Perceived Devaluation and STI Testing Uptake among a Cohort of Street-involved Youth in a Canadian Setting

Peer reviewed: 
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Final version published as: 

Karamouzian, M., Shoveller, J., Dong, H. et al. Perceived Devaluation and STI Testing Uptake among a Cohort of Street-involved Youth in a Canadian Setting. Archives of Sexual Behavior (2017).


Date created: 
DOI: 10.1007/s10508-017-1002-9
Perceived devaluation
Sexually transmitted infections
Homeless youth
Substance use
Sexual behaviour

Perceived devaluation has been shown to have adverse effects on the mental and physical health outcomes of people who use drugs. However, the impact of perceived devaluation on sexually transmitted infections (STI) testing uptake among street-involved youth, who face multiple and intersecting stigmas due to their association with drug use and risky sexual practices, has not been fully characterized. Data were obtained between December 2013 and November 2014 from a cohort of street-involved youth who use illicit drugs aged 14–26 in Vancouver, British Columbia. Multivariable generalized estimating equations were constructed to assess the independent relationship between perceived devaluation and STI testing uptake. Among 300 street-involved youth, 87.0% reported a high perceived devaluation score at baseline. In the multivariable analysis, high perceived devaluation was negatively associated with STI testing uptake after adjustment for potential confounders (Adjusted Odds Ratio = 0.38, 95% Confidence Interval 0.15–0.98). Perceived devaluation was high among street-involved youth in our sample and appears to have adverse effects on STI testing uptake. HIV prevention and care programs should be examined and improved to better meet the special needs of street-involved youth in non-stigmatizing ways.


The fulltext of this paper will be available in June 2018 due to the embargo policies of the journal Archives of Sexual Behavior for works funded by the Canadian Institutes of Health Research (CIHR). Contact to enquire if the full text of the accepted manuscript can be made available to you.

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Rights remain with the authors.
Canadian Institutes of Health Research (CIHR)