Understanding HIV Risk Environment for Youth in Supportive Housing

 描述(由申请人提供)：支持性住房(SH)是一种结构性干预措施，正越来越多地应用于过渡老年青年(Tay)中的无家可归者。尽管数据显示SH对住房稳定性有积极影响，但SH中的一些元素可能会促进危险行为，从而增加艾滋病毒感染率。本研究探讨了SH与HIV危险行为之间关系的机制。此外，由于没有研究表明SH对所有Tay是否产生相同的结果，我们将调查年龄、性别或性取向等个人因素如何调节SH对Tay HIV危险行为的影响。本次调查的目的是为指导未来流浪儿童助学服务的发展提供实证依据。这项为期3年的混合方法研究是在风险环境的强大社会生态概念框架的指导下进行的，该框架指的是一个空间--无论是社会的和/或物理的--在其中各种个人和背景因素相互作用，影响艾滋病毒风险行为。对于目标1(定量)，我们通过招募150名居住在上海的Tay和150名目前无家可归的Tay(总计N=300)来检验SH对Tay HIV危险行为(性风险和物质使用)的影响。生态瞬时评估(EMA)被认为是获取生态有效自我报告的黄金标准，将被用于收集艾滋病毒危险行为的特定背景预测数据。在一周的时间里，Tay将被提示每天多次使用手机技术回答一系列调查。对于目标2(定性)，我们将通过使用交互式、个性化的EMA响应的地理空间地图渲染(通过移动电话GPS生成)来调查SH for Tay内的高风险和低风险环境，作为深入访谈的启发工具。60名参与者将被有目的地抽样，以代表艾滋病毒风险高(n=30)和低(n=30)。对于目标3，我们将制定建议，通过世界卫生组织采用的指南制定方法，为Tay设计将艾滋病毒风险降至最低的SH。本研究除了提供实证基础以指导未来针对无家可归者Tay的SH发展外，亦可利用Tay广泛使用的行动电话技术，设计针对无家可归者及寄宿Tay的生态瞬时干预措施。

 DESCRIPTION (provided by applicant): Supportive housing (SH) is a structural intervention that is being increasingly applied to homelessness among transition aged youth (TAY). Despite data indicating the positive effects of SH on housing stability, there are elements of SH that may promote risky behaviors that increase HIV rates. This study investigates the mechanisms that explain the association between SH and HIV risk behaviors. In addition, since research has not addressed whether SH yields the same outcomes for all TAY, we will investigate how individual factors such as age, gender, or sexual orientation moderate the effects of SH on TAY HIV risk behaviors. The goal of this investigation is to provide an empirical basis to guide the future development of SH for homeless TAY. This 3-year mixed methods study is guided by a robust social ecological conceptual framework of risk environment that refers to a space- whether social and/or physical-in which a variety of individual and contextual factors interact to influence HIV risk behaviors. For aim 1 (quantitative), we examine the impact of SH on TAY HIV risk behaviors (sexual risk and substance use) by recruiting 150 TAY living in SH along with a matched comparison group of 150 TAY who are currently homeless (total N=300). Ecological momentary assessment (EMA), which is considered the gold standard for capturing ecologically valid self-report, will be used to collect context specific predictive data on HIV risk behaviors. TAY will be prompted multiple times a day over a one week period to answer a series of surveys using mobile phone technology. For aim 2 (qualitative), we will investigate high and low risk environments within SH for TAY through the use an interactive, personalized geospatial map rendering of EMA responses (generated through mobile phone GPS) as an elicitation device for in-depth interviews. 60 participants will be purposively sampled to represent both high (n=30) and low (n=30) HIV risk taking. For aim 3, we will develop recommendations for designing SH for TAY that minimizes HIV risk though guideline development methods adopted by the World Health Organization. In addition to providing an empirical basis to guide the future development of SH for homeless TAY, the findings from this study can capitalize on TAY's widespread use of mobile phone technology and be used to design Ecological Momentary Interventions for both homeless and housed TAY.