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Protective factors for adolescent sexual health in the context of homelessness
Methods: We used data from a statewide sample of adolescents in Minnesota who responded to a school-based survey during 2013 (N=79,339). The sample was 50% female and 75% non-Hispanic white. Multivariable logistic regression models controlled for demographic characteristics.
Results: Overall, 5% of adolescents reported having been homeless in the past year. Homeless adolescents had significantly lower levels of family and school connectedness than their continuously housed peers (both p<.001). Regarding indicators of sexual health, more homeless adolescents reported ever having sexual intercourse (45% vs. 25%) or experiencing a pregnancy (20% vs. 8%, among sexually-experienced youth), and fewer reported using a condom at last sex (58% vs. 66%) (all p<.001). Among homeless adolescents, higher levels of family or school connectedness were associated with better sexual health, including lower odds of having sex (family, OR=0.48; school, OR=0.50) or experiencing a pregnancy (family, OR=0.34), and greater odds of using a condom (family, OR=1.50) (all p<.05). In moderation analyses, family connectedness had a stronger protective effect on ever having sex for homeless, than for housed, adolescents (family connectedness*homelessness interaction, OR=0.76, p<.05).
Conclusion: Study findings highlight the importance of family and school connectedness for sexual health among homeless adolescents, despite their lower levels of these protective factors. Schools may provide a venue to intervene and support this vulnerable population.