Gender Differences in Sexual Risk and Sexually Transmitted Infections Correlate with Gender Differences in Social Networks Among San Francisco Homeless Youth

Purpose: To explore whether gender differences in sexual risk and sexually transmitted infections (STIs) among homeless youth may be explained in part by gender differences in their social networks.

Methods: Our sample includes 258 youth (64% male) recruited in San Francisco from street venues and transitional programs. Participants completed an audio computer-administered self-interview survey regarding their housing status and risk behaviors and an interviewer-administered survey regarding their social networks, and were tested for STIs (chlamydia and gonorrhea). We examined relationships between sexual risk and STI rates and social network characteristics by gender.

Results: Condom use was lower in young women than in young men, whereas young women were more likely to have an injection drug user (IDU) sex partner and to be diagnosed with an STI. Homeless young men were more likely to have stably housed contacts and same-sex friendships in their social networks than were young women. Stably housed network contacts were associated with increased condom use and decreased STI prevalence in young men. Same-sex friends were associated with increased condom use in young women. No young woman with a family member in her network had an IDU sex partner. Having a network member who had been recently incarcerated was associated with having an IDU sex partner for young women.

Conclusions: Homeless young women's networks may place them at greater risk for STIs than young men. Increasing mainstream contacts and same-gender friendships may protect all homeless youth from STIs. Interventions addressing homeless young women's social networks may decrease their gender-disparate STI risk.