Neighborhood Context, Drug Use, and Risky Sexual Behavior Among U.S. Adolescents

说明(申请人提供)：社区的不利地位，如较低的社区社会经济地位和较差的社会氛围(例如，社会凝聚力低)，与广泛的儿童和青少年健康和社会问题有关。证据还表明，社区特征对吸毒和性行为的独立影响。然而，很少有研究考察邻里因素对青少年吸毒和性行为之间关系的影响。在生态学理论框架的启发下，利用多元回归分析，这项横断面研究将检验社区劣势(社区贫困和社区社会凝聚力低)对具有全国代表性的美国青少年样本中危险性行为的影响，包括青少年吸毒的潜在中介作用。这项研究还将评估父母监督是否提供了一种保护作用，防止邻里劣势对青少年药物使用的影响。利用国家青少年健康纵向研究(Add Health)的数据，这项研究将重点关注两种特别危险的性行为，即以性换取毒品或金钱以及拥有多个性伴侣。之前关于以性换取毒品或金钱以及拥有多个性伴侣的研究主要集中在考察个体层面的特征和行为，这些特征和行为可以预测这些性行为。这项研究的概念框架是基于这样的前提，即个人的行为受到环境的影响，考虑环境背景可以提高对个人层面行为与健康结果之间关系的理解。鉴于青年中艾滋病毒/性传播感染造成的巨大和不成比例的负担，了解导致这一人群危险性行为的个人和环境因素至关重要。调查邻里劣势将有助于了解青少年吸毒和危险性行为的背景，并可以制定更有效和更全面的预防战略。这项研究将考察邻里劣势对青少年危险性行为的影响，包括青少年吸毒的潜在中介作用。了解导致青少年吸毒和危险性行为的环境因素将有助于制定更有效和更全面的战略，以预防这些行为及其后果，包括艾滋病毒和其他性传播感染。

DESCRIPTION (provided by applicant): Neighborhood disadvantage, as indicated by low neighborhood socioeconomic status and poor social climate (e.g., low social cohesion), has been associated with a wide range of child and adolescent health and social problems. Evidence also indicates independent effects of neighborhood characteristics on drug use and sexual behavior. However, little research has examined the effect of neighborhood factors on the nexus between drug use and sexual behavior among adolescents. Informed by ecological theoretical frameworks, and using multivariate regression analyses, this cross-sectional study will examine the influence of neighborhood disadvantage (neighborhood poverty and low neighborhood social cohesion) on risky sexual behavior among a nationally representative sample of U.S. adolescents, including the potential mediating role of adolescent drug use. The study will also assess whether parental monitoring provides a protective effect against the influence of neighborhood disadvantage on adolescent drug use. Using data from the National Longitudinal Study of Adolescent Health (Add Health), the study will focus on two particularly risky sexual behaviors, exchanging sex for drugs or money and having multiple sexual partners. Previous research on exchanging sex for drugs or money and having multiple sexual partners has focused on examining individual-level characteristics and behaviors that predict these sexual behaviors. This study's conceptual framework is based on the premise that individuals' behaviors are influenced by their environment and that consideration of environmental context can improve understanding of associations between individual-level behaviors and health outcomes. Given the large and disproportionate burden of HIV/STIs among youth, understanding the individual and environmental factors that contribute to risky sexual behaviors in this population is critical. Examining neighborhood disadvantage will contribute to understanding the context that underlies adolescent drug use and risky sexual behavior and can inform more effective and comprehensive prevention strategies. This study will examine the influence of neighborhood disadvantage on risky sexual behavior among adolescents, including the potential mediating role of adolescent drug use. Understanding the environmental factors that contribute to adolescent drug use and risky sexual behaviors will inform more effective and comprehensive strategies to prevent these behaviors and their consequences, including HIV and other sexually transmitted infections.