The literature on HIV risk behavior has shown that women who are at risk for HIV sexual disease transmission tend also to be at risk for a host of other issues, including increased substance use and past and current experiences with interpersonal violence. From increasing evidence in the relatively separate literatures on sexual risk behavior, substance use, and interpersonal violence (IPV), there is a pressing need for research to evaluate the intersection, or syndemic (Singer, 1994), of these risk issues with women's HIV sexual risk, so that interventions can attend to needs in domains that are interrelated and can theoretically effect behavioral changes of greater magnitude and greater duration. Bioecological Systems Theory (BST;Bronfenbrenner, 1993) may provide a framework for a greater understanding of the context of multiple risk behaviors in women. This prospective study will examine factors corresponding to the four levels of the BST model as they relate to the interaction of sexual risk behavior, substance use, and violence in women of lower socioeconomic status. Further, we will also examine changes in their reports over a six-month interval.
The specific aims are: (1)To recruit 396 inner-city women living in urban housing developments between the ages of 18 and 45 in order to retain 375 participants;(2) To perform multiple assessments on factors pertaining to the levels of the BST model, as they relate to sexual risk, substance use, and trauma/victimization history;these levels and factors include but are not restricted to: a) Individual (""""""""Ontogenic"""""""") factors, b) Interpersonal (""""""""Microsystem"""""""") factors (the immediate context of the behavior and relationships with others);c) Community (""""""""Exosystem"""""""") factors (encompassing community structures, institutions, and the social networks surrounding the individual's life);and d) Socio-cultural (""""""""Macrosystem"""""""") factors (attitudes, practices, and convictions shared throughout society at large);(3) To perform similar follow-up assessments with these participants six-months and 12-months following the first set of assessments;and (4) To analyze the above variables in relation to occurrence of occurrence and severity of sexual risk behavior, substance use, and interpersonal violence (either perpetrated or as a victim of) using structural equation modeling to examine application of variables related to Bronfenbrenner's BST (1993) model. Findings from this research will provide important new information: (1) leading to greater insight of the dynamics and complexity of sexual risk behavior, substance use and trauma history in at-risk women;(2) needed to design interventions that attend to multiple risk issues in at-risk women;(3) needed to design effective strategies to prevent these issues from occurring;and (4) to evaluate the applicability and validity of BST to the context of women's sexual risk behaviors, substance use, and trauma history.
The primary goals of this project are to examine individual, interpersonal, community and sociocultural factors (Bioecological Systems Theory;Bronfenbrenner, 1995) as they relate to the interaction of sexual risk behavior, substance use, and trauma history/victimization in low income African American women living in urban housing developments in Milwaukee, as measured at three points over a 12-month interval. Findings from this research will provide important new information: (1) leading to greater insight of the dynamics and complexity of sexual risk behavior, substance use and trauma history in low income African American women;(2) needed to design interventions that attend to multiple risk issues in low income African American women;(3) needed to design effective strategies to prevent these issues from occurring;and (4) to evaluate the applicability and validity of Bioecological Systems Theory to the context of low income African American women's sexual risk behaviors, substance use, and trauma history.
