HIV IN STREET YOUTH--EPIDEMIOLOGY AND PREVENTION

世界各地的街头青年在没有 成年看护人的指导或安全的家庭环境中的避难所。 他们处于发展不足的高风险之中， 包括艾滋病在内的健康问题。 这些儿童和青少年 靠打零工、小偷小摸来养活自己， 卖淫 接触男同性恋者和双性恋者， 接受性肛交在幼儿中很常见， 异性恋卖淫在年龄较大的女孩中几乎是普遍的， 在街上 性传播疾病很常见， 艾滋病毒感染率和艾滋病发病率迅速上升， 这些高危儿童。 关于认知和行为前因的有效信息， 艾滋病毒感染儿童和青少年的风险 “街道”是必要的，以便可以规划预防方案。 还迫切需要进行预防研究 对比不同的干预方法和强度， 在相关环境背景下的街头青年。 解决这些 问题，一个多学科的儿科医生研究小组， 心理学家、社会学家、人类学家和流行病学家 在艾滋病研究方面已经形成了经验。 在这份赠款中， 建议，我们概述了集成多方法描述分析， 在两个地点进行预防性干预研究 (the巴西贝洛奥里藏特和巴尔的摩的城市贫民窟， 马里兰州），不幸的“自然实验”涉及两个 规范的发展过程和亚文化习俗是 导致儿童中艾滋病毒感染率很高， 青少年。 巴西网址在政府、商业和社会方面是独一无二， 大学、健康和青年关怀组织邀请了 约翰霍普金斯大学的研究小组合作， 对艾滋病毒-I血清阳性的风险因素进行纵向评估， 描述性行为研究和对照预防研究 共同努力帮助数百万街头青年。

Street youth throughout the world struggle to survive without guidance from adult caretakers or refuge in safe home environments. They are at high risk for deficient development and a range of health problems including AIDS. These children and adolescents support themselves by performing odd jobs, petty theft, and prostitution. Exposure to male homosexuals and bisexuals by receptive anal intercourse is common in young children and heterosexual prostitution is almost universal in older girls living on the street. Sexually transmitted diseases are common and the incidence of HIV-I in sections and AIDS are increasing rapidly in these high-risk children. Valid information on the cognitive and behavioral antecedents and reinforcers of HIV risks among children and adolescents living "on the streets" is needed so that prevention programs can be planned. There is also an urgent need to undertake prevention studies contrasting different methods and intensities of intervention with street youth in relevant environmental contexts. To address these issues, a multidisciplinary research team of pediatricians, psychologists, sociologists, anthropologists, and epidemiologists experienced in AIDS research has been formed. In this grant proposal, we outline integrated multi-method descriptive analytic, and preventive intervention studies to be conducted at two sites (the urban slums of Belo Horizonte, Brazil and urban Baltimore, Maryland) where unfortunate "natural experiments" involving both normative developmental processes and sub-cultural practices are leading to a high incidence of HIV-I infections among children and adolescents. The Brazilian site is unique in that governmental, University, health, and youth care organizations have invited the Johns Hopkins University research team to collaborate in longitudinal assessment of risk factors for HIV-I seropositivity, descriptive behavioral studies and controlled prevention research in a concerted effort to help several million street youth.