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

描述（由申请人提供）：年轻妇女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、不孕症和宫颈癌等后果。这一疾病负担在一些年轻妇女群体，如种族/族裔少数群体和社会经济地位低的妇女身上差别很大。迄今为止，大多数研究和预防计划都集中在单个时间点测量的性风险行为的个人水平预测因素（例如，行为意图，态度）。然而，个人参与冒险或保护行为的意图可能会因环境和关系的过程而异。通过将尖端的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。该项目将利用在两年半的时间里每周从近1 000名年轻妇女那里收集的数据，包括关于她们的关系、性行为、避孕药具使用、态度和意图的详细信息。我们将运用一种新颖的分析技术，时变效应模型，来了解女性在与性伴侣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伙伴关系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在性伙伴关系中不同地预测不使用避孕套。最后，我们将通过研究这些性风险行为模式如何因种族/民族、社会经济因素和城市化而不同，深入研究性健康结果差异的来源。通过对性风险行为在一段关系中如何演变的建模，拟议中的项目将为制定针对高风险人群和关系背景的更有效的预防方案提供信息。

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.