When, Where, Why and with Whom Homeless Women Engage in Risky Sexual Behaviors

A Framework for Understanding Complex and Varied Decision-Making Processes

Published In: Sex Roles, v. 61, no. 7-8, Oct. 2009, p. 536-553

Posted on RAND.org on December 31, 2008

by Gery W. Ryan, Stefanie Howard, Lara Hilton, Joan S. Tucker, David P. Kennedy, Daniela Golinelli, Suzanne L. Wenzel

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Impoverished women worldwide are at high risk for contracting HIV/AIDS. This study explores how homeless women make risky sex decisions and the role that alcohol and drugs play in this process. We analyze 56 in-depth qualitative descriptions of recent sexual episodes among 28 women living in shelters in Los Angeles, California, USA. The sample (age 18-63) was 46% African American, 21% Hispanic/Latina, and 21% White. Findings suggest that: (1) homeless women engage in multiple types of relationships and sexual behaviors; (2) emotion and attachment play critical roles in women's risky sex choices; and (3) the role of alcohol and drugs on such choices varies across relationship commitment. Understanding the complexity of sexual decision-making among this population has implications for developing successful risk reduction interventions.

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