Running away from home is a dramatic response of many adolescents to a history of sexual abuse. Although there is increasing evidence that both males and females experience Child Sexual Abuse (CSA) (Chandy, Blum, & Resnick, 1996; Feiring, Taska, & Lewis, 1999; Chen, Tyler, Whitbeck, & Hoyt, 2004;), running away has been identified more often among females than males (Feiring et al., 1999). Moreover, most of what is known about the prevalence and consequences of CSA comes from studies of female children victimized by men (Reane, 1992). While there is increasing awareness of both short- and long-term consequences of CSA, little is known about how to prevent either the occurrence or the serious sequelae of this phenomenon. Unless adolescents are able to access resources to help them cope with experiences of CSA, the cycle of sexual abuse is likely to continue on the streets (Tyler, Whitbeck, & Hoyt, 2004).
The authors assumed that males and females experience CSA differently in terms of cognitions, perceptions, and subsequent behaviors. The goal of this study was to explore how gender and history of sexual abuse influence cognitive-perceptual and behavioral factors associated with sexual health practices of homeless adolescents.
Few studies have examined gender-specific factors associated with sexual health practices among homeless adolescents--a population at high risk for a variety of negative health outcomes including further victimization. Given that a large number of homeless adolescents run away from abusive family situations, they are an ideal sample for studying the broader issues of sexual health practices.
A reliable determination of the prevalence of homelessness among adolescents is difficult to obtain, but the most recent and vigorous attempt estimates that there are more than one million youth nationwide who are homeless during any given 12-month period (Ringwalt, Greene, Robertson, & McPheeters, 1998). Homeless adolescents, like homeless families, are increasing in number. Kurtz, and Kurtz and Jarvis (1991) identified five major groups of homeless adolescents: (1) members of homeless families; (2) runaways who leave home to escape physical and sexual abuse; (3) throwaways who were pushed out of their homes by parents or guardians; (4) system kids who escaped from intolerable foster care settings; and (5) street kids, often members of an immigrant minority group. Homeless adolescents in all subgroups, are uniquely subject to victimization as a result of the poverty, violence, and drug abuse they encounter on the streets (Rew & Horner, 2003). They experience numerous deprivations that may affect them for a lifetime. Many lose touch with any sort of environment that once offered a sense of security, identity, and belonging. Leaving home precociously may weaken primary supportive ties to caretakers. Many decide to reject the values and norms of mainstream society, which may in turn be detrimental to their mental health (Tyler, Cauce, & Whitbeck, 2004).
To date, no studies have been published that examine the differences in gender, cognitive-perceptual and behavioral factors, and sexual health practices among victimized homeless adolescents. This study was based on a conceptual model of sexual health practices and outcomes among homeless adolescents. The model provides a framework for understanding what is known about homeless youth and how community-based interventions may promote positive sexual health practices and outcomes. A detailed description of the model can be found elsewhere (Rew, 2001). Components of the model that guided this analysis included population characteristics (e.g., gender and sexual abuse history), cognitive-perceptual and behavioral factors (e.g., knowledge, social support, assertive communication), and health-related outcomes of sexual health practices. (See Figure 1.)
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Generally, professionals agree that with very few exceptions sexual abuse negatively affects children. …