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: 10250528
• 负责人: Heather I. Mosher
• 金额: $ 21.38万
• 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 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10250528
• 关键词: AIDS prevention; Address; Adult; Affect; Age; 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; substance use; 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 这项R21研究是对无家可归的年轻人减少艾滋病毒/性传播感染风险途径的纵向探索。 18-24岁的成年人（YAEH）通过以青年为中心的快速重新安置计划（YRR）。考虑到年轻人 是美国最有可能无家可归和感染艾滋病毒和性传播感染的年龄组之一， 需要对艾滋病毒/性传播感染采取有效和适合发展的结构性干预办法 预防YAEH。YRR被美国各地的社区广泛使用，作为解决青年问题的解决方案。 无家可归;然而，对短期住房计划的影响的研究有限， 作为YRR，关于YAEH的HIV/STI风险。先前的研究已经确定了一系列与艾滋病毒/性传播感染有关的可能的因果因素 YAEH中的风险行为;然而，对特定的有益因果过程知之甚少，即，的 相互作用的变量和产生结果的途径，通过 提供服务支持的短期住房干预。此外，许多证据表明，住房 YAEH中的不稳定性和艾滋病毒/性传播感染风险是横截面的，限制了我们对 应针对艾滋病毒预防的机制。本研究的具体目标是：目标1：探索 有助于复原力的潜在因果（生物、心理、社会和环境层面）过程， YAEH人群中艾滋病毒/性传播感染风险降低（多个性伴侣、药物使用、性交易、无保护性行为） 通过既定的以青年为中心的短期住房干预措施，利用小组设计和混合 方法方法（深入访谈、调查、艾滋病毒/性传播感染和压力生物标志物）跟踪客户（n=50） 12个月期间艾滋病毒/性传播感染行为风险结果的变化;目标2：建立一个理论， 模型的不同因果过程和艾滋病毒/性传播感染风险结果之间相互关联的途径和方向 目标3：对新制定的、适合发展的住房稳定措施进行试点测试， YAEH和相关的因果过程，使用目标1和2的调查结果以及与关键信息提供者的访谈 （n=5）和YAEH YRR客户（n=10）。从拟议的研究结果将被用来制定一个理论 框架和试点测试的措施，以建立一个大N混合方法研究的基础，以测试 YAEH中YRR和HIV/STI风险之间的因果机制。这项研究的影响是减少健康 * 通过帮助社区改善艾滋病毒/性传播感染在高危和脆弱人群中的分布情况， 为Yaeh的干预。