Piloting the Use of Artificial Intelligence to Enhance HIV Prevention Interventions for Youth Experiencing Homelessness

Objective: Youth experiencing homelessness are at risk for HIV and need interventions to prevent risky sex behaviors. We tested the feasibility of using artificial intelligence (AI) to select peer change agents (PCAs) to deliver HIV prevention messages among youth experiencing homelessness. Method: We used a pretest–posttest quasi-experimental design. In the AI condition (n = 62), 11 PCAs were selected via AI algorithm; in the popularity comparison (n = 55), 11 PCAs were selected 6 months later based on maximum degree centrality (most ties to others in the network). All PCAs were trained to promote HIV testing and condom use among their peers. Participants were clients at a drop-in center in Los Angeles, CA. HIV testing and condom use were assessed via a self-administered, computer-based survey at baseline (n = 117), 1 month (n = 86, 74%), and 3 months (n = 70, 60%). Results: At 3 months, rates of HIV testing increased among participants in the AI condition relative to the comparison group (18.8% vs. 8.1%), as did condom use during anal sex (12.1% vs. 3.3%) and vaginal sex (29.2% vs. 23.7%). Conclusions: AI-enhanced PCA intervention is a feasible method for engaging youth experiencing homelessness in HIV prevention.

[1]  Jessica Hathaway,et al.  Enhancing Risk Detection Among Homeless Youth: A Randomized Clinical Trial of a Promising Pilot Intervention , 2018, Journal of interpersonal violence.

[2]  Anne F. Farrell,et al.  Prevalence and Correlates of Youth Homelessness in the United States , 2017, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[3]  Nicole Immorlica,et al.  Uncharted but not Uninfluenced: Influence Maximization with an Uncertain Network , 2017, AAMAS.

[4]  E. Rice,et al.  Exploring the impact of network characteristics on substance use outcomes among homeless former foster youth , 2017, International Journal of Public Health.

[5]  E. Rice,et al.  Condomless Sex Among Homeless Youth: The Role of Multidimensional Social Norms and Gender , 2017, AIDS and Behavior.

[6]  E. Rice,et al.  Violence in the Social Networks of Homeless Youths , 2016 .

[7]  E. Rice,et al.  Risky Integration. , 2016, Crisis.

[8]  N. Milburn,et al.  Health insurance coverage and healthcare utilization among homeless young adults in Venice, CA. , 2016, Journal of public health.

[9]  Haifeng Xu,et al.  Using Social Networks to Aid Homeless Shelters: Dynamic Influence Maximization under Uncertainty , 2016, AAMAS.

[10]  Xin Feng,et al.  A Test of Outreach and Drop-in Linkage Versus Shelter Linkage for Connecting Homeless Youth to Services , 2016, Prevention Science.

[11]  E. Rice,et al.  Social Network Correlates of Methamphetamine, Heroin, and Cocaine Use in a Sociometric Network of Homeless Youth , 2015, Journal of the Society for Social Work and Research.

[12]  Leandro Soriano Marcolino,et al.  Preventing HIV Spread in Homeless Populations Using PSINET , 2015, AAAI.

[13]  E. Laumann,et al.  A new HIV prevention network approach: sociometric peer change agent selection. , 2015, Social science & medicine.

[14]  K. Steinbeck,et al.  The health diagnoses of homeless adolescents: a systematic review of the literature. , 2014, Journal of adolescence.

[15]  Amishi P. Jha,et al.  Taming a wandering attention: short-form mindfulness training in student cohorts , 2014, Front. Hum. Neurosci..

[16]  E. Rice Substantial differences in risk behaviors of homeless youth in two large networks of homeless youth in los angeles , 2013 .

[17]  Annie M Valente,et al.  Gender differences in sexual risk and sexually transmitted infections correlate with gender differences in social networks among San Francisco homeless youth. , 2013, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[18]  Kayla de la Haye,et al.  Shared risk: who engages in substance use with American homeless youth? , 2013, Addiction.

[19]  Karabi Nandy,et al.  Comparisons of substance abuse, high-risk sexual behavior and depressive symptoms among homeless youth with and without a history of foster care placement , 2012, Contemporary nurse.

[20]  Steven C Martino,et al.  If you provide the test, they will take it: factors associated with HIV/STI Testing in a representative sample of homeless youth in Los Angeles. , 2012, AIDS education and prevention : official publication of the International Society for AIDS Education.

[21]  Eric Rice,et al.  A family intervention to reduce sexual risk behavior, substance use, and delinquency among newly homeless youth. , 2012, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[22]  N. Milburn,et al.  Position-specific HIV risk in a large network of homeless youths. , 2012, American journal of public health.

[23]  E. Rice,et al.  Homeless But Connected: The Role of Heterogeneous Social Network Ties and Social Networking Technology in the Mental Health Outcomes of Street-Living Adolescents , 2012, Community Mental Health Journal.

[24]  Eric Rice,et al.  Sexual Health Information Seeking Online Among Runaway and Homeless Youth , 2011, Journal of the Society for Social Work and Research.

[25]  Eric Rice,et al.  Social Networking Technology, Social Network Composition, and Reductions in Substance Use Among Homeless Adolescents , 2010, Prevention Science.

[26]  E. Rice The Positive Role of Social Networks and Social Networking Technology in the Condom-Using Behaviors of Homeless Young People , 2010, Public health reports.

