HIV risk and prevention behavior and the role of social support networks among precariously housed youth: A mixed-methods study

项目总结/摘要 据估计，美国每年有350万18至25岁的青年无家可归。 相对于有稳定住房的同龄人，无家可归的年轻人容易受到多种因素的影响， 影响其健康和福祉的风险，包括药物滥用、精神健康挑战、受害， 与死YEH也更有可能从事危险的性行为， 感染艾滋病病毒的几率。了解艾滋病毒风险和预防行为的关键 YEH是他们的社会网络--他们的个人社会互动和关系的网络。艾滋病毒风险增加 在YEH中，参与社交网络与冒险同行有关， 不安全性行为、注射吸毒和共用针头的后果。相反，与家庭和 亲社会同伴已被证明会影响YEH中的艾滋病毒预防行为，包括 使用避孕套和艾滋病毒检测。然而，不同的生活状况的影响，叶，特别是 不稳定的住房（即，“沙发冲浪”或暂时与他人呆在一起）-关于艾滋病毒的风险和预防 行为在很大程度上仍然未知。据报告，YEH人口中有相当一部分人生活在不稳定的环境中， 住房，目前的证据也表明，有色人种和青年确定为LGBTQ+ 与其他YEH人群相比，更有可能居住在不稳定的地方，这些人群也具有不成比例的风险 艾滋病病毒拟议的混合方法研究有三个目标。目标1和2将使用来自 你听说了吗？青少年艾滋病预防同伴领导培训干预的纵向研究 洛杉矶，加州。目标1需要进行以自我为中心的社会网络分析， 不稳定的住房和社会支持是否与艾滋病毒风险有关（例如，性交易 无避孕套性行为、受影响的性行为、同时性伴侣）和预防（例如，最近的艾滋病毒检测和 在YEH中的PrEP意识和使用）行为。目标2将使用潜在类分析来探索 基于生活状况和社会支持网络的YEH异质性，以检查（a）是否 LGBTQ+身份，种族/少数民族地位和无家可归的持续时间与紧急亚组有关 以及（B）HIV风险和预防行为是否在这些紧急亚组中有所不同。目标3要求 对住房不稳定的青年（n = 20）进行定性访谈，探讨社会支持 网络和住房状况影响艾滋病毒的风险和预防行为的不稳定居住的青年人。 这项研究将扩大YEH人群对艾滋病毒风险和预防行为的认识， 为这一弱势群体制定更有针对性的艾滋病毒预防干预措施。此外，PI 将接受培训，以了解艾滋病毒的风险和预防脆弱的青年人口，先进的 统计方法和混合方法研究;获得与YEH进行HIV相关研究的经验; 和专业发展的机会。

PROJECT SUMMARY/ABSTRACT An estimated 3.5 million youth between the ages of 18 and 25 experience homelessness in the U.S. each year. Relative to their stably housed peers, youth experiencing homelessness (YEH) are vulnerable to a multitude of risks affecting their health and well-being, including substance abuse, mental health challenges, victimization, and death. YEH are also more likely to engage in risky sexual behaviors and are up to 10 times more likely to contract HIV compared to their housed peers. Key to understanding the HIV risk and prevention behaviors of YEH are their social networks—their web of personal social interactions and relationships. Increased HIV risk among YEH has been tied to involvement in social networks with risk-taking peers and predominantly the consequence of unsafe sex over injection drug use and needle sharing. Conversely, connections to family and pro-social peers have been demonstrated to influence HIV prevention behaviors among YEH, including condom use and HIV testing. However, the effect of different living situations among YEH—and particularly of precarious housing (i.e., “couch-surfing” or temporarily staying with others)—on HIV risk and prevention behaviors remains largely unknown. A sizable portion of the YEH population reports living in precarious housing, and current evidence also suggests that that youth of color and youth identifying as LGBTQ+ are more likely to be precariously housed compared to other YEH, populations that also carry disproportionate risk for HIV. The proposed mixed-methods study has three aims. Aims 1 and 2 will use an existing dataset from Have You Heard?, a longitudinal study of a peer leader training intervention for HIV prevention among YEH in Los Angeles, California. Aim 1 will entail conducting an egocentric social network analysis to investigate whether precarious housing and social support are associated with HIV risk (e.g., transactional sex, condomless sex, sex under the influence, concurrent sex partners) and prevention (e.g., recent HIV testing and PrEP awareness and use) behaviors among YEH. Aim 2 will use latent class analysis to explore the heterogeneity of YEH based on living situation and social support networks in order to examine (a) whether LGBTQ+ identity, racial/ethnic minority status, and duration of homelessness relate to emergent subgroups and (b) whether HIV risk and prevention behaviors vary across these emergent subgroups. Aim 3 will entail conducting qualitative interviews with precariously housed youth (n = 20) to explore how social support networks and housing status influence HIV risk and prevention behaviors among precariously housed YEH. This study will expand knowledge regarding HIV risk and prevention behaviors among YEH, paving the way for the development of more tailored HIV prevention interventions for this vulnerable population. In addition, the PI will receive training in understanding HIV risk and prevention among vulnerable youth populations, advanced statistical methods, and mixed-methods research; gain experience conducting HIV-related research with YEH; and opportunities for professional development.