A SAN FRANCISCO STREET YOUTH COHORT: AT-RISK AND HIV+

背景：青少年艾滋病毒和艾滋病现在主要归因于危险的性行为或药物使用。在无家可归的年轻人中，感染率很高，他们有额外的风险因素，如生存性行为或多个性伴侣。目标：1)拉金街青年中心(LSYC)-加州大学旧金山分校（UCSF）合作将招募、登记并维持75名艾滋病病毒阳性的街头青年进入旧金山青少年医学试验单位（AMTU），为他们提供行为和临床艾滋病研究的机会；2) LSYC-UCSF合作项目将招募、注册并维持125名HIV阴性但有风险的街头青年进入旧金山AMTU，为他们提供HIV初级预防和临床研究的机会；3) LSYC-UCSF合作项目将继续扩大旧金山有色人种HIV阳性青年的入学人数。对ATN的贡献：旧金山LSYC为离家出走和街头青年提供了17年的综合服务，自1990年以来为艾滋病毒阳性青年提供了全面的护理。自1998年以来，LSYC、加州大学旧金山分校青少年医学部和加州大学旧金山分校儿童艾滋病项目合作建立了一个由第四章资助的艾滋病青少年护理中心。拉金街善后和辅助护理（ACAC）项目在旧金山的一个地点为艾滋病毒阳性青年提供全面的医疗护理、住房、病例管理和社会支持服务。LSYC在街头青年的纵向合作研究方面有着成功的历史。方法：acc项目在98/99年度为82名艾滋病病毒阳性者提供了综合服务。除一人外，所有人都是通过高风险的性行为或物质感染的。通过广泛的外展计划确定青年，该计划增加了少数民族青年的外展和艾滋病毒检测。在99/00财年的前8个月，216名青年接受了检测，血清阳性率为6%。LSYC每年还向2 000多名艾滋病毒阴性但有风险的青年提供连续服务，其中400多人在LSYC诊所接受医疗护理。研究人员：主要研究人员、共同研究人员和项目协调员在多地点合作研究、基于队列的研究、街头青年研究、青少年医学和艾滋病毒初级保健方面拥有丰富的经验。创新/环境：LSYC一直是照顾难以接触到的人群的典范。LSYC在一个对青少年友好的环境中，为艾滋病毒阳性和有风险的无家可归青年提供完整的连续服务。

Background: Adolescent HIV and AIDS are now primarily attributable to risky sexual behaviors or substance use. Infection rates are high among homeless youth who have additional risk factors, such as survival sex or multiple partners. Aims: 1) The Larkin Street Youth Center (LSYC)- University of California, San Francisco (UCSF) collaborative will recruit, enroll, and maintain a cohort of 75 HIV+ street involved youth into the San Francisco Adolescent Medicine Trials Unit (AMTU) to provide them with access to behavioral and clinical HIV research; 2) The LSYC-UCSF collaborative will recruit, enroll, and maintain a cohort of 125 HIV negative but at-risk street involved youth into the San Francisco AMTU to provide them with access to on primary prevention of HIV and clinical studies; 3) The LSYC-UCSF collaborative will continue to expand enrollment of HIV + youth of color in San Francisco. Contribution to the ATN: LSYC in San Francisco has provided comprehensive services to runaway and street youth for seventeen years, and comprehensive care to HIV + youth since 1990. Since 1998, LSYC, the UCSF Division of Adolescent Medicine, and the UCSF Pediatric AIDS program have collaborated in a Title IV funded center for the care of HIV+ youth. The Larkin Street Aftercare and Assisted Care (ACAC) program provides comprehensive medical care, housing, case management, and social support services to HIV+ youth at a single site in San Francisco. LSYC has a history of successful collaborative longitudinal research of street youth. Approach: The ACAC program provided comprehensive services to 82 HIV+ street-involved clients in FY 98/99. All but one were infected through high risk sexual behaviors or substance. Youth are identified through an extensive outreach program, which has increased outreached and HIV-testing by minority youth. 216 youth have been tested in the first 8 months of FY99/00, with a 6% rate of seropositivity. LSYC also provides a continuum of services to over two thousand HIV-negative but at-risk youth every year, over 400 of whom receive medical care at the LSYC clinic. Investigators: The Principal investigator, co-investigators, and project coordinator have extensive experience in multi-site collaborative research, cohort-based research, research with street youth, adolescent medicine, and HIV primary care. Innovation/Environment: LSYC has been a model in care of hard-to-reach populations. LSYC offers a complete continuum of services for HIV + and at risk homeless youth which are provided in a youth friendly environment.