Type of Document	Dissertation
Author	Simmons, Melanie J
URN	etd-09042003-173357
Title	Problem Behavior Versus The Risk Amplification Approach: HIV Risk Behaviors Of Homeless Youth In Fort Lauderdale
Degree	Doctor of Philosophy
Department	Sociology, Department of
Advisory Committee	Advisor Name Title David F. Sly Committee Chair Dianne F. Harrison Committee Member Irene Padavic Committee Member Karin Brewster Committee Member
Keywords	Sexual Risk Drug Use Homeless Youth
Date of Defense	2003-06-01
Availability	unrestricted
Abstract Research indicates that homeless youth are at high risk for HIV infection compared to youth in general. This study used problem behavior and risk amplification theories to investigate HIV risk behaviors among homeless youth. Problem behavior theory posits that youth who have certain socially constructed personality characteristics develop co-occurring problem behaviors that increase the likelihood they will engage in additional problem behaviors. Risk amplification theory asserts that more exposure to homelessness is associated with an increased risk of substance abuse and adverse mental health outcomes. This study investigated how the theories work together to explain two HIV-related risk behaviors—sexual activity without condom use and high-risk drug use— in a sample of homeless youth. A cross-sectional, convenience sample of homeless youth in Fort Lauderdale, Florida (n=460) was interviewed through a cooperative agreement between the Florida Department of Health and the Centers for Disease Control and Prevention. Co-occurring problem behavior variables represented problem behavior theory and duration and frequency of homelessness represented risk amplification theory in the analysis. Binary and multinomial logistic regression tests were used to identify the associations of these theorized risk factors independently and within interactions. The analysis of condom use revealed that youth with co-occurring problem behaviors who had been homeless for a longer duration were the least likely to use condoms during the last sexual intercourse. Youth who reported only one risk (either problem behaviors or greater duration homeless) were also less likely to use condoms compared to youth with neither risk factor. The analysis of high-risk drug use also provided evidence of an association with an interaction between cooccurring problem behaviors and extended homelessness. An interaction was found between co-occurring problem behaviors and both measures of extended homelessness (frequency and duration homeless). One finding from the interaction analyses contradicted the risk amplification hypothesis that more time homeless necessarily increases risk. In the absence of problem behaviors, a greater duration of homelessness was not related to high-risk drug use. Thus, the risk amplification approach would have more explanatory value if it identified factors that might protect homeless youth from engaging in risk-taking behavior. The absence of problem behaviors while homeless might be one such protective factor against high-risk drug use. Limitations of the study are discussed.
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