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

描述(由申请人提供)：药物使用/滥用(SU/SUD)和其他艾滋病毒/性传播感染危险行为是主要的公共卫生挑战，在种族/民族群体中分布不均。美国增长最快的少数族裔--拉丁裔青年--艾滋病毒/性传播感染危险行为和SU/SUD的发生率较高，特别是在那些放弃传统拉丁裔价值观而转向美国价值观(文化适应)的人中。针对PA-09-236：美国的艾滋病毒/艾滋病、药物使用和弱势人群(R01)，本申请旨在确定与拉美裔青年在关键的过渡发展时期：成年初期发展的SU/SUD和艾滋病毒/性传播感染危险行为和感染相关的因素。现有的研究已经揭示了重要的差异，然而，它们识别的能力有限。 与拉美裔青年有关的进程，因为这些进程没有包括来自相当同质的亚群(例如波多黎各人、墨西哥裔美国人等)的足够数量的拉美裔青年。缺乏关于文化适应的信息，文化适应是拉美裔青年风险的关键决定因素。我们建议对Boricua青年研究(BYS~R01 MH56401)进行第四波研究，重点是艾滋病毒/性传播感染风险和成年初期感染(BYS波4，N=1,992，16-24岁青年)。BYS已经产生了3波关于波多黎各背景儿童(第1波为5-13岁)的数据(2001年至2004年)，迄今已有19份同行评议的出版物介绍了研究结果。除了全面的纵向评估战略外，BYS的一个独特特点是其两个地点的设计，因为它包括居住在南布朗克斯(SBX)的儿童， 波多黎各的纽约市和圣胡安(PR)。在第四次浪潮中，我们建议对艾滋病毒/性传播感染风险进行密集评估(包括艾滋病毒和性传播感染的测试)，并加强对SU/SUD的评估，同时继续跟踪文化经历、精神障碍和其他因素。这项拟议的研究的具体目标是：(I)成年初期艾滋病毒/性传播感染危险行为的流行率和艾滋病毒/性传播感染的比率，以及性取向、青少年意外怀孕和早期性首发性行为的影响。(2)在生态发展框架的背景下，从儿童期/青春期早期开始开发SU/SUD(尼古丁、酒精、非法/处方药)可能如何影响成年初期的艾滋病毒/性传播感染风险。(3)文化适应的作用(文化习俗、认同、 与SU/SUD的关系及其与艾滋病毒/性传播感染危险行为/感染的关系。一旦第四波完成，BYS将代表一个无与伦比的前瞻性信息来源，关于SU/SUD和HIV/STI危险行为和感染的发病，以及SU从童年到成年的持续和发展，在两个背景下(SBX和PR)进行研究。这些信息将填补知识的空白，我们调查产生的模型将允许和促进整合与拉美裔青年相关的特定因素(例如，文化适应)，作为对这一高危群体的干预的一部分。

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.