Violence Exposure and HIV Risk in Adolescent Women of Color

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): This R03 proposal requests funds to build on a larger longitudinal study with low-income, urban African American (AA) girls seeking outpatient mental health services (G. Donenberg, PI) by exploring the relationship between childhood violence exposure and risky sexual behavior. Underscoring the crucial need to reduce sexual risk-taking in this population, recent CDC estimates indicate that nearly half of all AA adolescent women are infected with a sexually transmitted disease (STD).1 Reflecting this pattern, AA women account for the largest proportion of HIV/AIDS cases among women in the US,2 and the vast majority of infections in AA women occur through heterosexual intercourse.3 Early violence exposure has been linked to risky sexual behavior, and low income, urban AA girls are exposed to high rates of violence.4, 5 Moreover, childhood violence exposure is likely to be prevalent in youth seeking psychiatric treatment since violence exposure is associated with mental health symptoms.6 Thus, high rates of exposure to family and community violence may be a critical factor increasing risk for HIV and other STDs among young women of color in mental health treatment.7 Building on a federally funded study of 12-16 year-old AA girls seeking mental health services and their female caretakers (N=265; G. Donenberg, PI), this small study will: (1) examine links between violence exposure in childhood and risky sexual behavior among 14-18 year old AA girls in mental health treatment; and (2) explore potential explanatory pathways from childhood violence exposure to risky sexual behavior in this population. We will re-contact all families who completed the larger longitudinal study and conduct a comprehensive assessment of lifetime trauma and victimization history (including 7 categories of trauma, age, perpetrator, frequency, and severity). Statistical analyses will employ regression and structural equation modeling, capitalizing on existing data from the larger longitudinal study. Results from this study will inform the design of a larger, prospective study of these relationships and will provide guidance for developing innovative, gender-sensitive, and culturally appropriate programs to reduce rates of HIV and other STDs among young AA women with histories of violence exposure and mental health problems. PUBLIC HEALTH RELEVANCE: Recent estimates from the CDC indicate that nearly 50% of teenage African American girls are infected with sexually transmitted diseases, and African American women account for the largest proportion of HIV/AIDS cases among women in the United States. Early exposure to home and community violence may be a crucial risk factor contributing to the development of risky sexual behavior in low-income, urban African American girls. The proposed project builds on a larger longitudinal study to examine the pathway from childhood violence exposure to risky sexual behavior in a sample of low-income, urban African American girls seeking mental health services and will yield information that can ultimately be used to reduce health compromising sexual behavior in this population.