Public Housing Relocations: Impact on HIV risk and drug use

描述(由申请人提供)：最近公共住房政策的范式转变正在催化美国历史上最大的计划移民之一。公共住房机构正在将空间集中的综合体的居民重新安置到地理上分散的私人市场上提供代金券补贴的租赁单元。HOPE VI政策体现了这一范式转变，正在将20万户家庭从集中式综合体搬迁到目标城市的租赁单元。Hope VI移民倾向于搬到更安全、不那么贫穷、涉及毒品较少的社区(尽管酗酒和其他吸毒者的收益会减弱)；与此同时，移民的社会网络和社会支持有所下降。移民的邻里条件、网络和支持可能会演变一段时间：希望六号为50%的移民开启了一段连续搬家的时期。大多数移民是非洲裔美国人，所有人都很贫穷。在这些居民中，AOD滥用和艾滋病毒风险在他们搬家前很高。在这项拟议的研究中，争论的焦点是HOPE VI重新安置，以及这些重新安置所造成的移民邻里条件、网络和社会支持的变化，是否以及如何影响非裔美国移民的AOD滥用和艾滋病毒风险。这项拟议的为期[4]年的研究将采用准实验性的暴露前/暴露后设计，并与未暴露的对照组进行比较。暴露组将由来自HOPE VI目标的7个亚特兰大住房管理局(AHA)建筑群的[180]名移民组成；未暴露的对照组将由6个未搬迁的AHA建筑群的150名居民组成。所有参与者都将是非裔美国人，我们将在样本中寻找AOD滥用基线状态的变化，以研究AOD滥用如何影响感兴趣结果的趋势。拟议的多层次纵向研究由一名新调查员领导，将实现以下目标：目标1：描述研究期间[4]年内HOPE VI移民的居住流动性趋势；描述移民居住的人口普查区域特征随时间的变化(例如贫困率)；以及了解AOD滥用状况如何影响这些趋势。目的2：在完整样本(N=[330])中描述网络和社会支持随时间的变化，并确定HOPE VI状态和AOD滥用状态如何影响这些变化。目标3：在全样本中描述AOD滥用、最近的艾滋病毒风险因素和艾滋病毒发病率随时间的趋势，并了解这些趋势与HOPE VI状态和AOD滥用状态(AOD滥用趋势不是结果)之间的关系。目标4：分析参与者居住的人口普查区域特征的变化(目标1)及其网络和支助的变化(目标2)与AOD滥用趋势和最近的艾滋病毒风险(目标3)的关系。这项研究将建立在NIDA R21研究的基础上，在该研究中，我们(1)创建了[330]个成员队列；(2)启动了数据收集；(3)改进了保留方法。这些成果将促进NIDA优先领域关于移民、AOD滥用和艾滋病毒以及非裔美国人使用AOD和艾滋病毒的决定因素的科学知识。

DESCRIPTION (provided by applicant): A recent paradigm shift in public housing policy is catalyzing one of the largest planned migrations in US history. Public housing agencies are relocating residents of spatially concentrated complexes to voucher- subsidized rental units in the private market that are geographically dispersed. The HOPE VI policy embodies this paradigm shift, and is relocating 200,000 households from concentrated complexes to rental units in target cities. HOPE VI migrants tend to move to safer, less poor, and less drug-involved neighborhoods (though gains are attenuated for alcohol and other drug [AOD] abusers); at the same time, migrants' social networks and social supports decline. Migrants' neighborhood conditions, networks, and supports may evolve for some time: HOPE VI inaugurates a period of serial moves for 50% of migrants. Most migrants are African-American and all are poor. Rates of AOD abuse and HIV risk are high among these residents before they move. At issue in the proposed study is whether and how HOPE VI relocations, and the changes in migrants' neighborhood conditions, networks, and social supports that these relocations create, shape African-American migrants' AOD abuse and HIV risk. The proposed [4]-year study will have a quasi-experimental pre-/post-exposure design with an unexposed comparison group. The exposed group will consist of [180] migrants from 7 Atlanta Housing Authority (AHA) complexes targeted by HOPE VI; the unexposed comparison group will consist of 150 residents of 6 AHA complexes that are not relocating. All participants will be African-American, and we will seek variation in the sample in baseline AOD abuse status in order to study how AOD abuse shapes trends in outcomes of interest. The proposed multilevel longitudinal study, led by a new investigator, will achieve the following aims: Aim 1: Characterize trends in residential mobility among HOPE VI migrants during the [4]-year the study period; describe changes in the characteristics of the census tracts where migrants live over time (e.g., poverty rates); and learn how AOD abuse status affects these trends. Aim 2: Characterize changes in network and social supports over time in the full sample (N=[330]), and determine how HOPE VI status and AOD abuse status affect these changes. Aim 3: Describe trends in AOD abuse, proximal HIV risk factors, [and HIV incidence] over time in the full sample, and learn how these trends relate to HOPE VI status and AOD abuse status (where AOD abuse trends are not the outcome). Aim 4: Analyze relationships of changes in the characteristics of the census tracts where participants live (Aim 1), and in their networks and supports (Aim 2), to trends in AOD abuse and proximal HIV risk (Aim 3). This study will build on foundations laid by a NIDA R21 study in which we are (1) creating the [330]-member cohort; (2) initiating data collection; and (3) refining retention methods. Results will advance scientific knowledge in NIDA priority areas on migrations, AOD abuse, and HIV, and on determinants of AOD use and HIV among African-Americans.