Skip to main content

Advertisement

Log in

Sex and Relationships on the Street: How Homeless Men Judge Partner Risk on Skid Row

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Homeless men in the U.S. represent a large and growing population, and have elevated rates of HIV/AIDS and sexual risk behaviors, including unprotected sex with women. We conducted qualitative interviews (n = 30) with homeless men using shelters and meal lines in downtown Los Angeles (Skid Row) to better understand how such men view the risks of sexual encounters with female partners. Men living on Skid Row perceived multiple risks, including HIV and unwanted pregnancy as well as emotional trauma, loss of resources, exacerbation of drug addiction, and physical attack. Respondents described using visual and behavioral cues, social reputation, geographical location, feelings of trust, perceived relationship seriousness, and medically inaccurate “folk” beliefs to judge whether partners were risky and/or condom use was warranted. Medically inaccurate beliefs suggest the potential utility of evidence-based interventions to change such beliefs. We also consider implications for relationships on the street and housing interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Higgins JA, Hoffman S, Dworkin SL. Rethinking gender, heterosexual men, and women’s vulnerability to HIV/AIDS. Am J Public Health. 2010;100(3):435–45.

    Article  PubMed  Google Scholar 

  2. Centers for Disease Control and Prevention. HIV/AIDS among women. CDC HIV/AIDS fact sheet 2008. http://www.cdc.gov/hiv/topics/women/resources/factsheets/pdf/women.pdf. Accessed Dec 2010.

  3. Robertson MJ, Clark RA, Charlebois ED, et al. HIV seroprevalence among homeless and marginally housed adults in San Francisco. Am J Public Health. 2004;94(7):1207–17.

    Article  PubMed  Google Scholar 

  4. Zolopa AR, Hahn JA, Gorter R, et al. HIV and tuberculosis infection in San Francisco’s homeless adults: prevalence and risk factors in a representative sample. JAMA. 1994;272(6):455–61.

    Article  PubMed  CAS  Google Scholar 

  5. Susser E, Valencia E, Miller M, Tsai W, Meyer-Bahlburg H, Conover S. Sexual behavior of homeless mentally ill men at risk for HIV. Am J Psychiatry. 1995;152(4):583–7.

    PubMed  CAS  Google Scholar 

  6. Allen DM, Lehman JS, Green TA, et al. HIV infection among homeless adults and runaway youth, United States, 1989–1992. AIDS. 1994;8(11):1593–8.

    Article  PubMed  CAS  Google Scholar 

  7. Paris NM, East RT, Toomey KE. HIV seroprevalence among Atlanta’s homeless. J Health Care Poor Underserved. 1996;7(2):83–93.

    PubMed  CAS  Google Scholar 

  8. Centers for Disease Control and Prevention. HIV/AIDS in the United States. CDC HIV/AIDS fact sheet 2008. http://www.cdc.gov/hiv/resources/factsheets/us.htm. Accessed Nov 2010.

  9. Strathdee SA, Galai N, Safaiean M, et al. Sex differences in risk factors for HIV seroconversion among injection drug users: a 10-year perspective. Arch. Intern. Med. 2001;161(10):1281–8.

    Google Scholar 

  10. Burt MR, Aron LY, Douglas T, Valente J, Lee E, Iwen B. Homelessness: programs and the people they serve. Findings of the national survey of homeless assistance providers and clients. http://www.huduser.org/portal/publications/homeless/homeless_tech.html (1999). Accessed May 2010.

  11. Cortes A, Khadduri J, Buron L, Culhane DP. The 2009 annual homelessness assessment report to congress. http://www.huduser.org/portal/publications/povsoc/ahar_5.html (2010). Accessed June 2010.

  12. Wenzel SL, Tucker JS, Elliott MN, et al. Prevalence and co-occurrence of violence, substance use and disorder, and HIV risk behavior: a comparison of sheltered and low-income housed women in Los Angeles County. Prev Med. 2004;39(3):617–24.

    Article  PubMed  Google Scholar 

  13. Wenzel S, Tucker J, Elliott M, Hambarsoomians K. Sexual Risk among impoverished women: understanding the role of housing status. AIDS Behav. 2007;11:9–20.

    Article  PubMed  Google Scholar 

  14. Watson WK, Bell NJ. Narratives of development, experiences of risk: adult women’s perspectives on relationships and safer sex. Br J Health Psychol. 2005;10:311–27.

    Article  PubMed  Google Scholar 

  15. Ryan GW, Stern SA, Hilton L, et al. When, where, why and with whom homeless women engage in risky sexual behaviors: a framework for understanding complex and varied decision-making processes. Sex Roles. 2009;61(7–8):536–53.

    Article  PubMed  Google Scholar 

  16. Masaro CL, Dahinten VS, Johnson J, Ogilvie G, Patrick DM. Perceptions of sexual partner safety. Sex Transm Dis. 2008;35(6):566–71.

    Article  PubMed  CAS  Google Scholar 

  17. Hoffman V, Cohen D. A night with Venus: partner assessments and high-risk sexual encounters. AIDS Care. 1999;11(5):555–66.

    Article  PubMed  CAS  Google Scholar 

  18. Ott MA, Millstein SG, Ofner S, Halpern-Felsher BL. Greater expectations: adolescents’ positive motivations for sex. Perspect Sex Reprod Health. 2006;38(2):84–9.

