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

项目摘要/摘要 据估计，美国每年有350万年龄在18岁到25岁之间的年轻人无家可归。 相对于住房稳定的同龄人，无家可归的年轻人(是的)容易受到 影响他们健康和福祉的风险，包括药物滥用、精神健康挑战、受害、 和死亡。他们也更有可能从事危险的性行为，并且有高达10倍的可能性 与他们住在一起的同龄人相比，他们感染了艾滋病毒。了解艾滋病风险和预防行为的关键 是的，是他们的社交网络--他们个人社交互动和关系的网络。艾滋病毒风险增加 在叶中，一直与参与社交网络的冒险同龄人联系在一起，主要是 不安全的性行为超过注射、吸毒和共用针头的后果。相反，与家庭和家庭的联系 亲社会的同伴已被证明影响叶诗文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，不同的生活状况对叶莉的影响--特别是 不稳定的住房(如“沙发冲浪”或暂时与他人同住)--关于艾滋病毒风险和预防 行为在很大程度上仍不为人所知。相当大一部分叶氏人口报告说，他们生活在不稳定的环境中 住房，目前的证据还表明，有色人种青年和被认为是LGBTQ+的青年 与其他YE相比，更有可能被安置在不稳定的住房中，这些人群也带有不成比例的风险 治疗艾滋病病毒。拟议的混合方法研究有三个目标。AIMS 1和2将使用来自 你听说了吗？，叶林县艾滋病预防同伴领导培训干预的纵向研究 洛杉矶，加利福尼亚州。目标1将需要进行以自我为中心的社交网络分析，以调查 不稳定的住房和社会支持是否与艾滋病毒风险有关(例如，交易性行为， 无公寓性行为、受影响的性行为、兼性伴侣)和预防(例如，最近的艾滋病毒检测和 预科意识和使用)的行为。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叶氏异质性，以检验(A)是否 LGBTQ+身份、种族/少数民族地位和无家可归持续时间与新出现的亚群有关 以及(B)艾滋病毒风险和预防行为是否在这些新出现的亚群中有所不同。目标3将需要 对居住条件不稳定的青年(n=20)进行定性访谈，以探索社会支持如何 网络和住房状况影响危险住房的艾滋病毒风险和预防行为。 这项研究将扩大叶诗文对艾滋病毒风险和预防行为的了解，为 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 将接受在弱势青年人群中了解艾滋病毒风险和预防的培训，高级 统计方法和混合方法研究；与叶教授一起获得开展艾滋病相关研究的经验； 和职业发展的机会。

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.