Toronto street youth and HIV/AIDS: Prevalence, demographics, and risks

Purpose: The purposes of this study were: (a) to identify human immunodefic iency virus (HIV) prevalence in Toronto street youth through paired blood a nd saliva specimens; (b) to identify the HIV risk and prevention behaviors of street involved youth; and (c) to identify demographic or other factors that may contribute to the risk of street youth becoming infected with HIV/ acquired immunodeficiency syndrome (AIDS) in the future. Methods: This was a cross-sectional convenience study of street-involved yo uth aged 14-25 years. The youth participated in interviews to identify HIV- related knowledge and personal risk and preventive behaviors. Following int erviews, they were asked to provide a saliva sample, blood spot or both. Th ey could refuse one or both samples without jeopardizing their involvement or receiving an honorarium. Two males were the only participants who declin ed to provide a sample. Results: Fifteen of 695 (2.2%) youth tested positive for HIV infection. All were male, ranging in age from 18 to 25 years. Same and opposite sex, intr avenous (IV) drug use, prostitution, and incarceration were risk factors as sociated with positive HIV test results. The rate of HIV infection was seve n times greater for the group 20 years of age and older (20-25) compared to the younger group aged 14-9 years. The proportion testing positive for HIV from small cities, towns, and rural communities in Ontario was 40%; yet, t hey represented 21% of the study population. Most (57%) youth had been an t heir own far no more than 3 years and had moved frequently. Nearly two thir ds (60%) had stayed in hostels or homeless shelters in the previous 6 month s. Conclusion: Street youth in Canada are at high risk of HIV infection with t heir risk increasing with age. Unprotected (same and opposite) sex, IV drug use, prostitution and incarceration were linked to their HIV infections. T he high level of mobility identified by street youth challenges governments , communities, and public health officials to develop appropriate preventio n strategies and to carefully monitor the spread of HIV infection in this v ulnerable population (C) Society for Adolescent Medicine, 1999.