What We (Don't) Know About the Infectious Disease Burden Among Youth Experiencing Homelessness in the United States and Canada

Youth experiencing homelessness (YEH) and sexual and gender minority (SGM) YEH may be at increased risk for infectious diseases due to living arrangements, risk behaviors, and barriers to health care access that are dissimilar to those of housed youth and older adults experiencing homelessness. Here, we synthesize findings from 12 peer-reviewed articles published between 2012 and 2020 that enumerate YEH or SGM YEH infectious disease burden in locations across the United States or Canada. Pathogens presented in the reviewed studies were limited to sexually transmitted infections (STIs) and bloodborne infections (BBI). Only 3 studies enumerated infectious diseases among SGM YEH. There was a dearth of comparison data by housing status or SGM identity. We also introduce 3 publicly available surveillance datasets from the United States or Canada that quantify certain STIs, BBIs, and tuberculosis among YEH to support future analyses. Our review calls for more comprehensive YEH-centered research and surveillence to improve estimates of infectious diseases among this vulnerable population. There is a dearth of literature and surveillance data quantifying infectious diseases of concern among YEH in the United States and Canada. This review calls for improved estimates of infectious disease burden among YEH to inform targeted, timely interventions.