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

描述（由申请人提供）：本研究将在前墨西哥裔美国帮派成员中研究青少年，早期青年和年轻人特定风险因素与感染艾滋病毒，乙型肝炎B和丙型肝炎，性传播感染和相关感染风险之间的关联。本申请拟对先前在NIDA资助的研究（R 01 DA 08604）中确定的圣安东尼奥的一组青少年墨西哥裔美国男性帮派成员（n=160）进行随访。该样本将作为拟定纵向队列研究的t1。对于第二次（回顾性五年测量点）和第三次（当前访谈），我们将重新访谈相同的受访者，并招募额外的150人队列。我们将使用非正式社会控制和西班牙文化的年龄分级理论的具体分析结构来解释与从青春期到青年期的过渡相关的健康后果，这可能是艾滋病干预工作的关键。数据收集将包括问卷调查（t2和t3），其中包括标准化评估、生物学评估和定性生活史访谈，将对样本子集进行。本研究的目的如下：1.确定青年期HIV、HBV、HCV和STI（沙眼衣原体、梅毒和单纯疱疹病毒-2）感染的患病率（检测）（n=310）。2.确定艾滋病毒、肝炎和性传播感染风险的患病率，包括高风险性行为、注射吸毒、非注射海洛因和兴奋剂使用以及青年期高风险毒品和性网络（n=310）3.确定，在10年前招募的帮派成员（n=160）中，艾滋病毒、肝炎和性传播感染检测呈阳性的青年成年结果和感染风险是否与非正式社会控制过程和风险行为的青少年风险因素相关（T1）。4.确定青年期艾滋病毒、肝炎和性传播感染检测阳性的结果和感染风险是否与青年期早期非正式社会控制过程和监禁史（T2）因素相关（n=310）。5.确定青年期艾滋病毒、肝炎和性传播感染检测阳性的结果和感染风险是否与青年期非正式社会控制过程、风险行为和文化因素（T3）相关（n=310）。6.定性描述复杂的过程，文化和背景，与艾滋病毒，肝炎和性传播感染的感染和感染风险的生命历程轨迹从青春期到青年期的重大风险因素。我们的研究将大大有助于选择性艾滋病毒干预预防和政策话语的发展，考虑到帮派成员人口的不同生命历程轨迹。 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，乙型B和丙型肝炎和性传播感染的长期健康后果和相关的感染风险。这项研究将提供一个独特的机会，以调查艾滋病毒流行的风险范围内的社区与高HCV和性传播感染的患病率。这项研究的结果可以用来制定艾滋病毒干预战略的文化适合高风险的墨西哥裔美国年轻人群体

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