Partner Age Discordance and HIV Risk Behaviors in Adolescent Girls (Sexual RP)

描述（由申请人提供）：处于暴力或控制关系中的青春期女孩感染艾滋病毒和性传播感染的风险可能更高。当伴侣比他们大两岁或两岁以上时，他们发生关系暴力或权力失衡的风险可能会更大。本研究的目的是在一个高风险的青春期女孩样本中检验性关系权力与亲密伴侣暴力（IPV）和艾滋病风险相关的性行为之间的相关性模型。该模型源自Blanc的基于证据的框架，用于评估人口中性别权力关系与生殖健康之间的关系，作为权力失衡的风险。具体而言，本研究旨在探讨14-18岁少女性伴侣年龄不一致超过2年与性高危行为的关系，以及性关系权力和IPV在这种关系中的中介作用。一个横断面的，描述性的，调查设计将被用来评估在青春期女孩的性风险的建议预测因素的模型。数据将从一个低收入社区的城市学校卫生中心的150名性活跃少女中收集。数据收集将通过一项自我管理的计算机辅助调查“促进健康”来完成，该调查将分析答复并编制一份报告，其中包括健康信息、转诊和针对个别参与者的资源。将对数据进行分析，以确定人口变量的主要影响，包括少女的年龄、种族/民族和文化适应状况以及身体或性虐待的历史。如果确定了主效应，那么这些因素将在回归分析中得到控制。通过多元回归分析确定性关系权力和IPV在伴侣年龄不协调与高危性行为之间的中介作用。我们将进行子分析来进一步研究变量之间的相关性，例如性关系权力和IPV。拟议的研究问题对于解决少女早期干预预防艾滋病毒/性传播疾病的需要至关重要，因为少女患IPV的风险很高，是感染艾滋病毒和其他性传播疾病人数增长最快的群体之一。了解恋爱关系中权力不平衡的普遍性和影响，对于制定减少艾滋病毒、其他性传播感染和IPV的策略至关重要。如果年龄不一致、相对权力和暴力等关系因素增加了处于危险中的青春期女孩发生性危险行为的可能性，则可以利用这些知识来确定临床风险评估中提出的问题，并制定预防干预措施和公共卫生政策。

DESCRIPTION (provided by applicant): Adolescent girls in violent or controlling relationships are likely to be at higher risk for HIV and STIs. Their risk of relationship violence or power imbalances may be greater when the partner is two or more years older. The purpose of this study is to test a proposed model of the correlations between sexual relationship power and intimate partner violence (IPV) and HIV risk related sexual behaviors in a sample of at-risk adolescent girls. The model is derived from Blanc's evidence-based framework for assessing the relationship between gender power relations and reproductive health in populations as risk for power imbalances. Specifically, the study aims to investigate the relationship of sexual partners' age discordance of more than two years to high-risk sexual behavior, in adolescent girls ages 14-18, as well as the mediating role of sexual relationship power and IPV in that relationship. A cross-sectional, descriptive, survey design will be used to evaluate the model of Proposed Predictors of Sexual Risk in Adolescent Girls. Data will be collected from 150 sexually active adolescent girls at an urban school-based health center, in a low-income neighborhood. Data collection will be done via a self-administered, computer-assisted survey, Promote Health, which will analyze responses and format a report with health information, referrals, and resources specific to the individual participant. Data will be analyzed for main effects of demographic variables, including age of adolescent girl, race/ethnicity and acculturation status, and history of physical or sexual abuse. If main effects are determined, then these factors will be controlled for in regression analysis. The role of sexual relationship power and IPV as mediators of the relationship among partner age discordance and high risk sexual behaviors will be determined through multiple regression analysis. Sub-analyses will be conducted to further investigate the correlations among variables, for example sexual relationship power and IPV. The proposed research questions are critical in addressing the needs for early intervention in HIV/STD prevention for adolescent girls, who are at high risk for IPV and one of the fastest growing groups infected with HIV and other STIs. Understanding the prevalence and effects of power imbalances in romantic relationships is essential in developing strategies to reduce HIV, other STIs, and IPV. If relationship factors, such as age discordance, relative power, and violence increase the likelihood of sexual risk behaviors in at-risk adolescent girls, this knowledge can be used to shape questions asked in clinical risk assessment, and to develop prevention interventions and public health policy.