Seth Puja, Jackson Jerrold M, DiClemente Ralph J, Fasula Amy M
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Vulnerable Child Youth Stud. 2017;12(4):353-359. doi: 10.1080/17450128.2017.1325547. Epub 2017 May 9.
Social determinants contribute to health disparities. Previous research has indicated that community trauma is associated with negative health outcomes. This study examined the impact of community trauma on sexual risk, marijuana use and mental health among African-American female adolescents in a juvenile detention center. One hundred and eighty-eight African-American female adolescents, aged 13-17 years, were recruited from a short-term detention facility and completed assessments on community trauma, sexual risk behavior, marijuana use, symptoms of posttraumatic stress disorder and psychosocial HIV/STD risk factors. Findings indicate that community trauma was associated with unprotected sex, having a sex partner with a correctional/juvenile justice history, sexual sensation seeking, marijuana use, affiliation with deviant peers and posttraumatic stress disorder symptoms at baseline and longitudinally. Findings reinforce the impact of community-level factors and co-occurring health issues, particularly in high-risk environments and among vulnerable populations. Structural and community-level interventions and policy-level changes may help improve access to resources and improve adolescents' overall health and standard of living in at-risk communities.
社会决定因素导致了健康差异。先前的研究表明,社区创伤与负面健康结果相关。本研究调查了社区创伤对青少年拘留中心非裔美国女性青少年的性风险、大麻使用和心理健康的影响。从一个短期拘留设施招募了188名年龄在13至17岁的非裔美国女性青少年,她们完成了关于社区创伤、性风险行为、大麻使用、创伤后应激障碍症状以及心理社会艾滋病毒/性传播感染风险因素的评估。研究结果表明,社区创伤在基线和纵向层面上都与无保护性行为、有惩教/青少年司法历史的性伴侣、性感觉寻求、大麻使用、与不良同伴交往以及创伤后应激障碍症状有关。研究结果强化了社区层面因素和并发健康问题的影响,特别是在高风险环境中和弱势群体中。结构性和社区层面的干预措施以及政策层面的变革可能有助于改善资源获取,并提高处于风险社区中的青少年的整体健康和生活水平。