One in 10 young adults aged 18 to 25 and one in 30 adolescents aged 13 to 17 experience homelessness over the course of a year. On any given night in the United States, 1.7 to 2.5 million youth under age 25 are homeless. The tumultuous experiences of daily life on the streets are incredibly difficult for youth experiencing homelessness (YEH). While surviving the dangers of the streets and meeting one’s basic needs for food and shelter, youth face enormous difficulties in maintaining their health and well-being. Congregate living settings such as shelters, halfway houses, encampments, and street dwelling and the lack of access to basic hygiene facilities and supplies may increase the risk of virus transmission and their potential for being exposed to Covid-19. 

While many cities have imposed stay-at-home orders to prevent Covid-19 transmission, those without shelter have largely been left on the streets and without access to resources due to shelter closures and shut downs of drop-in and food distribution centers. It is unclear how and where YEH have moved to during quarantines and lockdowns. It is also unclear what impact lockdowns and infection mitigation efforts may have had on YEH’s mental health. YEH already experience a mortality rate that is 5–10 times higher than that of the general population. Covid-19 infection might further increase morbidity and mortality. Many YEH also have chronic mental and physical conditions, engage in risky behaviors (i.e. drug use, condomless sex), and experience extreme challenges to accessing health care.

To address these gaps, we will conduct a mixed methods study utilizing the existing cohort of YEH from an ongoing longitudinal study (R01NR017837). We currently have 68 YEH and will be recruiting 200 additional YEH in the next 12 months. We will collect additional Covid-19 related measures at 3-month intervals for 1 year on the 268 participants. We will conduct qualitative interviews with 40 youth to learn what YEH know about Covid-19 and preventive measures and how it is affecting their daily life and health by inquiring about Covid-19 knowledge, knowledge of and adherence to preventive measures, symptoms, testing, ability to acquire basic needs, impact on social supports, access to healthcare including HIV care, substance use patterns, and mental and emotional health. Finally, we will assess prevalence rate by conducting Covid-19 antibody testing among the sample of 268 YEH.