Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
AIDS. 2012 Jan 2;26(1):105-10. doi: 10.1097/QAD.0b013e32834c4be4.
We evaluated the combined influences of orphaned status and homelessness on HIV seroprevalence and risk among street-involved Ukrainian youth in 2008.
Systematic, multicity, community-based, cross-sectional assessment.
Time-location sampling was used to identify eligible youth aged 15-24 after city-wide mapping of 91 sites where street-involved youth gathered in Odessa, Kiev, and Donetsk. Universal sampling identified 961 youth in 74 randomly selected sites; 97% consented. Youth reporting one or both parents dead were classified as orphaned; those without a stable residence or sleeping outside their residence at least two nights per week were classified as homeless. Trained staff provided HIV counseling and rapid testing via mobile vans. Adjusted odds ratios (AORs) were calculated using logistic regression, accounting for intracluster homogeneity.
We found 32% (300 of 929) were both orphaned and homeless; 48% either (but not both) homeless [37% (343 of 929)] or orphaned [11% (104 of 929)]; and [20% (182 of 929)] neither orphaned nor homeless. HIV seroprevalences were 7% for neither orphaned/homeless; 16 and 17%, respectively, for either orphaned/homeless; 28% for both orphaned/homeless (P for trend <0.0001). AORs for HIV infection were 1 for neither; 2.3 and 2.4 for either homeless [95% confidence interval (CI) 1.7-2.9] or orphaned (CI 1.8-3.3); 3.3 for both orphaned/homeless (CI 2.3-4.4). Ever-use of injection drugs increased from 15 to 32 to 48% for those who neither, either, or both orphaned and homeless, respectively (P for trend <0.0001).
One of four youths who were both homeless and orphaned was HIV-infected; these youths were significantly more likely to be HIV infected and to report injection drug use than those with adequate housing and living parents.
我们评估了孤儿身份和无家可归状态对 2008 年乌克兰街头青少年中 HIV 血清阳性率和风险的综合影响。
系统的、多城市的、基于社区的、横断面评估。
时间定位抽样用于识别在敖德萨、基辅和顿涅茨克全市范围内对 91 个街头青少年聚集点进行地图绘制后，符合条件的 15-24 岁青少年。通用抽样在 74 个随机选择的地点确定了 961 名青年；97%的人同意。报告父母一方或双方死亡的青年被归类为孤儿；没有稳定住所或每周至少有两个晚上不在住所睡觉的青年被归类为无家可归者。经过培训的工作人员通过移动面包车提供艾滋病毒咨询和快速检测。使用逻辑回归计算调整后的优势比（AOR），考虑到群内同质性。
我们发现，32%（300/929）既是孤儿又是无家可归者；48%的人（但不是两者）无家可归[37%（343/929）]或孤儿[11%（104/929）]；还有[20%（182/929）]既不是孤儿也不是无家可归者。无家可归/无孤儿者的 HIV 血清阳性率为 7%；孤儿/无家可归者分别为 16%和 17%；孤儿/无家可归者均为 28%（趋势 P<0.0001）。HIV 感染的 AOR 为 1 无孤儿/无家可归；2.3 和 2.4 分别为无家可归者[95%置信区间（CI）1.7-2.9]或孤儿（CI 1.8-3.3]；3.3 为孤儿/无家可归者（CI 2.3-4.4）。从不使用注射毒品的比例分别从 15%增加到 32%增加到 48%，依次为既无孤儿/无家可归、只有孤儿/无家可归或两者均有孤儿/无家可归的人（趋势 P<0.0001）。
四分之一既是无家可归者又是孤儿的青少年感染了 HIV；与有适当住房和健在父母的人相比，这些青少年更有可能感染 HIV，并且更有可能报告使用注射毒品。
