A systems science approach to understanding sexual risk behavior in young women

描述(由申请人提供)：年轻女性患性传播感染及其后果的风险不成比例，衣原体和淋病的发病率最高，以及盆腔炎、不孕不育和宫颈癌等后果。这一疾病负担对某些年轻妇女群体，如种族/族裔少数群体和社会经济地位较低的妇女，造成了不同程度的影响。到目前为止，大多数研究和预防计划都集中在单个时间点测量的个人水平的性风险行为预测因素(例如，行为意图、态度)。然而，个人从事危险或保护性行为的意图可能会在不同的背景和关系过程中有所不同。通过将尖端分析技术应用于丰富详细、密集的纵向数据，我们将扩展对性风险行为的研究，以解决影响这些行为的关系动态。该项目将利用每周从近1000名年轻女性那里收集的数据，包括关于她们的关系、性行为、避孕药使用、态度和意图的详细信息。我们将应用一种新的分析技术，即时变效应模型，来理解女性在与性伴侣的关系过程中的性风险行为。这个项目有三个具体目标。首先，我们将对年轻女性在性关系过程中不使用避孕套的模式进行建模。其次，我们将研究女性使用避孕套的意图如何不同地预测在性关系过程中不使用避孕套。最后，我们将通过研究这些性风险行为模式可能因种族/民族、社会经济因素和城市化程度的不同而不同，来探索性健康结果差异的来源。通过模型性风险行为在关系过程中的演变，拟议的项目将为创建更有效的预防计划提供信息，这些计划针对高危人群和关系背景。

DESCRIPTION (provided by applicant): Young women are at disproportionate risk of STIs and their consequences, with the highest rates of chlamydia and gonorrhea, as well as outcomes such as pelvic inflammatory disease, infertility and cervical cancer. This disease burden has a disparate on some groups of young women, such as racial/ethnic minorities and women of low socio-economic status. To date, most research and prevention programs have focused on individual- level predictors of sexual risk behavior measured at a single time point (e.g., behavioral intentions, attitudes). However, individuals' intentions to engage in risky or protective behaviors may vary across contexts and over the course of relationships. By applying a cutting-edge analytic technique to richly detailed, intensive longitudinal data, we will extend research on sexual risk behavior to address the relationship dynamics that influence these behaviors. This project will make use of data collected weekly from nearly 1,000 young women over 2.5 years, including detailed information about their relationships, sexual behavior, contraceptive use, attitudes and intentions. We will apply a novel analytic technique, the time-varying effect model, to understand women's sexual risk behavior over the course of the relationship with a sexual partner. This project has three specific aims. First, we will model patterns of young women's non-use of condoms over the course of sexual partnerships. Second, we will examine how women's intentions to use condoms differentially predict condom non-use over the course of sexual partnerships. Finally, we will delve into sources of disparities in sexual health outcomes by examining how these patterns of sexual risk behavior may differ by race/ethnicity, socioeconomic factors and urbanicity. By modeling how sexual risk behavior evolves over the course of a relationship, the proposed project will inform the creation of more effective prevention programs that are targeted to high risk populations and relationships contexts.