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会空间（发生社会互动的地点）和空间流动性对居住在美墨边境附近的青春期女孩衣原体和淋病风险的作用。在美国，与任何其他年龄组相比，青春期女孩的衣原体（CT）和淋病（GC）负担最高。一些研究已经开始审查邻里或社区一级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，这些研究并没有考虑到个人跨越任意社区边界的流动性。发生在青少年不同社会空间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更高性传播感染和性暴力风险的行为。流动性不仅会影响不同社区结构因素的暴露，还会影响人们经常光顾的社会空间的数量和类型。此外，可获得的通信技术的数量和类型的迅速增加，极大地影响了社会化发生的方式。了解青少年如何将这项技术纳入社会空间的识别和社会活动的参加，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)制定分类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检测呈阳性和阴性的青少年之间的流动模式。3)利用定性方法，更深入地了解通信技术在青少年对活动空间的识别、社会活动的参与以及相关的性行为和物质使用危险行为中的作用。为了实现这些目标，我们将与一个少数民族人口比例较高的多元文化社区的青年中心和诊所合作，在青春期女孩（15-19岁）中开展一项病例对照研究。50例病例（CT和/或GC检测呈阳性）将从诊所转介，150例对照将从青年中心寻求计划生育/生殖健康服务的人中招募。参加者将被要求完成一项由采访者管理的调查，其中包括有关人口统计、性/生殖健康、性行为和药物使用行为以及遭受性暴力的问题，以及利用谷歌" Earth确定社会空间的绘图部分。案例样本将被要求参加关于在社会活动决策中使用技术的第二次深入访谈。该研究与美国国立卫生研究院ANSWHR PAS （PAS-10-226）的目标一致，提供了一项跨学科研究，将空间流动性概念与性别视角结合起来，研究性活跃的青春期女孩的性传播感染风险，并将为探索创新的结构层面干预措施提供框架，以降低这一人群的性传播感染风险。

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.