Exposure to violence and unsafe sex in late adolescent African American women

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DESCRIPTION (provided by applicant): Dating violence and unsafe sexual behavior represent major public health concerns that disproportionately affect young AA women.1-3 This R01 proposal responds to the Research on Teen Dating Violence program by requesting funds to build on an NIH-funded longitudinal study of African American (AA) adolescent women from low-income, urban neighborhoods in Chicago. Consistent with the goals of the program, the proposed etiological research is aimed at providing a better understanding of the precursors and consequences of teen dating violence through use of longitudinal, multivariate analyses to examine pathways from early violence exposure to dating violence and unsafe sexual behavior in late adolescence. AA women ages 18-22 represent the demographic group at highest risk for both intimate partner violence (IPV)1, 4-6 and sexually transmitted infections (STIs).2, 7 Dating violence is a health concern not only because of direct physical and emotional risks, but also due to increased risk of unsafe sexual behavior in violent relationships.8, 9 The specific aims of this project are to: (1) Prospectively examine the pathway from violence exposure to dating violence and unsafe sexual behavior; (2) Longitudinally examine relationships between dating violence, unsafe sexual behavior, and STIs; and (3) Examine physiological, psychological, and relational mechanisms that may explain the pathway from violence exposure to both dating violence and unsafe sexual behavior. Adolescent girls who participated in a 2-year longitudinal study focused on HIV risk behavior (N=265; G. Donenberg, PI) are being asked to complete a comprehensive assessment of lifetime trauma and victimization history in 2009-2010 (H. Wilson, PI), with the aim of examining relationships between childhood violence exposure and risky sexual behavior in adolescence. The goal of the proposed study is to re-contact all participants who completed the trauma assessment and invite them to participate in a new wave of data collection to understand romantic relationships in late adolescence (ages 18-22). To capture the interactive processes that contribute to violence and unsafe sex in romantic relationships, we will also attempt to interview a romantic partner of each young woman and observe a structured interaction between the two. The proposed study will expand upon previous work in a number of innovative ways that include: (1) broadening relationship risk to dating violence; (2) assessing romantic partners; and (3) measuring biological markers of physiological stress response and sexually transmitted infections. Using multiple measures and methods (self report, partner report, observation, official records, and biological markers), we will examine links among early violence exposure, teen dating violence, and unsafe sexual behavior, and we will examine mechanisms that may explain the pathway from early violence exposure to dating violence and unsafe sexual behavior in late adolescent relationships. These findings can be used to develop culturally tailored, gender sensitive interventions to foster healthy romantic and sexual relationships in young African American women with histories of violence exposure.