description): Rates of risky behaviors in homeless youths are persistently high, resulting in high rates of morbidity, including seropositivity for HIV and Hepatitis B and C. Interventions based on risk-reduction in this population have had limited effectiveness. Recent research emphasizes that removal from the street should be a primary focus of HIV risk-reduction for homeless youths. Studies of risky behaviors in non-homeless youths and in at-risk adults strongly suggest that a better understanding of the relationships within which risk behaviors take place and of the meaning of the risky behaviors to the actors will lead to more effective interventions. The applicant is a pediatrician and specialist in adolescent medicine who has expertise in the ethnographic study of marginalized youths and experience in quantitative behavioral studies of risky behavior in adolescents. The candidate's career objective is to improve the health of marginalized youths, including homeless youths, through multidisciplinary research on the behavioral determinants of the health- related behaviors and barriers to care in this population. In the training phase of the award the applicant will have four primary development objectives: a) to develop further skills in patient-oriented qualitative research, b) to learn to follow longitudinal cohorts of hard-to-reach populations, c) to gain additional expertise in the integration of qualitative and quantitative methodologies in the study of adolescent health-related behavior, and d) to learn to analyze social network data in the study of risky behavior. She will pursue her objectives through mentored research experiences. These will be complemented by focused course work offered by the K-30 funded Advanced Training in Clinical Research program at the University of California, San Francisco. The objective of the research phase of the award will be to conduct a joint ethnographic-epidemiological-social network study to test the findings of her preliminary research. These findings, based on a street-based ethnographic study of youths, suggest that youths pass through stages of a life cycle of homelessness, each of which is characterized by different levels of acculturation to the street and different compositions of their social networks. By demonstrating in a large street-based longitudinal sample that youths in each stage differ according to acculturation and social networks and that these differences are correlated with rates of risky behaviors, we may have a powerful tool for designing interventions. An approach to intervention based on an understanding of these stages has practical implications, including new screening tools, the designing of stage- based services, and the development of intensive programs for the youths who are most susceptible to removal from the street. An understanding of how social network connections promote and prevent risky behaviors would also have significant implications for the designing of interventions with this population.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HD001490-02
Application #
6490356
Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
Newcomer, Susan
Project Start
2001-06-11
Project End
2005-12-31
Budget Start
2002-01-01
Budget End
2002-12-31
Support Year
2
Fiscal Year
2002
Total Cost
$122,920
Indirect Cost
Name
University of California San Francisco
Department
Pediatrics
Type
Schools of Medicine
DUNS #
073133571
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Valente, Annie M; Auerswald, Colette L (2013) Gender differences in sexual risk and sexually transmitted infections correlate with gender differences in social networks among San Francisco homeless youth. J Adolesc Health 53:486-91
Chew Ng, Rilene A; Muth, Stephen Q; Auerswald, Colette L (2013) Impact of social network characteristics on shelter use among street youth in San Francisco. J Adolesc Health 53:381-6
Hickler, Benjamin; Auerswald, Colette L (2009) The worlds of homeless white and African American youth in San Francisco, California: a cultural epidemiological comparison. Soc Sci Med 68:824-31
Parriott, Andrea M; Auerswald, Colette L (2009) Incidence and predictors of onset of injection drug use in a San Francisco cohort of homeless youth. Subst Use Misuse 44:1958-70
Doherty, Irene A; Minnis, Alexandra; Auerswald, Colette L et al. (2007) Concurrent partnerships among adolescents in a Latino community: the Mission District of San Francisco, California. Sex Transm Dis 34:437-43
Auerswald, Colette L; Sugano, Eiko; Ellen, Jonathan M et al. (2006) Street-based STD testing and treatment of homeless youth are feasible, acceptable and effective. J Adolesc Health 38:208-12
Carlson, Jennifer L; Sugano, Eiko; Millstein, Susan G et al. (2006) Service utilization and the life cycle of youth homelessness. J Adolesc Health 38:624-7
Auerswald, Colette L; Muth, Stephen Q; Brown, Beth et al. (2006) Does partner selection contribute to sex differences in sexually transmitted infection rates among African American adolescents in San Francisco? Sex Transm Dis 33:480-4
Auerswald, Colette L; Greene, Karen; Minnis, Alexandra et al. (2004) Qualitative assessment of venues for purposive sampling of hard-to-reach youth: an illustration in a Latino community. Sex Transm Dis 31:133-8
Auerswald, Colette L; Eyre, Stephen L (2002) Youth homelessness in San Francisco: a life cycle approach. Soc Sci Med 54:1497-512