HIV Prevention and Homeless Youth: Fixing a Catastrophic Failure

Published: July 31, 2013

 One of the hardest tasks at the Ali Forney Center is telling one of our youths that they have tested positive for the human immunodeficiency virus (HIV). Having already been dealt the cruel blows of family rejection and homelessness, our youths struggle daily with despair. When they find out that they are HIV-positive, many of our youths become so despondent that we have to have them hospitalized for risk of suicide.

Every month, 1,000 young people in our nation between the ages of 13 and 24 are infected with HIV. A hugely disproportionate number of these new infections are among LGBT youths of color. There is an undeniable correlation between poverty and HIV infection rates among youths. And the failure of HIV prevention efforts to reduce new infections among these youths is undeniably exacerbated by a lack of clarity and vision in public policy to address how homelessness and poverty force young people into situations where they are at grave risk of infection.
Last year in the United States, at least 500,000 youths experienced homelessness. However, there was only enough capacity in the youth shelters to house 50,000 of them. Lacking shelter, a great many homeless youths turn to prostitution, or "survival sex," to survive . A 2012 New York Times op-ed cites a study by John Jay College that indicates that almost 90 percent of the surveyed minors who engage in survival sex indicated that they would stop if they could, but they cited lack of shelter as a major barrier to doing so.
HIV prevention efforts directed at homeless youths typically focus on condom distribution and HIV prevention education. But focusing on condoms and awareness without responding to the lack of shelter, which forces homeless youths into survival sex, is a failed policy. Nothing heightens the risk of homeless youths becoming infected with HIV more than the lack of shelter, and nothing diminishes their risk behaviors more than providing them with shelter.
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