Impact of social network characteristics on shelter use among street youth in San Francisco.

PURPOSE We examined the cross-sectional and longitudinal association between social network characteristics and street youths' shelter use, a determinant of health outcomes for homeless youth. METHODS We analyzed interview data from 138 street youth recruited through venue-based sampling in San Francisco, to assess the cross-sectional relationship between shelter use in youths' social networks and youths' reported shelter use. We also assessed the relationship between baseline network shelter use and shelter use at 6-month follow-up. RESULTS Low proportions of street youth reported shelter use at baseline (38%) and follow-up (29.6%). Twenty-nine (26.9%) youth were in networks with shelter users at baseline, compared with 17 youth (15.7%) at follow-up. In cross-sectional analysis, youth in networks with shelter users had 5-fold increased odds of reporting shelter use (OR: 5.86, p = .006). A 1-person increase in the number of network shelter users was associated with 2-fold increased odds of youths' shelter use (OR: 2.16, p = .02). In longitudinal analysis, youth in networks with shelter users at baseline had nearly 5-fold increased odds of shelter use at follow-up (OR: 4.95, p = .01). A 1-person increase in the number of network shelter users at baseline was associated with 3-fold increased odds of shelter use at follow-up (OR: 3.15, p = .004). CONCLUSION Shelter users seem to cluster together. Shelter use by extended network members was associated with increased odds of youths' own shelter use. Understanding how network behaviors influence street youths' health-related behaviors, such as shelter use, could inform network-based interventions encouraging service uptake among marginalized and hard-to-reach street youth populations.