In the United States, homeless youth are becoming increasingly entrenched in problem substance use, including high prevalence of alcohol abuse and injection use. A total of 54 substance-using homeless youth (18-25 years) participated in focus groups in order to provide their perspectives on barriers to and facilitators of seeking treatment. Participants were recruited from shelters in Hollywood, CA, and from a street-based, drop-in site in Santa Monica, CA. Participants identified personal barriers to treatment, but reported that facilitators of treatment tended to be more systematic. Homeless youth used and abused substances to dim the psychological effects of living on the streets. They appreciated programs that facilitated treatment and rehabilitation such as mentoring, support groups, and alternative choices to substance use. Implications point to the need for further development and research on culturally-appropriate, age-sensitive programs for homeless youth. The experiences of these youth underscore the need for strategic interventions.

In this study of factors related to Hepatitis C virus (HCV) infection in 104 homeless HCV-infected men and 94 uninfected homeless men, findings reveal that homeless men with HCV infection are older and more likely to be cocaine injectors than those not infected. Moreover, the sharing of needles, use of injected cocaine during the past 6 months, previous incarceration, veteran status, fair or poor health, and having multiple tattoos are also associated with HCV infection. Reports of having completed the HBV vaccination series, weekly marijuana use, and snorting cocaine or methamphetamine are negatively associated with HCV infection. Among men not reporting lifetime injection drug use, factors such as sharing toothbrushes, having multiple tattoos, being in fair or poor health, and past incarceration are associated with HCV infection. These findings may need to be considered when making screening decisions and counseling homeless male patients about HCV.