Migration Patterns and Substance Use among Young Homeless Travelers

Abstract

Homeless youth are a diverse population of at risk adolescents and young adults who experience various negative health outcomes, including drug dependence, drug overdose, infectious diseases, and victimization. Previous studies have been directed toward understanding subgroups of homeless youth, such as injection drug users (IDUs) and young men who have sex with men (YMSM); yet limited research has focused on describing homeless “travelers,” a migratory subgroup of homeless youth who move from city to city. Based upon a larger three site study of young IDUs recruited in Los Angeles, New Orleans, and New York, a total of 133 travelers were identified. A subsample of 56 travelers participated in follow-up interviews, and provided data points for mapping. Travelers in all sites had extensive histories of criminal justice involvement and injection drug use. Four common traveling routes within and across the United States were identified. Reasons for traveling often related to drug use, money-making opportunities, and law enforcement. Risk-reduction services, such as shelters, syringe exchanges, or HIV/HCV testing, were used infrequently or occasionally. Mapping data documents the mobility of young IDUs across both urban and rural areas, which suggests that migration among IDUs across broad geographic regions may be a factor in the spread of blood-borne viruses.