YMSM Drug Use, Sexual Risk & Health Promoting Behaviors

描述（由申请人提供）：尽管在减少男同性恋者参与艾滋病毒风险相关的性行为和该人群中新感染的发生率方面取得了重大进展，但在降低年轻男同性恋者感染艾滋病毒的风险方面进展甚微。预防工作在一定程度上失败了，因为我们对广泛的个人、家庭、社会和社区特征的理解存在重大差距，这些特征单独和集体地影响男男性行为的年轻男子（YMSM）参与风险和保护因素。洛杉矶儿童医院（CHLA）在我们对YMSM和其他高危青年群体的研究基础上，建议开展理论驱动（即社会生态模型）的人种学和流行病学研究，从个人经历（如性身份和出床经历）和家庭(如：家庭组成和环境，家庭/父母的支持)，而这些又将在青年的人际关系(例如：亲密关系的数量和性质、同伴关系和融合、同伴支持)和社区背景(例如：(2)学术参与、教育工作者和来自他们生活和/或生活的社区的其他成员的支持、融入同性恋社区以及与同性恋社会服务（包括预防艾滋病毒和促进健康服务）的联系和使用。拟议的研究将包括三个阶段的研究。在第一阶段，将进行形成性人种学研究，以描述和背景化感兴趣的构念，以及这些构念与提议的依赖变量或结果变量之间的拟议关系，并开发和/或调整适用于目标人群的现有调查工具。在第二阶段，流行病学研究将通过对535名年龄在18至24岁之间的YMSM进行结构化调查来进行，他们将具有种族多样性，并采用基于场地的抽样设计进行招募；人种学研究将对这些年轻人中的100人进行研究。在第三阶段，研究结果将被总结并广泛传播给研究人员；联邦、州和地方的决策者；服务提供商;倡导组织;以及与ysm合作的社区组织。

DESCRIPTION (provided by applicant): Despite significant advances made in reducing gay men's involvement in HIV risk-related sexual behaviors and the incidence of new infection in this population, there has been little progress made in reducing young gay men's risk for HIV infection. Prevention efforts have in part failed because significant gaps exist in our understanding of the broad array of individual, familial, social, and community characteristics that both individually and collectively influence young men who have sex with men (YMSM) to engage in both risk and protective factors. Building on our own research with YMSM and other high risk youth groups, Children's Hospital Los Angeles (CHLA) is proposing to conduct theory-driven (i.e., the social ecological model) ethnographic and epidemiologic research to examine YMSM's drug use patterns, involvement in HIV sexual risk and protective behaviors, and health promoting and seeking behaviors in the context of individual experiences (e.g., sexual identity and coming-out experience) and the family (e.g., family composition and environment, familial/parental support), which in turn will be examined in the context of the youth's interpersonal relationships(e.g., number and nature of intimate relationships, peer ties and integration, peer support), and community contexts(e.g., academic engagement, support from educators and other members from the community in which they live and/or spend time, integration within the gay community and linkage with and use of gay social services, including HIV prevention and health promoting services). The proposed study will involve three phases of research. During Phase 1, formative ethnographic research will be conducted to characterize and contextualize the constructs of interest and the proposed relationship between these constructs and the proposed dependent or outcome variables, and develop and/or adapt existing survey instruments that are appropriate for use with the target population. During Phase 2, epidemiological research will be conducted by administering a structured survey to 535 YMSM, ages 18 to 24, who will be racially diverse and recruited using a venue-based sampling design; ethnographic research will be conducted with a subset of 100 of these youth. During Phase 3, the study findings will be summarized and widely disseminated to researchers; federal, state and local policy makers; service providers; advocacy groups; and community organizations that are working with YMSM.