Gender,Environment, and Adolescent Risk Behavior

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EXCEED THE SPACE PROVIDED. Adolescents and African-American adolescents in particularcontinueto be at heightened risk for HIV infection in the United States according to existing data. Recent HIV prevention literature clearly reflects a growing consensus that relying solely on individual cognitive paradigms of behavior change is insufficient to facilitate and sustain protective HIV/STl-related behavior including consistent condom use, especially among populations where environmental-structural constraints have been identified. Despite the recognized need for research and interventions that address environmental-structural factors, very little rigorous research exists on this subject. The following study seeks to contribute to filling this clearly identified gap in the literature. The study's specific aims are: (1) to assess the relationshipbetween adherence to gender roles and norms, relationship power and consistent condom use among adolescents; and (2) to determine the direct and indirect effects of the social organization of communities in which participating adolescents reside on consistent condom use and STI rates. In order to address these aims qualitative research methods will first be employed to develop culturally appropriate measures of adherence to gender roles, social capital, and collective efficacy. Subsequently, these constructs will be integrated into socio-behavioral surveys conducted every six months with a cohort of 810 adolescents attending STI and adolescent health clinics in Baltimore, MD. In addition to individual data, group-level reported and observational data will also be collected in the neighborhoods in which the participants reside including a street-based survey of community members and a neighborhood ecological assessment. Innovative analytical techniques such as structural equation modeling will be utilized in order to appropriately analyze the multi-level data collected. Throughout the process of measurement development, data collection, analysis, and interpretation, I will be guided' by a group of four mentors: Dr. Michael Sweat and Dr. Jonathan Ellen of the Johns Hopkins University; Dr. Geeta Rao Gupta of the International Center for Research on Women, and Dr. Ralph Taylor of Temple University. These mentors will work with me through a combination of directed readings, coursework, and supervised research opportunities over this course of the award and assist me to achieve my short and long-term goals. In the short-term, 1will further develop my theoretical understandingof the influence of gender and the social environment on health outcomes; sharpen my ability to develop reliable measures of complex constructs; and master new analytical techniques for multi-level data. Towards the end of the award, I will take my next step as an independent investigator and write my first R01 to test the efficacy of a community-basedintervention that addressees and harnesses environmental-structural constraints and facilitators of HIV/STI-related protective behavior among adolescents. Through this process I will work to fulfill my longer-term goal: to make significant contributions to the field of applied behavioral science in the area of HIV/STI prevention. PERFORMANCE SITE ========================================Section End===========================================