consistently maintain safer-sex behaviors and that some of these men are engaging in sexual activity while under the influence of drugs. Future recommendations support the need for effective public health outreach that emphasizes the importance of safer sexual decision making.     

TEMPORAL DIMENSIONS OF YOUTH HOMELESSNESS

This article identifies three temporal images of the homeless youth population. The dominant media typification is of an ‘underclass’ with chronic problems. A dissident image contends that most young people experience only short periods of homelessness, and that there is a ‘high turnover’ population. A third account suggests that there are both ‘short-term’ and ‘chronically’ homeless youth, but few individuals in-between. It is a ‘polarised’ image of the population. This article draws on information from a sample of 1,410 homeless young people to assess these accounts. The article theorises temporal concepts and it explains a methodological issue called the ‘point in time dilemma’. The main finding of the study is that the homeless population is characterised by temporal diversity. The basis for the dominant underclass typification is explained, and various policy issues are discussed.     

Homeless young people,families and change: family support as a facilitator to exiting homelessness

The families of homeless young people are most often portrayed as a precipitating factor in their homelessness. However, recent studies, particularly those taking a longitudinal approach, have drawn attention to the enabling role of family members and their positive influence on the housing trajectories of homeless youth. Drawing on selected findings from an ongoing longitudinal qualitative study of homeless young people in Dublin, Ireland, this paper aims to build on this relatively fertile area of research. We demonstrate the supportive role of the families of young people who experience homelessness (often as a consequence of difficult family environments) and specifically examine how family re‐engagement is negotiated and achieved. The findings highlight a number of dimensions of transition and change. Prominent among these is the importance of renewed trust and communication. Young people and their parents also had to accept responsibility for areas of life that previously served to undermine their relationships and were implicated in the circumstances surrounding a young person's premature home‐leaving. Tensions and resistances on the part of young people are highlighted, demonstrating the adaptive mechanisms at work as they attempt to re‐engage with family members. The implications of the findings for social work intervention with homeless youth are discussed.     

Examining the impact of family services on homeless children

This study examined the impact on children of services delivered through a collaborative initiative designed to provide supports to working poor families who are homeless or at immediate risk of becoming homeless. Overall, a number of positive findings can serve to inform the development of promising intervention strategies for children in homeless families and highlight areas for further research. Along with improved housing status, there was a statistically significant improvement in the economic self‐sufficiency of the families served, regardless of whether they completed the full programme cycle. In addition, youth self‐report data indicated significant improvements in externalizing and internalizing behaviour. The ability to combine programme data with school data for participating children also made it possible to explore school performance outcomes. Although these results did not indicate a change in participants’ levels of attendance or reading performance, there was a statistically significant improvement in students’ math scores. Moreover, when participating children were compared with a group of students matched on their level of academic performance at baseline who had not received housing or homeless services, no significant differences were detected between groups post‐intervention, indicating that services may help reduce the risk of homeless students’ falling further behind their peers academically.