STI Risk among adolescent females: activity spaces and spatial mobility

描述（由申请人提供）：本研究的目的是确定社交空间（社交互动发生的地点）和空间流动性对居住在美墨边境附近的少女衣原体和淋病风险的作用。与美国任何其他年龄性别组相比，青春期女孩的衣原体（CT）和淋病（GC）负担最高。一些研究已经开始研究邻里或社区层面的结构性因素如何影响健康风险，包括性风险和性暴力;然而，这些研究没有考虑到个人在任意邻里边界的流动性。青少年在不同社会空间中的接触和经历塑造了他们自己的行为，包括那些使他们面临性传播感染和性暴力更高风险的行为。流动性不仅可能影响到接触不同社区一级结构因素的机会，还可能影响到经常光顾的社交空间的数量和类型。此外，无障碍通信技术的数量和类型迅速增加，极大地影响了社会化的方式。了解青少年如何将这项技术纳入社交空间和社交活动的识别，可能有助于确定性健康干预的新目标。在这项研究中，我们的目标是1）开发类别和措施来描述青少年社会空间的类型和特征，包括青少年可能遭受性暴力的地点，以及青少年的流动模式，2）比较社会空间的类型，包括这些空间的地理位置，以及CT和/或GC检测阳性和阴性青少年之间的流动模式，（3）采用定性研究方法，深入了解传播技术在青少年活动空间识别、社会活动参与以及相关的性行为和物质使用风险行为中的作用。为了实现这些目标，我们将与一个青年中心和诊所合作，在一个少数民族比例较高的多元文化社区，在青春期女孩（15-19岁）中进行病例对照研究。50例病例（CT和/或GC检测阳性）将从诊所转诊，150例对照将从青年中心寻求计划生育/生殖健康服务的患者中招募。参与者将被要求完成一项由面试官管理的调查，包括有关人口统计学、性/生殖健康、性和物质使用行为以及性暴力暴露的问题，以及使用谷歌地球识别社交空间的地图组件。案例样本将被要求参加第二次深入访谈，了解在社会活动决策中使用技术的情况。这项研究与NIH ANSWHR PAS（PAS-10-226）的目标一致，提供了一项跨学科研究，将空间流动性的概念与性活跃少女性传播感染风险的性别观点相结合，并将提供一个框架，探索创新的结构层面干预措施，以减少这一人群中的性传播感染风险。

DESCRIPTION (provided by applicant): The goal of this study is to determine the role of social spaces (locations where social interactions occur) and spatial mobility on risk for chlamydia and gonorrhea among adolescent girls living near the US-Mexico border. Adolescent girls have the highest burden of chlamydia (CT) and gonorrhea (GC) compared to any other age- sex group in the United States. Several studies have begun to examine how neighborhood or community-level structural factors may influence health risks, including sexual risk and sexual violence; however, these studies don't account for mobility of individuals across arbitrary neighborhood boundaries. The exposures and experiences that occur in adolescents' different social spaces shape their own behaviors, including those that put them at higher risk for STI and sexual violence. Mobility may impact not only exposure to different community-level structural factors, but also the number and type of social spaces frequented. Additionally, the rapid increase in the number and type of accessible technologies for communication has greatly impacted the manner in which socialization occurs. Understanding how adolescents incorporate this technology into identification of social spaces and attendance of social activities, may help identify novel targets for sexual health interventions. In this study, we aim to 1) develop categories and measures to describe the types and characteristics of adolescents social spaces, including locations where adolescents may be exposed to sexual violence, and adolescents' patterns of mobility, 2) compare types of social spaces, include the geographic location of these spaces, and patterns of mobility between adolescents testing positive for CT and/or GC and those testing negative, and 3) to use qualitative methods to provide a deeper understanding of the role of communication technology in adolescents' identification of activity spaces and engagement in social activities and related sexual and substance use risk behaviors. To meet these aims, we will conduct a case-control study among adolescent girls (age 15-19 years) in collaboration with a youth center and clinic in a culturally diverse neighborhood with a high proportion of ethnic minorities. Fifty cases (positive test for CT and/or GC) will be referred from the clinic, and 150 controls will be recruited from those seeking family planning/ reproductive health services from the youth center. Participants will be asked to complete an interviewer administered survey including questions about demographics, sexual/reproductive health, sexual and substance use behavior, and exposure to sexual violence, as well as a mapping component to identify social spaces using Google" Earth. A sample of cases will be asked to participate in a second, in-depth interview about the use of technology in social activity decision making. This study is consistent with the goals of the NIH ANSWHR PAS (PAS-10-226), offering an interdisciplinary study combining concepts of spatial mobility with a gendered perspective on STI risk among sexually active adolescent girls and will provide a framework to explore innovative structural-level interventions to reduce STI risk among this population.