Competing Priorities: Pregnancy and Disease Prevention among Young Adults

相互竞争的优先事项：年轻人的怀孕和疾病预防

• 批准号: 8588213
• 负责人: Sandy Marie Harvey
• 金额: $ 7.3万
• 依托单位: OREGON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8588213
• 关键词: AIDS prevention; Address; Adoption; Area; Behavior; Behavioral; Centers for Disease Control and Prevention (U.S.); Clinical; Contraceptive Agents; Contraceptive methods; Counseling; Data; Decision Making; Development; Disease; Frequencies; Goals; HIV; Heterosexuals; Hormonal; Individual; Interview; Knowledge; Light; Los Angeles; Male Condoms; Methods; Modeling; Motivation; Outcome; Participant; Pregnancy; Pregnancy Rate; Prevention; Prevention program; Prevention strategy; Recruitment Activity; Relative (related person); Reproductive Behavior; Reproductive Health; Request for Applications; Research; Risk; Role; Sampling; Self Efficacy; Sex Behavior; Sexual Health; Sexual Partners; Sexually Transmitted Diseases; Staging; Surveys; Teenagers; Text; Theoretical model; Time; Vulnerable Populations; Woman; age group; aged; condoms; consistent condom use; design; disease transmission; disorder prevention; experience; interest; men; new technology; pregnancy prevention; prevent; programs; protective behavior; public health relevance; response; sex; sexual relationship; statistics; transmission process; unintended pregnancy; young adult

DESCRIPTION (provided by applicant): Protection strategies for the prevention of both unintended pregnancy and sexually transmitted infections (STIs) have become a focus of research interest in light of recent statistics on disease transmission and unintended pregnancy rates among young adults. Although the same sexual behavior leads to both, the methods most effective in preventing pregnancy and those most protective against STIs, including HIV, are not the same. Moreover, despite the fact that young adulthood is characterized by multiple sequential and concurrent relationships and decisions related to condom use are likely made with regard to a specific sexual partner, little research has addressed if and how relationship and partner factors influence the decision to use a method for disease prevention, pregnancy prevention or both disease and pregnancy prevention. Previous research has focused mainly on individual-level explanatory factors, included only a limited number of factors related to partners and relationship dynamics, and has relied on data from cross-sectional or retrospective surveys. Further, most studies have been conducted with women only. We propose to analyze secondary data from a racially/ethnically diverse sample of women and men aged 18-30 included in the Project on Partner Dynamics (POPD). The main objective of this application is to further our understanding of HIV acquisition/transmission by increasing knowledge regarding the intersection between reproductive behavior and HIV prevention. More specifically, we will examine choice and use of methods for pregnancy and disease prevention within the con- text of heterosexual relationships among a sample of young adult women and men at increased risk for HIV acquisition/ transmission. The specific aims of the study are to 1) investigate which partner-specific individual factors (e.g., perceived vulnerability to pregnancy and HIV/STIs, condom use self-efficacy) and relationship factors (e.g., commitment, relationship type, perceived exclusivity, and decision-making related to preventing pregnancy and disease) are associated with prevention method choice and consistency of use, and examine what factors predict change in method use over time and within partnerships; and 2) determine which partner- specific individual factors and relationship factors predict motivation to use condoms for disease prevention, pregnancy prevention or dual protection, and examine what factors predict change in motivation for condom use over time and within relationships. The POPD study includes data from 537 young adults recruited from the Los Angeles area who were interviewed 4 times, at 4-month intervals, over a 1-year study period. At each interview, participants provided detailed information about all heterosexual partnerships since the previous interview. Multilevel multinomial modeling will be used to investigate the associations between individual and relationship factors and the type and consistency of methods used for disease and pregnancy prevention. Findings will inform the design of clinical counseling and other programs to increase dual protection and prevent the acquisition/transmission of HIV/STIs and unintended pregnancy in this vulnerable population.

描述（由申请人提供）：预防意外怀孕和性传播感染（ETI）的保护策略已成为研究疾病传播统计数据和年轻人中意外怀孕率的统计数据的重点。尽管相同的性行为都导致了两者，但最有效的方法可以预防怀孕和最有害的人（包括艾滋病毒在内的性传播感染）的方法并不相同。此外，尽管成年的年轻成年以多种顺序和并发关系以及与避孕套使用相关的决策的特征是在特定的性伴侣方面做出了很少的研究，但很少研究的关系和伴侣因素如何影响使用预防疾病，预防妊娠或疾病和疾病和预防疾病的决定的决定。先前的研究主要集中于个人级别的解释因素，仅包括与伴侣有关的有限因素 和关系动态，并依赖于横截面或回顾性调查的数据。此外，大多数研究仅与女性进行。我们建议分析来自合作伙伴动力学项目（POPD）中包括18-30岁男性和男性的种族/种族多样性样本的次要数据。该应用的主要目的是通过增加有关生殖行为与预防艾滋病毒之间的交集的知识来进一步了解艾滋病毒的获取/传播。更具体地说，我们将研究和使用预防妊娠和疾病方法的选择，在年轻男性和男性样本中，艾滋病毒收购/传播风险增加。该研究的具体目的是：1）研究哪些特定伴侣特定的个人因素（例如，对怀孕和艾滋病毒/性传播疾病的脆弱性，避孕套使用自我效能）和关系因素（例如，承诺，关系类型，所感知的排他性，排他性，决策，以及与预防和疾病的使用相关的方法和方法相关，并且在使用方面的使用和培训方面的使用量与其他因素的一致性相关，并且在方法中的使用和方法是相关的。 2）确定哪些合作伙伴 - 特定的个人因素和关系因素可以预测使用避孕套的动机 预防疾病，预防妊娠或双重保护，并检查哪些因素可以预测避孕套动机随着时间和关系内的动机的变化。 POPD的研究包括来自洛杉矶地区招募的537名年轻人的数据，他们在1年的研究期间以4个月的间隔接受了4次采访。在每次访谈中，参与者提供了自上次访谈以来所有异性恋伙伴关系的详细信息。多级多项式建模将用于研究个人与关系因素之间的关联以及用于疾病和预防妊娠的方法的类型和一致性。调查结果将为临床咨询和其他计划的设计提供信息，以增加双重保护，并防止在这一脆弱人群中获得艾滋病毒/性传播感染和意外怀孕的收购/传播。