YMSM Drug Use, Sexual Risk & Health Promoting Behaviors

尽管在减少男同性恋者参与艾滋病毒风险相关性行为方面取得了重大进展 和这一人群中新感染的发生率，在减少年轻人口方面进展甚微 男同性恋者感染艾滋病毒的风险。预防努力之所以失败，部分原因是我们的 了解广泛的个人、家庭、社会和社区特征 个人和集体影响年轻的同性恋和双性恋男性从事风险和保护 各种因素。基于我们对年轻男同性恋者和双性恋者以及其他高危青年的研究， 洛杉矶儿童医院正在提议进行理论驱动(即社会生态模型) 对年轻男同性恋者和双性恋者使用药物和参与艾滋病毒风险的纵向研究 和个人经历背景下的保护性行为(例如，性认同和出柜 经验；种族/民族认同)和家庭(例如，家庭组成和环境；家庭 支持/拒绝)，这将在青年人际关系的背景下进行审查 (例如，亲密关系的数量和性质；同伴关系和融合；同伴支持)；以及社区 背景(例如，与居住社区、种族/族裔社区的融合和联系；宗教 组织、学校、工作场所、同性恋社区和社会服务机构)。拟议的研究将 涉及两个阶段的研究。在第一阶段，将进行形成性人种学研究，以 进一步描述感兴趣的结构以及这些结构之间的拟议关系并将其设置为背景 结构和建议的因变量或结果变量，并改进和/或适应现有调查 适合目标人群使用的工具。在第2阶段，纵向 流行病学研究将通过跟踪880名不同种族的年轻同性恋和 18至22岁的双性恋男性，持续30个月(基线，然后在6、12、18、24和30个月 基线)；受试者将使用基于场地的概率抽样设计进行招募，按以下策略确定 种族/民族和代际地位。还将进行纵向人种学研究， 从较大的队列招募的200名受试者的子集；数据收集将在基线、12和24进行 月份。

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 gay and bisexual males to engage in both risk and protective factors. Building on our own research with young gay and bisexual men, as well as other high risk youth, Childrens Hospital Los Angeles is proposing to conduct theory-driven (i.e., the social ecological model) longitudinal research to examine young gay and bisexual males' use of drugs and involvement in HIV risk and protective behaviors in the context of individual experiences (e.g., sexual identity and coming out experience; racial/ethnic identity) and the family (e.g., family composition and environment; familial support/rejection), 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., integration and linkage with community of residence, racial/ethnic community; religious organizations; school; workplace; the gay community; and social service agencies). The proposed study will involve two phases of research. During Phase 1, formative ethnographic research will be conducted to further characterize and contextualize the constructs of interest and the proposed relationship between these constructs and the proposed dependent or outcome variables, and refine and/or adapt existing survey instruments that are appropriate for use with the target population. During Phase 2, longitudinal epidemiologic research will be conducted by following a cohort of 880 ethnically diverse young gay and bisexual males, ages 18 to 22, for 30 months (at baseline and then at 6, 12, 18, 24, and 30 months following baseline); subjects will be recruited using a venue-based probability sampling design, stratefied by race/ethncity and generational status. Longitudinal ethnographic research will also be conducted with a subset of 200 subjects recruited from the larger cohort; data collection will occur at baseline, 12 and 24 months.