Exposure to violence and unsafe sex in late adolescent African American women

描述（由申请人提供）：约会暴力和不安全的性行为是主要的公共卫生问题，不成比例地影响着年轻的AA女性。1-3本R01提案是对青少年约会暴力研究项目的回应，要求在美国国立卫生研究院资助的芝加哥低收入城市社区的非裔美国人（AA）青少年女性纵向研究的基础上提供资金。与该项目的目标一致，提出的病因学研究旨在通过纵向、多变量分析来检查从早期暴力暴露到青春期后期约会暴力和不安全性行为的途径，从而更好地了解青少年约会暴力的前兆和后果。18-22岁的AA妇女是亲密伴侣暴力（IPV） 1,4 -6和性传播感染（STIs）风险最高的人口群体。2,7约会暴力是一个健康问题，不仅因为有直接的身体和情感风险，而且还因为暴力关系中不安全性行为的风险增加。8,9该项目的具体目的是：(1)前瞻性地研究从暴力暴露到约会暴力和不安全性行为的途径；(2)纵向考察约会暴力、不安全性行为和性传播感染之间的关系；(3)检查可能解释从暴力暴露到约会暴力和不安全性行为的途径的生理、心理和相关机制。参与了一项为期2年的艾滋病毒风险行为纵向研究（N=265； G. Donenberg， PI）的青春期女孩被要求在2009-2010年完成一项关于终身创伤和受害历史的综合评估（H. Wilson， PI），目的是研究童年暴力暴露与青春期危险性行为之间的关系。这项研究的目的是重新联系所有完成创伤评估的参与者，并邀请他们参与新一波的数据收集，以了解青春期晚期（18-22岁）的浪漫关系。为了捕捉在浪漫关系中导致暴力和不安全性行为的互动过程，我们还将尝试采访每个年轻女性的浪漫伴侣，并观察两者之间的结构化互动。拟议的研究将以一些创新的方式扩展以前的工作，包括：(1)扩大约会暴力的关系风险；(2)评估恋人；(3)生理应激反应和性传播感染的生物学标志物测定。使用多种测量和方法（自我报告、伴侣报告、观察、官方记录和生物标记），我们将研究早期暴力暴露、青少年约会暴力和不安全性行为之间的联系，我们将研究可能解释青少年关系晚期从早期暴力暴露到约会暴力和不安全性行为的途径的机制。这些发现可用于制定适合文化的、对性别敏感的干预措施，以促进有暴力史的年轻非裔美国妇女的健康浪漫关系和性关系。

DESCRIPTION (provided by applicant): Dating violence and unsafe sexual behavior represent major public health concerns that disproportionately affect young AA women.1-3 This R01 proposal responds to the Research on Teen Dating Violence program by requesting funds to build on an NIH-funded longitudinal study of African American (AA) adolescent women from low-income, urban neighborhoods in Chicago. Consistent with the goals of the program, the proposed etiological research is aimed at providing a better understanding of the precursors and consequences of teen dating violence through use of longitudinal, multivariate analyses to examine pathways from early violence exposure to dating violence and unsafe sexual behavior in late adolescence. AA women ages 18-22 represent the demographic group at highest risk for both intimate partner violence (IPV)1, 4-6 and sexually transmitted infections (STIs).2, 7 Dating violence is a health concern not only because of direct physical and emotional risks, but also due to increased risk of unsafe sexual behavior in violent relationships.8, 9 The specific aims of this project are to: (1) Prospectively examine the pathway from violence exposure to dating violence and unsafe sexual behavior; (2) Longitudinally examine relationships between dating violence, unsafe sexual behavior, and STIs; and (3) Examine physiological, psychological, and relational mechanisms that may explain the pathway from violence exposure to both dating violence and unsafe sexual behavior. Adolescent girls who participated in a 2-year longitudinal study focused on HIV risk behavior (N=265; G. Donenberg, PI) are being asked to complete a comprehensive assessment of lifetime trauma and victimization history in 2009-2010 (H. Wilson, PI), with the aim of examining relationships between childhood violence exposure and risky sexual behavior in adolescence. The goal of the proposed study is to re-contact all participants who completed the trauma assessment and invite them to participate in a new wave of data collection to understand romantic relationships in late adolescence (ages 18-22). To capture the interactive processes that contribute to violence and unsafe sex in romantic relationships, we will also attempt to interview a romantic partner of each young woman and observe a structured interaction between the two. The proposed study will expand upon previous work in a number of innovative ways that include: (1) broadening relationship risk to dating violence; (2) assessing romantic partners; and (3) measuring biological markers of physiological stress response and sexually transmitted infections. Using multiple measures and methods (self report, partner report, observation, official records, and biological markers), we will examine links among early violence exposure, teen dating violence, and unsafe sexual behavior, and we will examine mechanisms that may explain the pathway from early violence exposure to dating violence and unsafe sexual behavior in late adolescent relationships. These findings can be used to develop culturally tailored, gender sensitive interventions to foster healthy romantic and sexual relationships in young African American women with histories of violence exposure.