Violence Exposure and HIV Risk in Adolescent Women of Color

描述（由申请人提供）：本R 03提案要求提供资金，以建立一个更大的纵向研究与低收入，城市非洲裔美国人（AA）女孩寻求门诊心理健康服务（G。Donenberg，PI）通过探索儿童期暴力暴露与危险性行为之间的关系。最近CDC的估计表明，近一半的AA青少年女性感染了性传播疾病（STD）。1反映这种模式，AA女性占美国女性艾滋病毒/艾滋病病例的最大比例，这强调了减少这一人群性风险的迫切需要。2绝大多数AA妇女的感染发生在异性性交中。3早期的暴力暴露与危险的性行为和低收入有关，城市AA女孩遭受暴力的比例很高。4，5此外，儿童暴力暴露可能在寻求精神病治疗的青年中普遍存在，因为暴力暴露与精神健康问题有关。6因此，较高的家庭和社区暴力暴露率可能是增加有色人种年轻女性感染艾滋病毒和其他性病风险的一个关键因素。7基于一项联邦资助的研究，研究对象是寻求心理健康服务的12-16岁AA女孩及其女性照顾者（N=265; G. Donenberg，PI），这项小型研究将：（1）检查14-18岁AA女孩在心理健康治疗中儿童期暴力暴露与危险性行为之间的联系;（2）探索从儿童期暴力暴露到这一人群中危险性行为的潜在解释途径。我们将重新联系所有完成较大纵向研究的家庭，并对终身创伤和受害史（包括创伤，年龄，肇事者，频率和严重程度的7个类别）进行全面评估。统计分析将采用回归和结构方程模型，利用更大的纵向研究的现有数据。这项研究的结果将为这些关系的更大的前瞻性研究的设计提供信息，并将为制定创新的，对性别敏感的和文化上适当的方案提供指导，以降低有暴力暴露史和心理健康问题的年轻AA妇女的艾滋病毒和其他性病的发病率。公共卫生相关性：疾病预防控制中心最近的估计表明，近50%的非洲裔美国少女感染了性传播疾病，非洲裔美国妇女占美国妇女艾滋病毒/艾滋病病例的最大比例。早期暴露于家庭和社区暴力可能是一个关键的风险因素，有助于发展危险的性行为在低收入，城市非洲裔美国女孩。拟议的项目建立在一个更大的纵向研究，以研究从儿童暴力暴露到危险性行为的途径，在低收入的样本中，城市非洲裔美国女孩寻求心理健康服务，并将产生信息，最终可用于减少健康危害性行为在这一人群中。

DESCRIPTION (provided by applicant): This R03 proposal requests funds to build on a larger longitudinal study with low-income, urban African American (AA) girls seeking outpatient mental health services (G. Donenberg, PI) by exploring the relationship between childhood violence exposure and risky sexual behavior. Underscoring the crucial need to reduce sexual risk-taking in this population, recent CDC estimates indicate that nearly half of all AA adolescent women are infected with a sexually transmitted disease (STD).1 Reflecting this pattern, AA women account for the largest proportion of HIV/AIDS cases among women in the US,2 and the vast majority of infections in AA women occur through heterosexual intercourse.3 Early violence exposure has been linked to risky sexual behavior, and low income, urban AA girls are exposed to high rates of violence.4, 5 Moreover, childhood violence exposure is likely to be prevalent in youth seeking psychiatric treatment since violence exposure is associated with mental health symptoms.6 Thus, high rates of exposure to family and community violence may be a critical factor increasing risk for HIV and other STDs among young women of color in mental health treatment.7 Building on a federally funded study of 12-16 year-old AA girls seeking mental health services and their female caretakers (N=265; G. Donenberg, PI), this small study will: (1) examine links between violence exposure in childhood and risky sexual behavior among 14-18 year old AA girls in mental health treatment; and (2) explore potential explanatory pathways from childhood violence exposure to risky sexual behavior in this population. We will re-contact all families who completed the larger longitudinal study and conduct a comprehensive assessment of lifetime trauma and victimization history (including 7 categories of trauma, age, perpetrator, frequency, and severity). Statistical analyses will employ regression and structural equation modeling, capitalizing on existing data from the larger longitudinal study. Results from this study will inform the design of a larger, prospective study of these relationships and will provide guidance for developing innovative, gender-sensitive, and culturally appropriate programs to reduce rates of HIV and other STDs among young AA women with histories of violence exposure and mental health problems. PUBLIC HEALTH RELEVANCE: Recent estimates from the CDC indicate that nearly 50% of teenage African American girls are infected with sexually transmitted diseases, and African American women account for the largest proportion of HIV/AIDS cases among women in the United States. Early exposure to home and community violence may be a crucial risk factor contributing to the development of risky sexual behavior in low-income, urban African American girls. The proposed project builds on a larger longitudinal study to examine the pathway from childhood violence exposure to risky sexual behavior in a sample of low-income, urban African American girls seeking mental health services and will yield information that can ultimately be used to reduce health compromising sexual behavior in this population.