[27]  A. Nyamathi,et al.  Health-Seeking Challenges Among Homeless Youth , 2010, Nursing research.

[28]  Carol Woodell,et al.  Results of the NIMH Collaborative HIV/STD Prevention Trial of a Community Popular Opinion Leader Intervention , 2010 .

[29]  Eric Rice,et al.  Adolescents Exiting Homelessness Over Two Years: The Risk Amplification and Abatement Model. , 2009, Journal of research on adolescence : the official journal of the Society for Research on Adolescence.

[30]  Caitlin Kennedy,et al.  Effectiveness of peer education interventions for HIV prevention in developing countries: a systematic review and meta-analysis. , 2009, AIDS education and prevention : official publication of the International Society for AIDS Education.

[31]  Mary Jane Rotheram-Borus,et al.  Comparisons of Prevention Programs for Homeless Youth , 2009, Prevention Science.

[32]  D. Martins Experiences of homeless people in the health care delivery system: a descriptive phenomenological study. , 2008, Public health nursing.

[33]  A. Nyamathi,et al.  Attitudes of homeless and drug-using youth regarding barriers and facilitators in delivery of quality and culturally sensitive health care. , 2008, Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc.

[34]  T. Valente,et al.  Identifying Opinion Leaders to Promote Behavior Change , 2007, Health education & behavior : the official publication of the Society for Public Health Education.

[35]  N. Milburn,et al.  Pro-social and problematic social network influences on HIV/AIDS risk behaviours among newly homeless youth in Los Angeles , 2007, AIDS care.

[36]  Chuck K. Wen MSc,et al.  Homeless People’s Perceptions of Welcomeness and Unwelcomeness in Healthcare Encounters , 2007, Journal of General Internal Medicine.

[37]  J. Kelly,et al.  Popular opinion leaders and HIV prevention peer education: resolving discrepant findings, and implications for the development of effective community programmes , 2004, AIDS care.

[38]  R. Catalano,et al.  Positive Youth Development in the United States: Research Findings on Evaluations of Positive Youth Development Programs , 2004 .

[39]  Juwon Song,et al.  Reductions in HIV Risk Among Runaway Youth , 2003, Prevention Science.

[40]  Thomas W Valente,et al.  Effects of a social-network method for group assignment strategies on peer-led tobacco prevention programs in schools. , 2003, American journal of public health.

[41]  Jon Kleinberg,et al.  Maximizing the spread of influence through a social network , 2003, KDD '03.

[42]  Carl A Latkin,et al.  HIV prevention among drug users: outcome of a network-oriented peer outreach intervention. , 2003, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[43]  Sylvia Vassileva,et al.  Evaluation of a social network HIV prevention intervention program for young men who have sex with men in Russia and Bulgaria. , 2003, AIDS education and prevention : official publication of the International Society for AIDS Education.

[44]  L. Whitbeck,et al.  Familial and "on-the-street" risk factors associated with alcohol use among homeless and runaway adolescents. , 2002, Journal of studies on alcohol.

[45]  K. Bauman,et al.  Trends in parent and friend influence during adolescence: the case of adolescent cigarette smoking. , 2001, Addictive behaviors.

[46]  J. Arnett,et al.  Conceptions of the Transition to Adulthood: Perspectives From Adolescence Through Midlife , 2001 .

[47]  K. Wilson,et al.  Homeless and runaway youths' access to health care. , 2000, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[48]  Devon D. Brewer,et al.  Forgetting in the recall-based elicitation of personal and social networks , 2000, Soc. Networks.

[49]  J. Arnett Emerging adulthood. A theory of development from the late teens through the twenties. , 2000, The American psychologist.

[50]  N. Williams,et al.  How Runaway and Homeless Youth Navigate Troubled Waters: Personal Strengths and Resources , 2000 .

[51]  R. Booth,et al.  The challenge of changing drug and sex risk behaviors of runaway and homeless adolescents. , 1999, Child abuse & neglect.

[52]  L. Whitbeck,et al.  A Risk-Amplification Model of Victimization and Depressive Symptoms Among Runaway and Homeless Adolescents , 1999, American journal of community psychology.

[53]  S. Ennett,et al.  Social network characteristics associated with risky behaviors among runaway and homeless youth. , 1999, Journal of health and social behavior.

[54]  J. Ensign,et al.  Health and access to care: perspectives of homeless youth in Baltimore City, U.S.A. , 1998, Social science & medicine.

[55]  A. Tenner,et al.  Seattle YouthCare's prevention, intervention, and education program - An AIDS risk reduction model (AARM) , 1998 .

[56]  R. Winett,et al.  Randomised, controlled, community-level HIV-prevention intervention for sexual-risk behaviour among homosexual men in US cities , 1997, The Lancet.

[57]  R W Pfeifer,et al.  A study of HIV seroprevalence in a group of homeless youth in Hollywood, California. , 1997, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[58]  S. W. Fors,et al.  Evaluation of a Peer-Led Drug Abuse Risk Reduction Project for Runaway/Homeless Youths , 1995, Journal of drug education.

[59]  G. Abraham,et al.  HIV testing. , 2008, The British journal of general practice : the journal of the Royal College of General Practitioners.

[60]  A. Bandura Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[61]  T. J. Berndt,et al.  Developmental Changes in Conformity to Peers and Parents , 1979 .

[62]  U. Bronfenbrenner Toward an Experimental Ecology of Human Development. , 1977 .