Developmental Changes in Sexual Risk and Substance Use Among African American Females: an Integrated Data Analysis Approach Using Time-varying Effect Models.

Developmental Changes in Sexual Risk and Substance Use Among African American Females: an Integrated Data Analysis Approach Using Time-varying Effect Models.
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非裔美国女性性风险和药物使用的发展变化:使用时变效应模型的综合数据分析方法。

DOI:
10.1007/s11121-019-01046-w
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发表时间:
2020
期刊:
Prevention science : the official journal of the Society for Prevention Research
影响因子:
--
通讯作者:
Haardörfer,Regine
Haardörfer,Regine
中科院分区:
--
文献类型:
--
作者:
Swartzendruber,Andrea;Brown,JenniferL;Sales,JessicaM;DiClemente,RalphJ;Windle,Michael;Haardörfer,Regine

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本研究的目的是利用在佐治亚州亚特兰大进行的三项艾滋病毒/性传播感染 (STI) 预防试验的现有数据来描述性风险和药物使用与年龄相关的变化,该试验招募了年轻的非裔美国女性。我们使用了两种新颖的分析方法:综合数据分析(IDA)和时变效应模型(TVEM)。每项试验都收集了自我报告的行为数据和阴道拭子样本,用于检测衣原体、淋病和滴虫。使用 IDA 方法将所有参与者的基线数据和未随机分配到主动干预组的参与者的后续数据整合到汇总数据集中。汇总数据集包括对 1974 名个体的观察,这些个体的行为结果为 14-25 岁,性传播感染结果为 16-25 岁。我们使用 TVEM 来模拟性风险、药物使用行为和性传播感染的年龄相关变化,并将试验调整为固定效应。 20 岁出头时,性交频率和无套性行为有所增加,而多重伴侣关系则保持相当稳定。饮酒和吸烟的人数在 24 岁左右有所增加,然后有所下降。大麻的使用在 16 至 17 岁之间达到顶峰,此后普遍下降。性传播感染在 16 岁时感染率最高。这项研究证明了利用多项试验的现有数据,创新方法技术解决与青少年发展相关的新问题的可行性和实用性。结果表明,青春期中期和二十岁出头可能是特别危险的时期。研究结果可能有助于为年轻的非洲裔美国女性安排文化和发展相关的预防干预措施。
The aim of this study was to describe age-related changes in sexual risk and substance use using existing data from three HIV/sexually transmitted infection (STI) prevention trials conducted in Atlanta, Georgia, that enrolled young African American women. We used two novel analysis methods: integrative data analysis (IDA) and time-varying effect models (TVEM). Each trial collected self-reported behavioral data and vaginal swab specimens assayed for chlamydia, gonorrhea, and trichomonas. Baseline data from all participants and follow-up data from participants not randomized to an active intervention arm were integrated in a pooled dataset using an IDA approach. The pooled dataset included observations for 1974 individuals, aged 14–25 years for behavioral outcomes and 16–25 years for STI outcomes. We used TVEM to model age-related changes in sexual risk and substance use behaviors and STI acquisition, adjusting for trial as a fixed effect. Coital frequency and condomless sex increased through the early 20s while multiple partnerships remained fairly steady. Alcohol use and cigarette smoking increased through about age 24 years before declining. Marijuana use peaked at age 16–17 years and thereafter generally declined. STI acquisition was highest at age 16 years. This study demonstrates the feasibility and utility of innovative methodological techniques to address novel questions related to adolescent development using existing data from multiple trials. The results suggest that mid-adolescence and the early 20s may be periods of particular risk. The findings may be useful for timing culturally and developmentally relevant prevention interventions for young African American women.
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