Milburn Norweeta G, Liang Li-Jung, Lee Sung-Jae, Rotheram-Borus Mary Jane
University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Center for Community Health, Los Angeles, CA, USA.
Vulnerable Child Youth Stud. 2009 Jan 1;4(4):346-352. doi: 10.1080/17450120902884068.
Using cluster analysis techniques, we identified two distinct clusters of newly homeless adolescents in Los Angeles (n = 261): those who are protected and doing relatively well while out of home with more protective than risk factors, and those who are risky with more risk than protective factors. The objective of this study was to examine the trajectories of human immunodeficiency virus (HIV) risk behaviors and exiting homelessness among protected newly homeless adolescents, compared to those who are classified as risky. HIV risk behavior included unprotected sex, having multiple sex partners and hard drug use. Logistic regression mixed-effects models were used to evaluate the trajectories of HIV risk behaviors and exiting homelessness over time. The adolescents in the protected group reported significantly less unprotected sex ( p = 0.0156), being abstinent or monogamous ( p < 0.0001) and less hard drug use ( p < 0.0001) compared to the adolescents in the risky group. In addition, the protected group reported more "exiting homelessness", compared to the risky group ( p = 0.0007). However, the differences in the level of unprotected sex between the protected and risky groups decreased over time. Our findings confirm the notion that newly homeless adolescents are indeed heterogeneous. Given that the risk behavior profiles of protected group merges to the risky group over time, our findings underscore the need to mount tailored interventions to be designed for the protected group early in the process.
我们运用聚类分析技术，在洛杉矶识别出两类不同的新成为无家可归者的青少年群体（n = 261）：一类受到保护，离家后情况相对较好，保护因素多于风险因素；另一类风险较大，风险因素多于保护因素。本研究的目的是考察与被归类为有风险的青少年相比，受到保护的新成为无家可归者的青少年中人类免疫缺陷病毒（HIV）风险行为轨迹及摆脱无家可归状态的情况。HIV风险行为包括无保护性行为、有多个性伴侣以及使用硬性毒品。采用逻辑回归混合效应模型来评估HIV风险行为轨迹及随着时间推移摆脱无家可归状态的情况。与有风险组的青少年相比，受保护组的青少年报告的无保护性行为显著更少（p = 0.0156），保持禁欲或一夫一妻制（p < 0.0001），且使用硬性毒品更少（p < 0.0001）。此外，与有风险组相比，受保护组报告“摆脱无家可归状态”的情况更多（p = 0.0007）。然而，受保护组和有风险组之间无保护性行为水平的差异随着时间推移而减小。我们的研究结果证实了新成为无家可归者的青少年确实具有异质性这一观点。鉴于受保护组的风险行为特征随时间推移与有风险组趋同，我们的研究结果强调了在此过程早期针对受保护组制定量身定制干预措施的必要性。
