The specific aims of this project are to 1) establish the nature of the relationship over time between STD acquisition and changes in three indices of maturation (cognitive, biological, and psychosexual maturation); 2) examine the relationships between the development of knowledge and perceptions about symptoms and consequences of STD and STD acquisition; 3) assess the relationships between the evolution of sociocultural context and the acquisition of STD; 4) determine the relationships over time between the level of management skills and the acquisition of STD; and 5) describe the interrelationships among important developmental characteristics and assess the implications of the relative timing of their attainment on STD acquisition. The original sample consisted of 174 girls born between 1979 and 1983 recruited randomly from within each age group. At enrollment , the adolescents had a mean age of 14.5 years (range 12 to 16 years) ; 76% were African-American, 24% were Caucasian. By visit 6, a total of 120 girls reported having become sexually active, although because of missing data, only 117 girls were included in the analysis. As a result of attrition and inconsistent study attendance, the number of subjects assessed at each visit varied. The longitudinal relationship between the predictors (race, years of sexual activity, K-BIT composite IQ score, How is Your Logic? score, risk due to age of sexual initiation, risk due to number of lifetime partners, frequency of condom use, views of prevalence of STDs among female friends, and direct and indirect parental monitoring) and the likelihood of developing an STD was tested by the generalized estimating equations (GEE) technique. In addition, interactions of age with all risk parameters were tested in the initial GEE model. A backward elimination strategy of insignificant age interactions and main effects was followed until only statistically significant predictors of STD occurrence remained in the model. The findings that lifetime partners, age of sexual initiation, and age were related to risk for STD support the notion of the importance of exposure opportunities. Race may also be a factor of exposure opportunity and may reflect differences in prevalence of infection among different partner pools. It is unclear whether the negative relationship of IQ to STD acquisition reflects better ability to protect oneself from infection (i.e., use barrier methods of contraception) or a greater investment in their future, leading to decreased risk-taking during early adolescence. Finally, the role of indirect monitoring supports the importance of parental involvement in their children's lives. Examination of the 29 adolescent girls who acquired their first STD after the first study visit suggests that perceptions of prevalence increase immediately after STD acquisition. Consistent with previous studies, adolescent girls who had a history of a STD at enrollment were not at decreased risk of acquiring a future STD. Our next plan is to evaluate changes in risk status and STD acquisition over time. We are going to collect an eighth wave of data collection and resubmit the competing continuation grant.
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