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: 10081851
• 负责人: Heather I. Mosher
• 金额: $ 25.65万
• 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 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10081851
• 关键词: AIDS prevention; Address; Adult; Affect; Age; Alcohol or Other Drugs use; 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; 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.

摘要