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代表着主要的公共卫生问题，对年轻的非裔美国人(AA)女性产生了不成比例的影响。1-3本R01提案回应了青少年约会暴力项目公告(PA-09-169)，要求提供资金，以建立在NIH资助的对芝加哥低收入城市社区AA青少年女性的纵向研究基础上。与该计划的目标一致，拟议的病因学研究旨在通过使用纵向、多变量分析来检查从早期暴力暴露到约会暴力和青春期后期不安全的性行为的路径，以更好地了解青少年约会暴力的前兆和后果。18-22岁的女性是亲密伴侣暴力(IPV)1、4-6和性传播感染(STI)的高危人群。2、7约会暴力是一个健康问题，不仅因为直接的身体和情感风险，而且因为在暴力关系中不安全的性行为的风险增加。8、9本项目的具体目标是：(1)前瞻性地检查从接触到约会暴力和不安全的性行为的途径；(2)检查约会暴力、不安全的性行为和STI之间的关系；(3)考察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恋爱关系特征；(4)考察作为从暴力暴露到约会暴力和不安全性行为途径的中介的生理应激反应；以及(5)检验可能解释从暴力暴露到约会暴力和不安全性行为途径的心理机制。参与了一项专注于艾滋病毒危险行为的为期两年的纵向研究(R01 MH65155)和创伤和受害历史的后续评估(R03 MH086361)的青春期女孩将被重新联系，以参与新一轮关注青春期后期(18-22岁)浪漫关系的数据收集。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位年轻女性的浪漫伴侣，并观察两者之间的结构化互动。这项拟议的研究将在以前工作的基础上进行一些创新，包括：(1)将恋爱风险扩大到约会暴力；(2)评估浪漫伴侣；(3)测量生理压力反应和性传播感染的生物标记物。我们将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物)来考察早期暴力暴露、青少年约会暴力和不安全性行为之间的联系，并研究可能解释从早期暴力暴露到约会暴力和青春期晚期不安全性行为的机制。这些发现可用于开发针对文化量身定做的、对性别敏感的干预措施，以促进有暴力接触史的年轻非裔美国女性建立健康的浪漫和性关系。 公共卫生相关性：约会暴力和不安全的性行为是发生在浪漫关系中的主要公共卫生问题，对年轻的城市非裔美国人(AA)女性的影响不成比例。这项拟议的研究将在18-22岁的低收入城市AA女性样本中研究从早期暴力暴露到约会暴力和不安全性行为的途径。结果将产生可用于在城市AA女性青春期晚期培养健康约会关系的信息。

DESCRIPTION (provided by applicant): Dating violence and unsafe sexual behavior represent major public health concerns that disproportionately affect young African American (AA) women.1-3 This R01 proposal responds to the Research on Teen Dating Violence Program Announcement (PA-09-169) by requesting funds to build on an NIH-funded longitudinal study of 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) Examine relationships among dating violence, unsafe sexual behavior, and STIs; (3) Examine romantic relationship characteristics that may explain the pathway from violence exposure to dating violence and unsafe sexual behavior; (4) Examine physiological stress response as a mediator of the pathway from violence exposure to dating violence and unsafe sexual behavior; and (5) Examine psychological mechanisms that may explain the pathway from violence exposure to dating violence and unsafe sexual behavior. Adolescent girls who participated in a 2-year longitudinal study focused on HIV risk behavior (R01 MH65155) and a follow-up assessment of trauma and victimization history (R03 MH086361) will be re-contacted to participate in a new wave of data collection focused on 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. PUBLIC HEALTH RELEVANCE: Dating violence and unsafe sex represent major public health concerns that take place within romantic relationships and disproportionately affect young, urban African American (AA) women. The proposed study will examine pathways from early violence exposure to dating violence and unsafe sex in a sample of low- income, urban AA women at ages 18-22. Results will yield information that can be used to foster healthy dating relationships in late adolescent urban AA women.