Longitudinal Exploration of Pathways to HIV/STI Risk Reduction among Homeless Young Adults through a Youth-Centric Rapid Re-Housing Program

通过以青年为中心的快速安置计划，纵向探索减少无家可归年轻人艾滋病毒/性传播感染风险的途径

• 批准号: 10250528
• 负责人: Heather I. Mosher
• 金额: $ 21.38万
• 依托单位: INSTITUTE FOR COMMUNITY RESEARCH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10250528
• 关键词: AIDS prevention; Address; Adult; Affect; Age; Behavioral; Biological Factors; Biological Markers; Case Management; Child; Child Abuse; Chronic; Client; Color; Communities; Development; Diagnosis; Emotional; Environmental Risk Factor; Exposure to; Feeling; Foundations; Future; HIV Infections; HIV risk; HIV/STD; Homelessness; Housing; Intervention; Interview; Knowledge; Lesbian Gay Bisexual Transgender; Link; Literature; Loneliness; Measures; Methods; Outcome; Pathway interactions; Persons; Prevention Research; Prevention approach; Process; Psychological Factors; Research; Resources; Risk; Risk Behaviors; Risk Factors; Risk Reduction; STI prevention; Science; Services; Sexual Partners; Social Environment; Social support; Stress; Structure; Subgroup; Surveys; Testing; Time; Unsafe Sex; Vulnerable Populations; Youth; adverse childhood events; age group; behavior change; condoms; coping; design; early life exposure; emerging adulthood; experience; health disparity; high risk; high risk sexual behavior; holistic approach; housing instability; improved; informant; innovation; insight; middle age; model building; programs; protective factors; psychological distress; psychosocial; resilience; response; sex; social; social factors; substance use; supported housing; theories; therapy design; young adult

ABSTRACT This R21 study is a longitudinal exploration of pathways to HIV/STI risk reduction among homeless young adults ages 18-24 (YAEH) through a youth-centric rapid re-housing program (YRR). Given that young adults are one of the age groups most at risk of homelessness and of acquiring HIV and STIs in the US, an urgent need exists for effective and developmentally-appropriate structural intervention approaches to HIV/STI prevention for YAEH. YRR is widely used by communities across the U.S. as a solution to addressing youth homelessness; however there has been limited research on the impact of short-term housing programs, such as YRR, on YAEH's HIV/STI risk. Prior studies have identified a range of likely causal factors linked to HIV/STI risk behaviors among YAEH; however, little is known about the specific beneficial causal processes, i.e., the interacting variables and pathways generating the outcomes, to HIV/STI risk reduction among YAEH through a short-term housing intervention with service supports. Furthermore, much of the evidence linking housing instability and HIV/STI risk among YAEH has been cross-sectional, limiting our understanding of the mechanisms that should be targeted for HIV prevention. The specific aims of this study are to: Aim 1: Explore potential causal (bio-, psycho-, social- and environment-level) processes that contribute to resilience and reduction in HIV/STI risk (multiple sex partners, substance use, trading sex, unprotected sex) among YAEH through an established short-term youth-centric housing intervention, utilizing a panel design and mixed methods approach (in-depth interviews, surveys, HIV/STI and stress biomarkers) to track clients' (n=50) change in HIV/STI behavioral risk outcomes over a 12-month period; Aim 2: Build a theory that describes the interrelated pathways and directions among different causal processes and HIV/STI risk outcomes for model building; and Aim 3: Pilot test newly created, developmentally-appropriate measures of housing stability for YAEH and relevant causal processes, using findings from Aims 1 and 2 and interviews with key informants (n=5) and YAEH YRR clients (n=10). Results from the proposed study will be used to develop a theoretical framework and pilot-tested measures in order to build the foundation for a large-N mixed-methods study to test causal mechanisms linking YRR and HIV/STI risk among YAEH. The impact of this study is to reduce health disparities in HIV/STIs among high risk and vulnerable populations by helping communities improve their interventions for YAEH.

抽象的 这项R21研究是对无家可归者降低HIV/STI风险降低途径的纵向探索 通过以青年为中心的快速重新安置计划（YRR）的成年人18-24岁（YAEH）。考虑到年轻人 是最有无家可归风险和在美国获得艾滋病毒和性传播感染的年龄段之一，这是紧急的 存在有效且具有开发性的结构干预方法的艾滋病毒/STI的需求 预防Yaeh。 YRR被美国各地社区广泛使用，以解决青年的解决方案 无家可归；但是，关于短期住房计划的影响的研究有限，例如 作为YRR，对Yaeh的HIV/STI风险。先前的研究已经确定了与HIV/STI相关的一系列可能因果因素 Yaeh之间的风险行为；但是，对于特定的有益因果过程，即 相互作用的变量和途径产生结果，通过yaeh之间的艾滋病毒/性传播感染风险降低 服务支持的短期住房干预。此外，连接住房的许多证据 Yaeh的不稳定性和艾滋病毒/STI风险是横截面，限制了我们对 应针对预防HIV的机制。这项研究的具体目的是：目标1：探索 潜在的因果（生物，心理，社会和环境级别）过程，有助于弹性和 Yaeh中降低HIV/STI风险（多个性伴侣，药物使用，交易性行为，无保护性） 通过建立的短期以青年为中心的住房干预，利用面板设计和混合 方法方法（深入访谈，调查，HIV/STI和压力生物标志物）跟踪客户（n = 50） 在12个月内，HIV/STI行为风险结果的变化；目标2：建立一个描述的理论 不同因果过程之间的相互关联的途径和方向与模型的艾滋病毒/性传播感染风险结果 建筑;目标3：试点测试新创建的，适合开发的住房稳定性衡量标准 Yaeh和相关因果过程，使用AIM 1和2的调查结果以及与主要线人的访谈 （n = 5）和yaeh yrr客户端（n = 10）。拟议的研究的结果将用于发展理论 框架和试验测试措施，以建立大N混合方法研究的基础 在YAEH中将YRR和HIV/STI风险联系起来的因果机制。这项研究的影响是减少健康 通过帮助社区改善他们的艾滋病毒/性传播疾病差异 Yaeh的干预措施。