Early Adversity Shapes Adolescent Risk Behavior Trajectories in Mexican Americans

描述（申请人提供）：自艾滋病流行以来，美国已有超过 50 万人死于艾滋病，而且现在感染艾滋病毒的人数比以往任何时候都多。目前，美国有超过 100 万成年人和青少年感染艾滋病毒。大多数新的艾滋病毒病例发生在 25 岁之前，年轻的拉丁裔人受到的影响尤为严重。与非拉丁裔白人青少年相比，拉丁裔青少年感染艾滋病毒的风险是非拉丁裔白人青少年的 4 倍，到成年后，艾滋病诊断率是非拉丁裔白人青少年的 4 倍多。与其他族裔群体相比，拉丁美洲人更有可能在青春期早期使用药物，并且更有可能进行无保护的性行为，这增加了他们感染艾滋病毒/艾滋病的风险。鉴于美国拉丁裔年轻人口不断增长，这些差异是持续存在的，并且是一个严重的公共卫生问题。墨西哥裔美国人是拉丁裔中最大的亚群，但由于存在许多方法论障碍，对墨西哥裔美国青年的纵向研究很少。拟议的纵向研究解决了这些问题，以弥补重要的科学差距。该项目以丰富、完善、长期的墨西哥裔美国儿童及其父母为基础，旨在了解生命早期的逆境是否以及如何导致青春期药物滥用和艾滋病毒危险行为的出现。为了实现这一目标，我们将收集 14 岁和 15.5 岁青少年的物质使用和性冒险行为的详细信息，此时青少年正在经历青春期的主要社会和生物转变。强有力的研究设计建立在：（1）在怀孕期间和整个童年时期为墨西哥裔美国青少年及其父母这一既定群体收集的丰富广告数据，并结合在青春期提出的同样丰富的新数据收集； (2) 迄今为止，在这个难以接触的人群中，参与者的保留率令人印象深刻； (3) 使用在多个时间点获得的基于临床的前沿方法对青春期进行持续评估； (4) 纳入压力反应和青春期激素的新测量方法，以更好地了解潜在的生物生理过程； (5) 纳入关键的保护因素，包括父母的影响和文化因素，这些因素可能会缓冲 青少年问题行为的风险。该项目的结果将提供有关这一高度弱势群体中药物滥用和性冒险行为的重要信息。通过关注潜在可改变的特征，这项研究有可能阐明干预的不同领域，以防止青春期的冒险行为 从而降低一生中感染艾滋病毒/艾滋病和其他性传播感染的风险。

DESCRIPTION (provided by applicant): Over half a million people in the United States have died of AIDS since the beginning of the epidemic, and the number of people living with HIV infection is higher now than ever before. Currently, over 1 million adults and adolescents in the US are living with HIV. The majority of new HIV cases occur before age 25 and young Latinos are disproportionately affected. Compared to non-Latino white youths, Latino adolescents have 4 times the risk of HIV infection and, by young adulthood, more than 4 times the rate of AIDS diagnosis. Latinos are more likely to use substances in early adolescence and more likely to engage in unprotected sex than other ethnic groups, which increases their risk for HIV/AIDS. These disparities are persistent and represent a critical public health issue given the growing population of young Latinos in the US. Mexican Americans represent the largest subgroup of Latinos, yet longitudinal studies with Mexican American youth have been sparse due to a host of methodological barriers. The proposed longitudinal research resolves these issues to address important scientific gaps. By building on a rich, well-established, long-term cohort of Mexican American children and their parents, this project aims to understand whether and how adversity exposure in early life contributes to the emergence of substance use and HIV risk behaviors during adolescence. Towards this aim, we will gather detailed information on substance use and sexual risk-taking at ages 14y and 15.5y, when adolescents are sustaining the major social and biological transitions of the pubertal period. The strong study design builds on: (1) rich adversit data already collected during pregnancy and throughout childhood for this established cohort of Mexican American youth and their parents, combined with new equally rich data collection proposed in adolescence; (2) impressive participant retention to date in this hard-to-reach population; (3) ongoing assessing of puberty using leading-edge clinic-based methods obtained at multiple points in time; (4) the inclusion of new measures of stress responsively and pubertal hormones to better understand underlying bio physiological processes; and (5) the inclusion of key protective factors, including parental influences and cultural factors, that may buffer against risk for adolescent problem behaviors. Results from this project will yield important information about the emergence of substance use and sexual risk-taking within this highly vulnerable group. By focusing on potentially modifiable characteristics, this research has the potential to elucidate distinct areas to target for intervention to prevent risk-taking behaviors in adolescence and thereby reduce risk for HIV/AIDS and other STIs over the life course.