    Article  PubMed  Google Scholar 

  19. Bourgois PI, Schonberg J. Righteous Dopefiend. Berkeley, CA: University of California Press; 2009.

    Google Scholar 

  20. Liu WM, Stinson R, Hernandez J, Shepard S, Haag S. A qualitative examination of masculinity, homelessness, and social class among men in a transitional shelter. Psychol Men Masc. 2009;10(2):131–48.

    Article  Google Scholar 

  21. Somlai AM, Kelly JA, Wagstaff DA, Whitson DP. Patterns, predictors, and situational contexts of HIV risk behaviors among homeless men and women. Soc Work. 1998;43(1):7–20.

    Article  PubMed  CAS  Google Scholar 

  22. Wright NMJ, Tompkins CNE, Jones L. Exploring risk perception and behaviour of homeless injecting drug users diagnosed with hepatitis C. Health Soc Care Commun. 2005;13(1):75–83.

    Article  Google Scholar 

  23. Michels TM, Kropp RY, Eyre SL, Halpern-Felsher BL. Initiating sexual experiences: how do young adolescents make decisions regarding early sexual activity? J Res Adolesc. 2005;15(4):583–607.

    Article  Google Scholar 

  24. Los Angeles Homeless Services Authority. 2009 Great Los Angeles homeless count report: City of Los Angeles—Skid Row. Los Angeles, CA: Los Angeles Homeless Services Authority; 2009.

  25. Los Angeles Homeless Services Authority. 2009 Great Los Angeles homeless count report. Los Angeles, CA: Los Angeles Homeless Services Authority; 2009.

  26. Shelter Partnership. 2006 Short-term housing directory of Los Angeles County. http://www.shelterpartnership.org/Common/Documents/studies/housingdirectory2006_000.pdf (2006). Accessed Aug 2010.

  27. Ryan GW, Bernard HR. Techniques to identify themes. Field Methods. 2003;15(1):85–109.

    Article  Google Scholar 

  28. Bernard HR, Ryan GW. Analyzing qualitative data: systematic approaches. Thousand Oaks, Calif: Corwin; 2010.

    Google Scholar 

  29. Misovich SJ, Fisher JD, Fisher WA. Close relationships and elevated HIV risk behavior: evidence and possible underlying psychological processes. Rev Gen Psychol. 1997;1(1):72–107.

    Article  Google Scholar 

  30. Burnam MA, Koegel P. Methodology for obtaining a representative sample of homeless persons. Eval Rev. 1988;12(2):117–52.

    Article  Google Scholar 

  31. Halpern-Felsher BL, Millstein SG, Ellen JM, Adler NE, Tschann JM, Biehl M. The role of behavioral experience in judging risks. Health Psychol. 2001;20(2):120–6.

    Article  PubMed  CAS  Google Scholar 

  32. Carey MP, Lewis BP. Motivational strategies can enhance HIV risk reduction programs. AIDS Behav. 1999;3(4):269–76.

    Article  PubMed  Google Scholar 

  33. Operario D, Smith CD, Arnold E, Kegeles S. The Bruthas project: evaluation of a community-based HIV prevention intervention for African American men who have sex with men and women. AIDS Educ Prev. 2010;22(1):37–48.

    Article  PubMed  Google Scholar 

  34. Bourgois P. The moral economies of homeless heroin addicts: confronting ethnography, HIV risk, and everyday violence in San Francisco shooting encampments. Subst Use Misuse. 1998;33(11):2323–51.

    Article  PubMed  CAS  Google Scholar 

  35. Stein J, Nyamathi A, Ullman J, Bentler P. Impact of marriage on HIV/AIDS risk behaviors among impoverished, at-risk couples: a multilevel latent variable approach. AIDS Behav. 2007;11(1):87–98.

    Article  PubMed  Google Scholar 

  36. Aidala A, Cross J, Stall R, Harre D, Sumartojo E. Housing status and HIV risk behaviors: implications for prevention and policy. AIDS Behav. 2005;9(3):251–65.

    Article  PubMed  Google Scholar 

  37. Wolitski R, Kidder D, Pals S, et al. Randomized trial of the effects of housing assistance on the health and risk behaviors of homeless and unstably housed people living with HIV. AIDS Behav. 2010;14(3):493–503.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by NICHD—R01HD059307 (Wenzel). Many thanks to Mary Lou Gilbert, Fred Mills, and Rick Garvey for their critical efforts during field work and interviewing. We would also like to thank the men we interviewed on Skid Row for their trust and patience during the interview process. This research would not have been possible without the cooperation of participating shelters and meal lines in downtown Los Angeles: Los Angeles Mission, Midnight Mission, Union Rescue Mission, New Image Emergency Shelter, St. Vincent Cardinal Manning Center, Fred Jordan Mission, and Emmanuel Baptist Rescue Mission.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ryan A. Brown.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brown, R.A., Kennedy, D.P., Tucker, J.S. et al. Sex and Relationships on the Street: How Homeless Men Judge Partner Risk on Skid Row. AIDS Behav 16, 774–784 (2012). https://doi.org/10.1007/s10461-011-9965-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-011-9965-3

Keywords

Navigation