ADOLESCENT TRAJECTORIES FOR HOMELESSNESS & RISK FOR HIV

描述（摘自摘要）：一些研究告诉我们， 青年长期无家可归者感染艾滋病毒风险很大， 在美国和澳大利亚，尽管这些研究通常是 横截面或方便的样本。为了理解高 老年无家可归青年的血清阳性率，发展轨迹 艾滋病毒和无家可归的风险最好从以下方面来理解： 首次离家出走（First Time Runaways，FTR）在这些青年背景 因素（国家，社区支持，街头经验，同行， 家庭），影响这些轨迹可以识别和观察 时间若要获得策略和提供程序上下文的对比， 在澳大利亚和美国的FTR之间的建议。澳大利亚不同于 美国在减少伤害，针头交换，国家计划， 积极的性健康以及社区的组织和分布 为无家可归的年轻人提供资源。将招募FTR的代表性样本 在洛杉矶，加利福尼亚州和墨尔本，澳大利亚（n=480）按性别分层（120名男性和 每个城市120名女性;年龄11-17岁）。跨城市，信息将 在招募时以及从以下时间点开始的3、6、12、18、24、30和36个月间隔采集 青年关于四个领域：1）个人的艾滋病毒的风险（物质使用和 性行为）和长期无家可归; 2）街头经历（每天 活动、生存战略、暴力、犯罪行为和 学校/就业模式）和个人资源（社会标识符，目标， 应对方式、心理困扰）; 3）同伴之间的冒险行为竞争 和社区因素（如服务提供者、政策因素和非正式 影响青年对无家可归的反应的网络;以及4） 青年及其家庭的背景特征。进一步 了解青年艾滋病毒相关的社会和结构背景 发展轨迹，FTR的实证评估将是 并辅以从三个其他国家收集的定性案例说明， 资料来源：1）对有经验的离家出走者样本的年度经验评估 （每年收集三个横断面样本，每个城市n=200），以便 描述随着时间的推移，无家可归文化的差异以及 随着时间的推移，有经验的离家出走者和FTR之间的相似性/差异; 2)关于艾滋病毒相关政策和服务提供者的个案研究 每个城市（n=20）;和3）定性访谈的一个子集的FTR， 社交网络（n=25/城市）。结果将用于设计 FTR干预措施，以减少他们感染艾滋病毒的风险，并为可能 影响他们的轨迹，增加或减少艾滋病毒的风险， 成为长期无家可归的人

DESCRIPTION (Taken from abstract): A number of studies have informed us about the substantial risk for HIV associated with chronic homelessness among youth in both the U.S. and Australia, even though these studies have typically been cross-sectional or samples of convenience. To understand the high seroprevalence rates among older homeless youth, the developmental trajectories into and out of risk for HIV and homelessness can best be understood from longitudinal studies of First Time Runaways (FTR). Among these youth contextual factors (the national, community supports, street experiences, peers, and family) that influence these trajectories can be identified and observed over time. To obtain a contrast for the policy and provider context, comparisons between FTR in Australia and the U.S. are proposed. Australia differs from the U.S. in policies of harm reduction, needle exchange, national programs for positive sexual health, and the organization and distribution of community resources for homeless youth. A representative sample of FTR will be recruited in LA, CA and Melbourne, Australia (n=480) stratified by gender (120 males & 120 females per city; aged 11-17 years). Across cities, information will be collected at recruitment, 3, 6, 12, 18, 24, 30, and 36 month intervals from youth regarding four domains: 1) the individual's risk for HIV (substance use & sexual behaviors) and chronic homelessness; 2) street experiences (daily activities, survival strategies, violence, delinquent acts and school/employment patterns) and personal resources (social identifiers, goals, coping styles, psychiatric distress); 3) the contest of the peers' risk acts and community factors (e.g. service provider, policy factors, and informal networks) that influence youth's response to becoming homeless; and 4) background characteristics of the youth and their families. To further understand the social and structural context of youth's HIV-related developmental trajectories, the empirical assessments of the FTR will be complemented by qualitative case descriptions gathered from three additional sources: 1) annual empirical assessment of samples of Experienced Runaways (three cross-sectional samples gathered annually, n=200 per city), in order to describe differences in the culture of homelessness over time and the drift over time in the similarity/differences between Experienced Runaways and FTR; 2) case studies of HIV-related policies and service providers for runaways in each city (n=20); and 3) qualitative interviews of a subset of FTR regarding their social networks (n=25/city). The results will be used to design interventions for FTR to reduce their risk for HIV and for providers who may influence their trajectories into increasing or decreasing risk for HIV and becoming chronically homeless.