Shared risk: who engages in substance use with American homeless youth?

Aims To identify characteristics of social network members with whom homeless youth engage in drinking and drug use. Design A multi-stage probability sample of homeless youth completed a social network survey. Setting Forty-one shelters, drop-in centers and known street hangouts in Los Angeles County. Participants A total of 419 homeless youth, aged 13-24 years (mean age = 20.09, standard deviation = 2.80). Measurements Respondents described 20 individuals in their networks, including their substance use and demographics, and the characteristics of the relationships they shared, including with whom they drank and used drugs. Dyadic, multi-level regressions identified predictors of shared substance use. Findings Shared drinking was more likely to occur with recent sex partners [odds ratio (OR) = 2.64, confidence interval (CI): 1.67, 4.18], drug users (OR = 4.57, CI: 3.21, 6.49), sexual risk takers (OR = 1.71, CI: 1.25, 2.33), opinion leaders (OR = 1.69, CI: 1.42, 2.00), support providers (OR = 1.41, CI: 1.03, 1.93) and popular people (those with high degree scores in the network) (OR = 1.07, CI: 1.01, 1.14). Shared drug use was more likely to occur with recent sex partners (OR = 2.44, CI: 1.57, 3.80), drinkers (OR = 4.53, CI: 3.05, 6.74), sexual risk takers (OR = 1.51, CI: 1.06, 2.17), opinion leaders (OR = 1.24, CI: 1.03, 1.50), support providers (OR = 1.83, CI: 1.29, 2.60) and popular people (OR = 1.16, CI: 1.08, 1.24). Conclusions Homeless youth in the United States are more likely to drink or use drugs with those who engage in multiple risk behaviors and who occupy influential social roles (popular, opinion leaders, support providers, sex partners). Understanding these social networks may be helpful in designing interventions to combat substance misuse.