Homelessness is highly associated with HIV, with 5.3% seropositive in 1989. While this is the only domestic study, in 2010, the HIV prevalence among homeless youth in Ukraine was 18.4%. Homeless youth (HY) are likely to have psychiatric disorders, substance abuse problems (usually poly substances, including alcohol), and have homes with high levels of conflict (sometimes because parents have substance abuse, or mental health problems themselves). Many homeless youth were ejected from their home or left due to neglect or abuse. Bartering sex is a means of survival. Risk for HIV comes both from youth’s life circumstances, as well as a history of multiple behavioral risks.