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 研究是对降低无家可归年轻人艾滋病毒/性传播感染风险途径的纵向探索 18-24 岁的成年人 (YAEH) 通过以青少年为中心的快速安置计划 (YRR)。鉴于年轻人 是美国最有可能无家可归以及感染艾滋病毒和性传播感染的年龄组之一，这是一项紧迫的任务 需要针对艾滋病毒/性传播感染采取有效且适合发展的结构性干预方法 预防YAEH。 YRR 被美国各地社区广泛用作解决青少年问题的解决方案 无家可归；然而，关于短期住房计划的影响的研究有限，例如 作为 YRR，关于 YAEH 的 HIV/STI 风险。先前的研究已经确定了一系列与艾滋病毒/性传播感染相关的可能致病因素 YAEH 中的危险行为；然而，人们对具体的有益因果过程知之甚少，即 相互作用的变量和产生结果的途径，通过以下方法降低 YAEH 中的 HIV/STI 风险 短期住房干预和服务支持。此外，许多证据表明住房 YAEH 中的不稳定和 HIV/STI 风险是跨部门的，限制了我们对 YAEH 的理解 艾滋病毒预防的目标机制。本研究的具体目标是： 目标 1：探索 有助于恢复和恢复的潜在因果（生物、心理、社会和环境层面）过程 YAEH 中艾滋病毒/性传播感染风险（多个性伴侣、药物滥用、性交易、无保护性行为）的降低 通过既定的以青年为中心的短期住房干预措施，利用面板设计和混合 方法（深入访谈、调查、HIV/STI 和压力生物标志物）来跟踪客户 (n=50) 12 个月内 HIV/STI 行为风险结果的变化；目标 2：建立一个理论来描述 模型的不同因果过程和 HIV/STI 风险结果之间的相互关联路径和方向 建筑;目标 3：对新制定的、适合发展的住房稳定性措施进行试点 YAEH 和相关因果过程，利用目标 1 和 2 的调查结果以及对关键知情人的采访 (n=5) 和 YAEH YRR 客户 (n=10)。拟议研究的结果将用于制定理论 框架和试点措施，为大N混合方法研究奠定基础 YAEH 中 YRR 和 HIV/STI 风险之间的因果机制。这项研究的影响是降低健康水平 通过帮助社区改善他们的艾滋病毒/性传播感染高风险和弱势群体的差异 对 YAEH 的干预。