142nd APHA Annual Meeting and Exposition

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Multi-level risk and protective factors and the long-term mental health effects of risky sexual behaviors on young adult black females

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 9:10 AM - 9:30 AM

Jerrold M. Jackson, PhD , Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
Ralph J. DiClemente, PhD , Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory Univeristy, Atlanta, GA
Background: Seroprevalent environments can significantly increase the risk of poor mental health outcomes, particularly for young black females also impacted by neighborhood exposures (i.e. crime and violence). However, certain individual-, peer-, and family-level factors may serve as protective against inherent risks posed by the multiplicative effects of living in highly underserved communities. 

Methods: Analyses were performed on a sample (N=701, mean age: 18 years) of African American females involved in a HIV prevention trial. Mean differences were assessed in baseline depression and stress by level of neighborhood crime and violence exposure, and two multivariate GEE models were constructed to examine risk and protective factors of stress and depression over a 36-month follow-up period.

Results:Differences existed in baseline stress [t(699)=4.5,  p<.0001] and depression [t(699)=2.97,  p=0.003]  by level of neighborhood crime and violence exposure, with level of neighborhood exposures associated with levels of stress and depression. Additionally, the baseline prevalence of high neighborhood exposures and simultaneous biologically confirmed STI (chlamydia, gonorrhea, or trichomonas) was 24.9%. A multivariate GEE model associated risky partner involvement, peer norms, and neighborhood exposures as risk factors for depression over time; sex refusal self-efficacy and social support were protective. Comparably, sexual sensation seeking, peer norms, and neighborhood exposures were risk factors for stress over time, and social support as a protective factor.

Conclusion: Increased understanding of the association between multi-level, co-occurring mental health and sexual health risk factors can inform the development and implementation of complex, multi-modal prevention strategies tailored precisely for at-risk young black women.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify key sexual risk and protective factors associated with stress and depression in young adult African American females exposed to neighborhood crime and violence. Discuss the importance of developing multi-level, multi-modal prevention strategies to address the complex, co-occurring sexual and mental health risk factors experienced by African American young adult females.

Keyword(s): Risk Factors/Assesment, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently a NIH-funded postdoctoral fellow at the Rollins School of Public Health, Department of Behavioral Sciences and Health Education at Emory University, as well as a member of the Emory Center for AIDS Research. As a NIH-funded predoctoral fellow I completed a PhD in Clinical Research from Mount Sinai School of Medicine. Prior to doctoral work I worked as a licensed clinical social worker to deliver evidence-based HIV and mental health prevention interventions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.