ADOLESCENT DEVELOPMENT AND STD ACQUISITION IN FEMALES

该项目的具体目标是：1)确定性传播疾病感染与性成熟（认知成熟、生理成熟和性心理成熟）三个指标之间随时间变化的关系；2)研究性传播疾病症状和后果的认知发展与性传播疾病感染之间的关系；3)评估社会文化背景的演变与性病的发生之间的关系；4)确定管理技能水平与性病感染之间的长期关系；5)描述重要发展特征之间的相互关系，并评估这些特征实现的相对时间对性病感染的影响。最初的样本包括174名1979年至1983年间出生的女孩，这些女孩是从每个年龄组中随机招募的。入组时，青少年的平均年龄为14.5岁（12至16岁）；76%是非洲裔美国人，24%是白种人。到第6次访问时，总共有120名女孩报告性活跃，尽管由于缺少数据，只有117名女孩被纳入分析。由于人员流失和不一致的研究出勤率，每次访问时评估的受试者数量各不相同。预测因子（种族、性活动年数、K-BIT综合智商分数、你的逻辑如何？）之间的纵向关系通过广义估计方程（GEE）技术检验了得分、性开始年龄风险、终生伴侣数量风险、避孕套使用频率、女性朋友对性传播疾病流行程度的看法、父母直接和间接监测)以及发生性传播疾病的可能性。此外，在初始GEE模型中测试了年龄与所有风险参数的相互作用。采用反向消除不显著的年龄相互作用和主要影响的策略，直到模型中只剩下具有统计意义的性病发生预测因子。终生伴侣、开始性行为的年龄和年龄与性病风险相关的研究结果支持了暴露机会的重要性。种族也可能是暴露机会的一个因素，并可能反映不同伴侣群体之间感染流行程度的差异。目前尚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）或对未来的更大投资，导致青少年早期的冒险行为减少。最后，间接监督的作用支持了父母参与孩子生活的重要性。对29名在第一次研究访问后首次感染性病的青春期女孩的检查表明，在感染性病后，对患病率的认识立即增加。与之前的研究一致，在入学时有性病病史的青春期女孩在未来感染性病的风险并没有降低。我们的下一个计划是评估风险状况和性病感染随时间的变化。我们将收集第八波数据收集并重新提交竞争性的持续拨款。

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.