Understanding HIV Risk Environment for Youth in Supportive Housing

 描述（由申请人提供）：支持性住房（SH）是一种结构性干预措施，越来越多地应用于过渡年龄青年（TAY）中的无家可归问题。尽管有数据表明性健康对住房稳定性有积极影响，但性健康的某些因素可能会促进增加艾滋病毒感染率的危险行为。本研究探讨了解释SH和HIV危险行为之间联系的机制。此外，由于研究尚未解决SH是否会对所有TAY产生相同的结果，我们将研究年龄，性别或性取向等个体因素如何调节SH对TAY HIV风险行为的影响。本研究的目的是为无家可归的TAY提供一个实证依据，以指导其未来的发展。 这项为期3年的混合方法研究是由一个强大的社会生态概念框架的风险环境，是指一个空间-无论是社会和/或物理-在其中各种个人和环境因素相互作用，影响艾滋病毒的风险行为。对于目标1（定量），我们通过招募150名居住在SH的TAY与150名目前无家可归的TAY（总N=300）相匹配的对照组（沿着），研究SH对TAY HIV风险行为（性风险和物质使用）的影响。生态瞬时评估（EMA），这被认为是捕获生态有效的自我报告的黄金标准，将被用来收集特定的艾滋病毒风险行为的预测数据。TAY将在一周内每天多次被提示使用移动的电话技术回答一系列调查。对于目标2（定性），我们将调查高风险和低风险的环境内SH TAY通过使用交互式，个性化的地理空间地图渲染的EMA响应（通过移动的手机GPS生成）作为一个启发设备进行深入访谈。将有目的地抽样60名参与者，代表高（n=30）和低（n=30）HIV风险。对于目标3，我们将通过世界卫生组织采用的指南制定方法，为TAY设计最大限度地减少艾滋病毒风险的SH提出建议。除了提供一个实证基础，以指导未来的发展，SH无家可归的TAY，本研究的结果可以利用TAY的广泛使用的移动的电话技术，并用于设计无家可归和居住TAY的生态瞬时干预。

 DESCRIPTION (provided by applicant): Supportive housing (SH) is a structural intervention that is being increasingly applied to homelessness among transition aged youth (TAY). Despite data indicating the positive effects of SH on housing stability, there are elements of SH that may promote risky behaviors that increase HIV rates. This study investigates the mechanisms that explain the association between SH and HIV risk behaviors. In addition, since research has not addressed whether SH yields the same outcomes for all TAY, we will investigate how individual factors such as age, gender, or sexual orientation moderate the effects of SH on TAY HIV risk behaviors. The goal of this investigation is to provide an empirical basis to guide the future development of SH for homeless TAY. This 3-year mixed methods study is guided by a robust social ecological conceptual framework of risk environment that refers to a space- whether social and/or physical-in which a variety of individual and contextual factors interact to influence HIV risk behaviors. For aim 1 (quantitative), we examine the impact of SH on TAY HIV risk behaviors (sexual risk and substance use) by recruiting 150 TAY living in SH along with a matched comparison group of 150 TAY who are currently homeless (total N=300). Ecological momentary assessment (EMA), which is considered the gold standard for capturing ecologically valid self-report, will be used to collect context specific predictive data on HIV risk behaviors. TAY will be prompted multiple times a day over a one week period to answer a series of surveys using mobile phone technology. For aim 2 (qualitative), we will investigate high and low risk environments within SH for TAY through the use an interactive, personalized geospatial map rendering of EMA responses (generated through mobile phone GPS) as an elicitation device for in-depth interviews. 60 participants will be purposively sampled to represent both high (n=30) and low (n=30) HIV risk taking. For aim 3, we will develop recommendations for designing SH for TAY that minimizes HIV risk though guideline development methods adopted by the World Health Organization. In addition to providing an empirical basis to guide the future development of SH for homeless TAY, the findings from this study can capitalize on TAY's widespread use of mobile phone technology and be used to design Ecological Momentary Interventions for both homeless and housed TAY.