ADOLESCENT DEVELOPMENT AND STD ACQUISITION IN FEMALES

本项目的具体目标是：1）确定性病的获得与三个成熟指数变化之间随时间推移的关系的性质（认知、生理和性心理成熟）; 2）检查对STD症状和后果的知识和看法的发展与STD获得之间的关系;（3）评估社会文化背景的演变与性病的获得之间的关系：（4）确定管理技能水平与性病获得之间随时间的关系; 5）描述重要发育特征之间的相互关系，并评估其获得的相对时间对STD获得的影响。 最初的样本包括174名出生于1979年至1983年之间的女孩，从每个年龄组中随机招募。 入组时，青少年的平均年龄为14.5岁（范围12至16岁）; 76%为非洲裔美国人，24%为白人。 到第6次访问时，共有120名女孩报告性活跃，但由于数据缺失，分析中只包括117名女孩。由于脱落和不一致的研究出席情况，每次访视时评估的受试者数量各不相同。 预测因素之间的纵向关系（种族，性活动年数，K-BIT综合智商得分，你的逻辑如何？ 通过广义估计方程（GEE）技术检验了性行为发生的风险（包括性行为发生的年龄、性伴侣数量、避孕套使用频率、女性朋友对STD流行的看法以及父母的直接和间接监控）和发生STD的可能性。 此外，在初始GEE模型中检验了年龄与所有风险参数的相互作用。 遵循不显著的年龄相互作用和主效应的向后消除策略，直到模型中仅保留STD发生的统计学显著预测因子。终身伴侣、性行为开始年龄和年龄与性病风险相关的研究结果支持了暴露机会重要性的概念。 种族也可能是接触机会的一个因素，并可能反映不同伴侣群体之间感染流行率的差异。 目前还不清楚智商与性病感染的负相关是否反映了更好的保护自己免受感染的能力（即，使用屏障避孕方法）或对未来进行更多投资，从而减少青春期早期的冒险行为。最后，间接监督的作用支持了父母参与子女生活的重要性。 检查29个青春期女孩谁获得了他们的第一次性病后，第一次研究访问表明，患病率增加后立即性病收购的看法。 与以前的研究一致，在入学时有性病史的青春期女孩未来患性病的风险并没有降低。 我们的下一个计划是评估风险状态和STD获取随时间的变化。 我们将收集第八波数据收集，并重新提交竞争继续补助金。

The specific aims of this project are to 1) establish the nature of the relationship over time between STD acquisition and changes in three indices of maturation (cognitive, biological, and psychosexual maturation); 2) examine the relationships between the development of knowledge and perceptions about symptoms and consequences of STD and STD acquisition; 3) assess the relationships between the evolution of sociocultural context and the acquisition of STD; 4) determine the relationships over time between the level of management skills and the acquisition of STD; and 5) describe the interrelationships among important developmental characteristics and assess the implications of the relative timing of their attainment on STD acquisition. The original sample consisted of 174 girls born between 1979 and 1983 recruited randomly from within each age group. At enrollment , the adolescents had a mean age of 14.5 years (range 12 to 16 years) ; 76% were African-American, 24% were Caucasian. By visit 6, a total of 120 girls reported having become sexually active, although because of missing data, only 117 girls were included in the analysis. As a result of attrition and inconsistent study attendance, the number of subjects assessed at each visit varied. The longitudinal relationship between the predictors (race, years of sexual activity, K-BIT composite IQ score, How is Your Logic? score, risk due to age of sexual initiation, risk due to number of lifetime partners, frequency of condom use, views of prevalence of STDs among female friends, and direct and indirect parental monitoring) and the likelihood of developing an STD was tested by the generalized estimating equations (GEE) technique. In addition, interactions of age with all risk parameters were tested in the initial GEE model. A backward elimination strategy of insignificant age interactions and main effects was followed until only statistically significant predictors of STD occurrence remained in the model. The findings that lifetime partners, age of sexual initiation, and age were related to risk for STD support the notion of the importance of exposure opportunities. Race may also be a factor of exposure opportunity and may reflect differences in prevalence of infection among different partner pools. It is unclear whether the negative relationship of IQ to STD acquisition reflects better ability to protect oneself from infection (i.e., use barrier methods of contraception) or a greater investment in their future, leading to decreased risk-taking during early adolescence. Finally, the role of indirect monitoring supports the importance of parental involvement in their children's lives. Examination of the 29 adolescent girls who acquired their first STD after the first study visit suggests that perceptions of prevalence increase immediately after STD acquisition. Consistent with previous studies, adolescent girls who had a history of a STD at enrollment were not at decreased risk of acquiring a future STD. Our next plan is to evaluate changes in risk status and STD acquisition over time. We are going to collect an eighth wave of data collection and resubmit the competing continuation grant.