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ABSTRACT
Objectives. This study examined the prevalence and correlates of survival sex among runaway and homeless youths.
Methods. A nationally representaptive sample of shelter youths and a multicity sample of street youths were interviewed.
Results. Approximately 28% of street youths and 10% of shelter youths reported having participated in survival sex, which was associated with age, days away from home, victimization, criminal behaviors. substance use, suicide attempts, sexually transmitted disease, and pregnancy.
Conclusions. Intensive and ongoing services are needed to provide resources and residential assistance to enable runaway and homeless youths to avoid survival sex, which is associated with many problem behaviors. (Am J Public Health. 1999;89:1406-1409)
"Survival sex" refers to the selling of sex to meet subsistence needs. It includes the exchange of sex for shelter, food, drugs, or money. The dangers inherent in survival sex make it among the most damaging repercussions of homelessness among youths.
Previous estimates of the proportion of runaway and homeless youths who engage in survival sex range from 10% to 50%.1-16 These estimates, however, were based on relatively small and geographically limited samples. We report the proportions engaging in survival sex among runaway and homeless youths in a nationally representative sample of youths in shelters and in a multicity sample of youths on the streets. We also examined potential correlates of survival sex; identification of such correlates may help programs tailor specialized interventions for this high-risk population.
Methods
Sample Selection
Eligibility requirements were the same for youths identified in shelters and on the streets: (1) age 12 to 21 years and (2) having spent at least 1 night in the previous year in a youth or adult shelter, an improvised shelter (e.g., abandoned building), outside (e.g., under a bridge), or with a stranger. Youths 17 years or younger who had spent at least 1 night in the past year away from home without the permission of parents or legal guardians also were eligible. The sampling procedures used in each survey are described briefly below. The sampling design is reported elsewhere in greater detail.17,18
Shelter sample. Multistage sampling techniques were used to select a nationally representative sample of youths from youth shelters. In the first stage, 25 primary sampling units (PSUs) representing metropolitan and nonmetropolitan areas were...