In November 2013, REACH  PIs Dombrowski and Whitbeck applied to the National Institute of Drug Abuse (NIDA) for funding to undertakes a national-level survey of HIV and HIV-risk among homeless and unstably housed young people, aged 14-24, in the United States. Its overarching goal is to help service providers better understand the populations they serve, and to inform policy makers of the population, needs, and conditions of a group that stands to benefit significantly from a reconnection with the society that surrounds them.  The project grows out of prior collaboration with homeless youth service agencies via the Family and Youth Services Bureau (FYSB). In this research, we will interview 3,300 homeless and unstably housed young people in 11 major cities across the United States via novel peer network data collection technology. Beyond being the first project of this scale to focus on homeless and unstably housed young people, the study will advance on prior research in several significant ways: First we will develop an empirically-informed model of peer influence and social network factors that specifically affect homeless and unstably-housed youth (SA1). Second, we will investigate the epidemiology of HIV/AIDS infection in this population using the network model of peer influence from Aim 1 (SA2). Third, we will relate the network model to the actual distribution of mental health screening factors in a first of its kind national sample that takes into account movement among a range of unstable housing situations (SA3).  Lastly, we will produce accurate population estimates for young people living in a range of housing conditions that will allow for the development of effective prevention and treatment efforts (SA4).

Collaboration with agencies from each study city via our Advisory and Dissemination Board (ADB) will provide the means for broad reassessment of housing policy and HIV interventions among homeless and unstably housed youth.  To ensure the maximum influence of these broader impacts we have developed a three part dissemination plan that informs 1) local agencies and service providers including our agency partners in Boston, New York, Atlanta, Miami, Chicago, Austin, Minneapolis, Denver, Seattle, San Francisco, and San Diego, 2) public health scientists and other researchers via four board members internationally regarded as experts in HIV, homelessness, and injection drug use, and 3) national level policy forums—including RHYTTAC (Runaway and Homeless Youth Training and Technical Assistance Center), The US Conference of Mayors (HIV/AIDS Prevention Program), and the National Health Policy Forum.

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