Public Housing Relocations: Impact on HIV risk and drug use

描述（由申请人提供）：最近公共住房政策的范式转变正在催生美国历史上最大的计划性移民之一。公共住房机构正在将空间集中的建筑群的居民转移到地理上分散的私人市场的代金券补贴租赁单位。HOPE VI政策体现了这种范式转变，并将目标城市的20万户家庭从集中的建筑群转移到租赁单元。希望VI移民倾向于搬到更安全、不那么贫穷、毒品较少的社区（尽管酗酒和其他药物滥用者的收益有所减少）；与此同时，移民的社会网络和社会支持也在下降。移民的社区条件、网络和支持可能会在一段时间内发生变化：HOPE VI开启了50%移民的连续迁移时期。大多数移民是非裔美国人，而且都很穷。在这些居民迁居之前，滥用AOD和感染艾滋病毒的风险都很高。拟议研究中的问题是HOPE VI是否以及如何重新安置，以及这些重新安置所产生的移民社区条件、网络和社会支持的变化，塑造了非裔美国移民的AOD滥用和艾滋病毒风险。这项为期100年的研究将采用准实验的暴露前/暴露后设计，并与未暴露的对照组进行比较。受影响的群体将包括来自HOPE VI所针对的7个亚特兰大住房管理局（AHA）建筑群的[180]移民；未暴露的对照组将由6个美国心脏协会建筑群的150名居民组成，他们不会搬迁。所有参与者都是非裔美国人，我们将在样本中寻找基线AOD滥用状况的变化，以研究AOD滥用如何影响感兴趣的结果的趋势。这项由一位新研究者领导的多层次纵向研究将实现以下目标：目标1：在研究期间，描述HOPE VI移民在2010年期间的居住流动趋势；描述移民居住的人口普查区的特征随时间的变化（例如贫困率）；并了解AOD滥用状况如何影响这些趋势。目标2：描述整个样本中网络和社会支持随时间的变化（N=[330]），并确定HOPE VI状态和AOD滥用状态如何影响这些变化。目标3：描述在整个样本中，随着时间的推移，AOD滥用的趋势，近端艾滋病毒风险因素，[和艾滋病毒发病率]，并了解这些趋势如何与HOPE VI状态和AOD滥用状态相关（其中AOD滥用趋势不是结果）。目标4：分析参与者居住的人口普查区（目标1）及其网络和支持（目标2）的特征变化与AOD滥用趋势和近端艾滋病毒风险（目标3）的关系。这项研究将建立在NIDA R21研究奠定的基础上，我们正在(1)创建[330]成员队列；(2)启动数据收集；(3)细化保留方法。结果将推进NIDA优先领域的科学知识，包括移民、AOD滥用和艾滋病毒，以及非洲裔美国人AOD使用和艾滋病毒的决定因素。

DESCRIPTION (provided by applicant): A recent paradigm shift in public housing policy is catalyzing one of the largest planned migrations in US history. Public housing agencies are relocating residents of spatially concentrated complexes to voucher- subsidized rental units in the private market that are geographically dispersed. The HOPE VI policy embodies this paradigm shift, and is relocating 200,000 households from concentrated complexes to rental units in target cities. HOPE VI migrants tend to move to safer, less poor, and less drug-involved neighborhoods (though gains are attenuated for alcohol and other drug [AOD] abusers); at the same time, migrants' social networks and social supports decline. Migrants' neighborhood conditions, networks, and supports may evolve for some time: HOPE VI inaugurates a period of serial moves for 50% of migrants. Most migrants are African-American and all are poor. Rates of AOD abuse and HIV risk are high among these residents before they move. At issue in the proposed study is whether and how HOPE VI relocations, and the changes in migrants' neighborhood conditions, networks, and social supports that these relocations create, shape African-American migrants' AOD abuse and HIV risk. The proposed [4]-year study will have a quasi-experimental pre-/post-exposure design with an unexposed comparison group. The exposed group will consist of [180] migrants from 7 Atlanta Housing Authority (AHA) complexes targeted by HOPE VI; the unexposed comparison group will consist of 150 residents of 6 AHA complexes that are not relocating. All participants will be African-American, and we will seek variation in the sample in baseline AOD abuse status in order to study how AOD abuse shapes trends in outcomes of interest. The proposed multilevel longitudinal study, led by a new investigator, will achieve the following aims: Aim 1: Characterize trends in residential mobility among HOPE VI migrants during the [4]-year the study period; describe changes in the characteristics of the census tracts where migrants live over time (e.g., poverty rates); and learn how AOD abuse status affects these trends. Aim 2: Characterize changes in network and social supports over time in the full sample (N=[330]), and determine how HOPE VI status and AOD abuse status affect these changes. Aim 3: Describe trends in AOD abuse, proximal HIV risk factors, [and HIV incidence] over time in the full sample, and learn how these trends relate to HOPE VI status and AOD abuse status (where AOD abuse trends are not the outcome). Aim 4: Analyze relationships of changes in the characteristics of the census tracts where participants live (Aim 1), and in their networks and supports (Aim 2), to trends in AOD abuse and proximal HIV risk (Aim 3). This study will build on foundations laid by a NIDA R21 study in which we are (1) creating the [330]-member cohort; (2) initiating data collection; and (3) refining retention methods. Results will advance scientific knowledge in NIDA priority areas on migrations, AOD abuse, and HIV, and on determinants of AOD use and HIV among African-Americans.