At Risk Hispanic Gangs: Long-Term Consequences for Hiv, Hepatitis and STI

描述(申请人提供)：这项研究将在前墨西哥裔美国帮派成员中调查青少年、成年早期和年轻人特有的风险因素与感染艾滋病毒、乙肝和丙型肝炎、性传播感染和相关感染风险之间的关系。这项申请建议对圣安东尼奥的一群墨西哥裔男性青年帮派成员(n=160)进行跟踪调查，这些成员以前是在NIDA资助的一项研究(R01 DA08604)中确定的。该样本将作为拟议的纵向队列研究的T1。对于时间二(回溯性的五年测量点)和时间三(当前面试)，我们将重新面试相同的受访者，并再招募150人。我们将使用非正式社会控制和拉美裔文化的年龄分级理论中的特定分析结构来解释从青春期过渡到青壮年的相关健康后果，这可能对艾滋病毒干预努力至关重要。数据收集将包括管理问卷(T2和T3)，其中将包括标准化评估、生物评估和定性生活史访谈，这些访谈将与样本的一部分一起进行。本研究的目的如下：1.确定310名青壮年(n=310)艾滋病病毒、乙肝病毒、丙型肝炎病毒和性传播感染(沙眼衣原体、梅毒和单纯疱疹病毒-2)的感染率。2.确定青年时期艾滋病毒、肝炎和性传播感染风险的患病率(n=310)，包括高危性行为、注射毒品、非注射海洛因和使用兴奋剂以及高风险毒品和性关系网络(n=310)3.在10年前招募的帮派成员中(n=160)，确定青年时期艾滋病毒、肝炎和性传播感染检测呈阳性的结果和感染风险是否与青少年非正式社会控制过程和危险行为的风险因素有关(T1)。4.确定艾滋病毒、肝炎和性传播感染检测呈阳性的青壮年结局和感染风险是否与青春期早期非正式社会控制过程因素和监禁史(T2)有关(n=310)。5.确定青年时期HIV、肝炎和性传播疾病检测阳性的结果和感染风险是否与青年时期的非正式社会控制过程、危险行为和文化因素(T3)有关(n=310)。6.定性描述与艾滋病毒、肝炎和性传播感染相关的重大风险因素有关的复杂过程、文化和背景，以及从青春期到青年时期的生命轨迹中的感染风险。我们的研究将对制定有选择性的艾滋病毒干预预防和政策论述做出重大贡献，这些预防和政策论述考虑到帮派附属人口的不同生命轨迹。 公共卫生相关性：拟议的研究提供了一个独特的机会，以寻求全面了解青年帮派成员感染艾滋病毒、乙肝、丙型肝炎和性传播感染以及相关感染风险的长期健康后果。这项研究将提供一个独特的机会，在丙型肝炎病毒和性传播感染高流行率的社区内调查艾滋病毒流行的风险。这项研究的发现可以用来开发文化上适合高危墨西哥裔美国年轻人的艾滋病毒干预策略。

DESCRIPTION (provided by applicant): This study will examine among former Mexican American gang members the associations between adolescent, early young adulthood and young adult-specific risk factors and the outcomes of infection with HIV, hepatitis B and C, sexually transmitted infections, and related infection risks. This application proposes to follow up a cohort of adolescent Mexican American male gang (n=160) members in San Antonio previously identified in a NIDA funded study (R01 DA08604). This sample will serve as t1 of the proposed longitudinal cohort study. For time two (a retrospective five year measurement point) and time three (current interview), we will re-interview the same respondents and recruit an additional cohort of 150 individuals. We will use specific analytical constructs from the age-graded theory of informal social control and Hispanic culture to explain the health consequences associated with the transition from adolescence to young adulthood that may be critical for HIV intervention efforts. Data collection will consist of the administration of a questionnaire (t2 and t3) that will include standardized assessments, biological assessments and qualitative life history interviews that will be conducted with a subset of the sample. The aims of the study are the following: 1. Determine the prevalence (tested) of HIV, HBV, HCV, and STIs, (chlamydia trachomatis, syphilis and herpes simplex virus-2) infection in young adulthood (n=310). 2. Determine the prevalence of HIV, hepatitis and STI infection risks, including high risk sexual behaviors, injecting drug use, non-injecting heroin and stimulant use and high-risk drug and sexual networks in young adulthood (n=310) 3. Determine, among gang members recruited ten years ago (n=160) whether the young adulthood outcomes of testing positive for HIV, hepatitis and STIs and infection risks are associated with the adolescent risk factors of informal social control processes and risk behaviors (T1). 4. Determine whether the young adulthood outcomes of testing positive for HIV, hepatitis and STIs and infection risks are associated with the early young adulthood factors of informal social control processes and incarceration history (T2) (n=310). 5. Determine whether the young adulthood outcomes of testing positive for HIV, hepatitis and STIs and infection risks are associated with the young adulthood informal social control processes, risk behaviors, and cultural factors (T3) (n=310). 6. Characterize qualitatively the complex processes, culture and context, associated with significant risk factors that are related to HIV, hepatitis, and STI's infection and infection risks during the life course trajectories from adolescence to young adulthood. Our research will significantly contribute to the development of selective HIV intervention preventions and policy discourse that take into consideration the distinct life course trajectories of gang affiliated populations. PUBLIC HEALTH RELEVANCE: The proposed study provides a unique opportunity to seek a comprehensive understanding of the long term health consequences of youth gang membership for infection with HIV, hepatitis B and C and STIs and related infection risks. The study will provide a unique opportunity to investigate the risk of an HIV epidemic within the context of a community with a high HCV and STI prevalence. Findings from this study can be used to develop HIV intervention strategies culturally appropriate for high risk Mexican American young adult populations