HIV risk and prevention behavior and the role of social support networks among precariously housed youth: A mixed-methods study

住房不稳定的青少年的艾滋病毒风险和预防行为以及社会支持网络的作用：混合方法研究

• 批准号: 10755078
• 负责人: Laura Petry
• 金额: $ 4.77万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10755078
• 关键词: AIDS prevention; Affect; Age; Appointment; Attention; Awareness; Behavior; California; Cessation of life; Characteristics; Child Abuse; Conceptions; Contracts; Data; Data Set; Development; Educational Intervention; Family; Friends; Goals; HIV; HIV risk; Health; Hearing; Heterogeneity; Homeless Youth; Homeless persons; Homelessness; Household; Housing; Human immunodeficiency virus test; Internet; Intervention; Interview; Knowledge; Lesbian Gay Bisexual Transgender Queer; Literature; Longitudinal Studies; Los Angeles; Mental Depression; Mental Health; Methodology; Methods; Needle Sharing; Pathway Analysis; Personal Satisfaction; Persons; Pharmaceutical Preparations; Phase; Population; Prevalence; Prevention; Reporting; Research; Research Methodology; Research Personnel; Risk; Risk Behaviors; Risk Taking; Role; Safety; Sample Size; Science; Sexual Partners; Social Environment; Social Interaction; Social Network; Social support; Statistical Methods; Subgroup; Substance abuse problem; Surveys; Training; Transact; Unsafe Sex; Victimization; Vulnerable Populations; Work; Youth; career; child neglect; children of color; condoms; ethnic minority; experience; family support; high risk population; high risk sexual behavior; injection drug use; peer; pre-exposure prophylaxis; preventive intervention; racial minority; sex; skills; social relationships; substance use; supported housing; transmission process

PROJECT SUMMARY/ABSTRACT An estimated 3.5 million youth between the ages of 18 and 25 experience homelessness in the U.S. each year. Relative to their stably housed peers, youth experiencing homelessness (YEH) are vulnerable to a multitude of risks affecting their health and well-being, including substance abuse, mental health challenges, victimization, and death. YEH are also more likely to engage in risky sexual behaviors and are up to 10 times more likely to contract HIV compared to their housed peers. Key to understanding the HIV risk and prevention behaviors of YEH are their social networks—their web of personal social interactions and relationships. Increased HIV risk among YEH has been tied to involvement in social networks with risk-taking peers and predominantly the consequence of unsafe sex over injection drug use and needle sharing. Conversely, connections to family and pro-social peers have been demonstrated to influence HIV prevention behaviors among YEH, including condom use and HIV testing. However, the effect of different living situations among YEH—and particularly of precarious housing (i.e., “couch-surfing” or temporarily staying with others)—on HIV risk and prevention behaviors remains largely unknown. A sizable portion of the YEH population reports living in precarious housing, and current evidence also suggests that that youth of color and youth identifying as LGBTQ+ are more likely to be precariously housed compared to other YEH, populations that also carry disproportionate risk for HIV. The proposed mixed-methods study has three aims. Aims 1 and 2 will use an existing dataset from Have You Heard?, a longitudinal study of a peer leader training intervention for HIV prevention among YEH in Los Angeles, California. Aim 1 will entail conducting an egocentric social network analysis to investigate whether precarious housing and social support are associated with HIV risk (e.g., transactional sex, condomless sex, sex under the influence, concurrent sex partners) and prevention (e.g., recent HIV testing and PrEP awareness and use) behaviors among YEH. Aim 2 will use latent class analysis to explore the heterogeneity of YEH based on living situation and social support networks in order to examine (a) whether LGBTQ+ identity, racial/ethnic minority status, and duration of homelessness relate to emergent subgroups and (b) whether HIV risk and prevention behaviors vary across these emergent subgroups. Aim 3 will entail conducting qualitative interviews with precariously housed youth (n = 20) to explore how social support networks and housing status influence HIV risk and prevention behaviors among precariously housed YEH. This study will expand knowledge regarding HIV risk and prevention behaviors among YEH, paving the way for the development of more tailored HIV prevention interventions for this vulnerable population. In addition, the PI will receive training in understanding HIV risk and prevention among vulnerable youth populations, advanced statistical methods, and mixed-methods research; gain experience conducting HIV-related research with YEH; and opportunities for professional development.

项目摘要/摘要 估计每年在美国的18至25岁之间有350万年龄在18至25岁之间的无家可归者。 相对于他们稳定的同龄人，经历无家可归的青年（Yeh）很容易受到众多 影响其健康和福祉的风险，包括滥用药物，心理健康挑战，胜利， 和死亡。 Yeh也更有可能从事风险的性行为，并且最多的可能性高出10倍 与他们的同龄人相比，艾滋病毒合同。了解艾滋病毒风险和预防行为的关键 Yeh是他们的社交网络 - 他们的个人社交互动和人际关系的网络。增加艾滋病毒的风险 在Yeh中，与参与具有冒险同龄人的社交网络有关，主要是 对注射药物使用和针头共享不安全性的结果。相反，与家人的联系 已经证明了亲社会同伴会影响YEH之间的HIV预防行为，包括 避孕套使用和HIV测试。但是，Yeh之间的不同生活环境的影响，尤其是 不稳定的住房（即“沙发冲浪”或与他人暂时待在一起） - 艾滋病毒风险和预防 行为在很大程度上是未知的。 YEH人口的大部分报告生活在不稳定的 住房和目前的证据也表明，有色和青年的青年被认为是LGBTQ+ 与其他YEH相比，以前更有可能被安置，种群也带来不成比例的风险 艾滋病毒。拟议的混合方法研究具有三个目标。目标1和2将使用现有数据集 您听说过吗？ 加利福尼亚州洛杉矶。 AIM 1将需要进行以自我为中心的社交网络分析以调查 不稳定的住房和社会支持是否与艾滋病毒风险有关（例如，交易性行为， 无避孕套的性别，影响下的性别，并发性伴侣）和预防（例如，最近的艾滋病毒测试和 Yeh之间的PREP意识和使用行为。 AIM 2将使用潜在类别分析来探索 基于生活状况和社会支持网络的YEH的异质性，以便检查（a）是否是否 LGBTQ+身份，种族/族裔少数群体状况以及与新兴亚组相关的无家可归者 （b）在这些新兴亚组中，艾滋病毒的风险和预防行为是否有所不同。 AIM 3将需要 与以前住过的青年进行定性访谈（n = 20），以探讨社会支持如何 网络和住房状况会影响不稳定的Yeh的艾滋病毒风险和预防行为。 这项研究将扩大有关YEH之间有关艾滋病毒风险和预防行为的知识，为 为此脆弱人群开发更量身定制的HIV预防干预措施。另外，PI 将接受了解脆弱的青年人口中的艾滋病毒风险和预防培训，高级 统计方法和混合方法研究；获得与YEH进行HIV相关研究的经验； 和专业发展的机会。