Association Between Peer-to-Peer HIV Prevention Conversations and Perceived HIV Susceptibility Among Homeless Youth

Introduction: Nearly 2 million runaway and homeless youth (RHY) are at great risk for contracting HIV/AIDS each year, with prevalence rates reported as high as 11.5%. HIV/AIDS risk for RHY has been tied to their social networks, identified primarily as other homeless peers who are engaging in HIV risk-taking behaviors. Studies have shown that perceived susceptibility to HIV and HIV knowledge predicts risk-taking behaviors. To our knowledge, few studies have examined RHY peer-to-peer communication within their social networks as sources of HIV knowledge and its association to perceived HIV susceptibility. The purpose of this study is to examine the relationship between peer-to-peer communication regarding HIV testing and condom use, and perception of susceptibility to HIV in RHY.

Method: As a part of a longitudinal study, Los Angeles area homeless youth ages 14-27 years (N=598) were recruited from two drop-in centers. Each participant was asked to complete a computerized self-administered questionnaire and an interviewer-led social network interview. HIV susceptibility was measured using four Likert items, which were summed to a scale (range 0-16). Presence of at least one network tie with whom youth discussed using condoms or getting tested for HIV were derived from the social network interview. OLS regression models assessed the associations between HIV susceptibility, conversations about HIV prevention within one’s network, controlling for demographics, time homeless, recent sexual risk-taking.

Results: 47% of youth reported a susceptibility score of 8 or less, indicating that they on average somewhat or strongly disagree that they are susceptible to HIV. 57% of youth reported talking to at least one network member about HIV testing and 52% reported talking to at least one network member about using condoms. There was a significant relationship between both types of network ties and increased perception of susceptibility. In multivariate models, controlling for recent HIV risk-taking, demographics and time spent homeless, youth who reported talking to at least one person in their network about HIV testing reported higher levels of perceived susceptibility.

Conclusions: The present analyses identifies significant associations between peer-to-peer conversations regarding HIV testing and condom use, and increase perceived HIV susceptibility. Further research should examine the level at which HIV prevention information is reciprocated between homeless youth and their peers, and the impact of reciprocity levels on perceived HIV susceptibility and HIV risk-taking behaviors. While these data are preliminary, we believe these results provide support for the development of social network based peer-to-peer HIV interventions for runaway and homeless youth.