Substance Use/Abuse & HIV/STI Risk Behaviors in Puerto Rican Youth Growing Up

描述（由申请人提供）：物质使用/滥用（SU/SUD）和其他艾滋病毒/性传播感染风险行为是主要的公共卫生挑战，在种族/族裔群体中分布不均。在美国增长最快的少数民族人口，拉丁裔青年，艾滋病毒/性传播感染的风险行为和SU/SUD的比率上升，特别是在那些放弃传统的拉丁裔价值观和转向美国价值观（文化适应）。本申请是对PA-09-236：美国艾滋病毒/艾滋病、药物使用和弱势群体（R 01）的回应，旨在确定与拉丁美洲青年在关键的过渡发展时期（成年期）发生SU/SUD和HIV/STI风险行为和感染相关的因素。现有的研究揭示了重要的差异，但是，他们的能力有限，以确定 与拉丁美洲青年有关的进程，因为这些进程没有包括足够数量的来自相当同质的亚群（例如波多黎各人、墨西哥裔美国人等）的拉丁美洲青年。缺乏文化适应方面的信息，这是拉丁美洲青年风险的一个关键决定因素。我们建议进行Boricua青年研究（BYS~ R 01 MH 56401）的第四波，重点是艾滋病毒/性传播感染的风险，在成年初的感染（BYS波4，N=1,992，青年年龄16 - 24）。BYS已经产生了三波（2001年至2004年）关于波多黎各背景儿童（第一波年龄为5 - 13岁）的数据，迄今已有19篇同行评审出版物描述了研究结果。除了全面的纵向评估策略外，BYS的一个独特之处在于其两个地点的设计，因为它包括生活在南布朗克斯（SBx）的儿童， 纽约和圣胡安，波多黎各（PR）。在第四阶段，我们建议对艾滋病毒/性传播感染风险进行深入评估（包括艾滋病毒和性传播感染检测），并加强对SU/SUD的评估，此外还继续跟踪文化经历、精神障碍和其他因素。拟议的研究的具体目标是审查：（一）艾滋病毒/性传播感染危险行为的流行率和成年初期艾滋病毒/性传播感染率，以及性取向、少女意外怀孕和过早初次性行为的影响。(II)在生态发展框架的背景下，从儿童/青春期早期开始的SU/SUD（尼古丁，酒精，非法/处方药）的发展如何影响成年后的艾滋病毒/性传播感染风险。(III)文化适应的作用（文化习俗、认同、 价值观）与SU/SUD及其与HIV/STI风险行为/感染的关系。 一旦第4波完成，BYS将代表一个无与伦比的前瞻性信息来源，这些信息涉及SU/SUD和HIV/STI风险行为和感染的发生，以及在两种情况下检查的同质拉丁美洲亚组中SU从儿童期到成年期的持续性和进展（SBx和PR）。这些信息将填补知识的空白，从我们的调查中得出的模型将使和促进与拉丁美洲青年相关的具体因素的整合（例如，文化适应）作为针对这一高危群体的干预措施的一部分。

DESCRIPTION (provided by applicant): Substance use/abuse (SU/SUD) and other HIV/STI risk behaviors are major public health challenges not equally distributed across racial/ethnic groups. The fastest growing minority population in the US, Latino youth, have elevated rates HIV/STI risk behaviors and SU/SUD, particularly among those abandoning traditional Latino values and shifting towards American values (acculturation). This application, in response to PA-09-236: HIV/AIDS, Drug Use, and Vulnerable Populations in the US (R01), aims to identify factors related to the development of SU/SUD and HIV/STI risk behaviors and infection among Latino youth during a critical transitional developmental period: emerging adulthood. Existing studies have revealed important disparities, however, they are limited in their ability to identify processes relevant for Latino youth, as they have not included sufficient numbers of Latino youth from fairly homogeneous subgroups (e.g. Puerto Ricans, Mexican- Americans, etc.) and lack information about acculturation, a key determinant of risk among Latino youth. We propose to conduct the fourth wave on the Boricua Youth Study (BYS~ R01 MH56401) focused on HIV/STI risk, infection in emerging adulthood (BYS Wave 4, N=1,992, youth ages 16 - 24). The BYS has already generated 3 waves of data (years 2001 to 2004) on children of Puerto Rican background (ages 5 -13 at Wave 1), with study findings described in 19 peer-reviewed publications to date. Besides the comprehensive longitudinal assessment strategy, a unique feature of the BYS is its two-site design, as it included children living in the South Bronx (SBx), NYC and San Juan, Puerto Rico (PR). At BYS Wave 4, we propose to conduct intensive assessment of HIV/STI risk (including testing for HIV and STIs) and enhance the assessment of SU/SUD, in addition to continuing tracking of cultural experiences, and psychiatric disorders and other factors. The proposed study has as its specific aims, to examine: (I) Prevalence of HIV/STI risk behaviors and rates of HIV/STI infection in emerging adulthood and the influence of sexual orientation, teenage unintended pregnancy and early sexual debut. (II) How development of SU/SUD (nicotine, alcohol, illicit/prescription drugs) starting in childhood/earlyadolescence may influence HIV/STI risk in emerging adulthood in the context of a Ecodevelopmental framework. (III) The role of acculturation (cultural practices, identification, values) in relation to SU/SUD and its relationship to HIV/STI risk behaviors/infection. Once Wave 4 is completed, the BYS will represent an unparalleled source of prospective information about onset of SU/SUD and HIV/STI risk behaviors and infection as well as persistence and progression of SU from childhood to emerging adulthood in a homogeneous Latino subgroup examined in two contexts (SBx and PR).This information will fill a gap in knowledge, and the model resulting from our investigation will enable and facilitate the integration of specific factrs of relevance for Latino youth (e.g., acculturation) as part of interventions for this high-risk group.