Multilevel Moderators of Drugs, Violence, Poverty and HIV Among Black Youth and Young Adults Living in Baltimore

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Project Summary Blacks disproportionately reside in urban neighborhoods characterized by crime, poverty, drugs and violence. They are more likely to experience prolonged unemployment, be incarcerated, become homeless and have fewer financial resources available to them compared to Whites. They are also more likely to report serious psychological distress. Blacks are eight times more likely to be infected with HIV, accounting for 44% of HIV infections in the United States in 2010. This application is for a competitive renewal of the Progression and Clustering of Marijuana Use in African-American Neighborhoods study (DA032550). Using data from a cohort of Black youth living in Baltimore, we examined the influence of neighborhood environment on marijuana use during adolescence. Our data suggest that despite facing challenges and adversity that the majority of American youth never encounter, many Black youth do not exhibit the risk behaviors shown to be associated with growing up in distressed, urban neighborhoods. There is scant research, however, focused on understanding the process by which Black youth successfully adapt to the challenges faced in these neighborhoods. We aim to fill this gap by conducting a series of new analyses from this cohort to identify factors at multiple ecological levels that moderate the effects of living in a distressed urban neighborhood on risk behavior trajectories during the life course. In our prior award, we focused on adolescence. With this renewal award, we will extend our work to emerging adulthood; a period frequently marked by increased risk- taking and as well as social role transitions than can redirect a trajectory. We will expand our inquiry to include other substances as well as trajectories of violent and sexual risk behavior that often co-occur with drug use. The Specific Aims of this research project are to 1) identify individual and joint trajectories of drug use, violence and sexual risk behaviors from adolescence to emerging adulthood and estimate the influence of living in a distressed urban neighborhood on these trajectories, 2) identify factors present at multiple ecological levels during adolescence that moderate the effects of living in a distressed urban neighborhood on risk behavior trajectories, 3) estimate the influence of risk behavior trajectories on young adult socioeconomic, mental health, drug, crime and sexual risk outcomes, and 4) assess the impact of social role transitions on risk behavior trajectories and young adult outcomes. This is one of the few studies that follow low-income, urban Blacks from childhood to emerging adulthood. It has the potential to inform both public health interventionists and policy-makers of ways Black youth and young adults living in distressed neighborhoods can be provided with the opportunities, supports and services necessary to promote positive development at a time when drug use is pervasive, violence is on the rise and concentrated poverty continues to grow in America's inner cities.