Callahan1

RosemaryCallahan
ResearchSeminarProposal

SexualTransmittedDiseaseRiskinAdolescentWomeninUptown

I. THEPROBLEMANDITSSETTING
A. StatementoftheTopictobeExplored
ThethemeofthisresearchproposalisKnowingNeighborhoods.ThecitythatIwill
exploreisChicago;itisregardedashighlydiverseandsegregated.Chicagocontains77distinct
communitiesorneighborhoods(CityofChicagoCommunityAreas).AccordingtoWalter
NugentfortheEncyclopediaofChicago,Chicagohaslongbeenknownasanethniccity.
Startingin1910manyAfricanAmericansmigratedfromthesouthtoChicago.Theywere
followedbyimmigrantsfrommanydifferentcountriesincludingpeoplefromPoland,Ireland,
Germany,Britain,Scandinavia,Czechoslovakia,Lithuania,Serbia,Croatia,Greece,andChina
(Nugent).Recently,Mexicans,Caribbeans,andabroadsourcedarrayofCentralAmericans
andAsians,alongwithanew(andsmaller)waveofEasternEuropeanshaveestablishedtheir
homesinChicago(Nugent).
AccordingtotheUnitedStatesCensusBureau,Chicagoisroughly228squaremilesand
in2010therewereabout2,700,000peopleresidinginChicago.About23percentofthe
populationwasundertheageof18and51.5percentwerefemale(U.S.CensusBureau).
Recently,MayorEmanuelhaslaidoutplansforaprogramcalledHealthyChicago,which
addressesthehealthdisparitiesamongChicagosneighborhoods.Theareasthattheplan
addressesare:tobaccouse,obesityprevention,HIVprevention,adolescenthealth,cancer

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disparities,heartdiseaseandstroke,accesstocare,healthymothersandbabies,
communicablediseasecontrolandprevention,healthyhomes,violenceprevention,andpublic
healthinfrastructure(PublicHealth).AccordingtotheHealthyChicagoFebruary2012
Updatethecityhasmadepositivestridestowardstheirgoalsintheareasofadolescenthealth,
cancerdisparities,communicablediseasecontrolandprevention,healthymothersandbabies,
publichealthinfrastructure,andobesityprevention(HealthyChicago).
TheChicagoneighborhoodIwillbeexploringisUptown.Uptownisraciallyand
ethnicallydiverse.ItisaboutsixmilesnorthoftheLoopandcontainsmanyentertainment
venuesandsocialserviceorganizations(Seligman).AccordingtotheEncyclopediaofChicago,in
2000therewere63,551residents(Seligman).TheCityofChicagosDepartmentofPublicHealth
reportedintheir2011SpecialSurveillanceReport:STI/HIVSurveillanceReportthatratesof
HIVandsyphilisdiagnosesinUptownwereamongthehighestinChicago(8;19).
B. StatementoftheProblemandSubproblemwithintheTopictobeExplored
AdolescenthealthistheproblemwithinthethemethatIamexploring.Adolescenceisa
timeofrisk.Manyyoungpeoplearestartingtoidentifywhotheyareorwhattheywantto
becomeandthisstageofdevelopmentrequiresexperimentation.Withexperimentationcomes
risk.Oneoftherisksthatadolescentsmayencounteraspartofgrowingolderisdrivingacar
forthefirsttime,whileotherrisksdontnecessarilyhavetotakeplace,suchassexualrisk
behaviorsordruguse.

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Therearemanysubproblemswithintheproblemofadolescenthealth.Someofthese
subproblemsare:sexuallytransmitteddiseaseriskbehavior,teenpregnancy,alcoholandother
druguse,abuse,anddependence,violence,andmentalillness.
ThesubproblemIwillbeexploringinthisresearchproposalisfemaleadolescents
sexuallytransmitteddiseaserisk.Femalesareunique,inthesensethattheyaredifferentthan
maleswhenitcomestosexuallytransmitteddiseases,becausetheyarepronetosexually
transmitteddiseasesthatwillcontinuetoplaguethemthroughouttheirlives.Accordingtothe
UnitedStatesDepartmentofHealthandHumanServices2009YouthRiskBehaviorSurvey,
althoughsexualactivityamongadolescentshasdecreasedsince1991,46percentofteenagers
werehavingsex.Oftheteenagersthatwerehavingsex,62.8percentofthemusedcondoms
(JohnsonandMalowIroff54).Theseareencouragingstatistics;however,ofthe46percentof
teenagersthatwerehavingsex,35percenthaveusedcontraceptivesinconsistently(Scottetal.
114).AlthoughnodatawasfoundonyouthinUptownspecifically,inChicagos2007Youth
RiskBehaviorSurvey,53percentoffemaleadolescentsinChicagohadhadsexualintercourse
andeightpointsevenpercentoffemaleadolescentshadusedalcoholorotherdrugsthelast
timetheyhadhadsex(ChildrensMemorialResearchCenter53;57).Additionally,63.5percent
offemaleadolescentsinChicagohadusedacondomduringtherelastsexualencounter(58).
Somewomenrelyoncondomstoprotectthemselvesfromsexuallytransmitted
infections.AccordingtotheGuttmacherInstitute,6,200,000peoplerelyoncondomstoprotect
themselves.Also,23percentofteenagewomenrelyoncondomsastheirprimarymethodof
birthcontrolandcondomuseishighinwomenages2024andteenagers(GuttmacherInstitute
2).

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Withthelownumberofwomenrelyingoncondomsastheirprimarymethodof
protection,thereseemstobeacorrelationbetweenthisandthefactthattheCityofChicagos
DepartmentofPublicHealthsSTI/HIVSurveillanceReportfoundthatin2009oneoutof
everyfourpersonsdiagnosedwithAIDSwasundertheageof20.Additionally,theyfoundthat
diagnosesforpeopleages1318wentup50percentbetween2003and2009withadolescents
andyoungadultsrepresenting39percentofthediagnosesinChicagoin2009(Special
SurveillanceReport:STI/HIVSurveillanceReport).
AlongwithAIDSandHIV,thelackofcondomusecanbeattributedtootherdiseases
suchaschlamydia,syphilis,andgonorrhea.AccordingtoMcCreeandPampalo,untreated
gonococcalandchlamydialinfectionscanproducesignificantanddisproportionate
reproductivesystemmorbidityinwomen,includingpelvicinflammatorydisease,infertility,
ectopicpregnancy,andchronicpelvicpain(310).In2007,womenaccountedforthreetimes
therateofchlamydiaovermenwith70percentofthecasesoccurringinpeopleundertheage
of25(GuttmacherInstitute;SpecialSurveillanceReport:STI/HIVSurveillanceReport).Thirty
fivepercentofchlamydiacasesand27percentofgonorrheacaseswerereportedinadolescent
ages1519(EitherandOrr279).Womenages1524werethehardesthitbychlamydia
(GuttmacherInstitute).AccordingtotheCityofChicagosDepartmentofPublicHealths
STI/HIVSurveillanceReportthreequartersofthechlamydiathatisreportedisamong
females.Between2009and2012,therateofsyphilisamongwomeninChicagogrewby171
percent;mostcaseswerediagnosedinpeopleages2029(SpecialSurveillanceReport:STI/HIV
SurveillanceReport).
C. StatementoftheQuestionabouttheProblemthatResearchwillAddress

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ThequestionIwillbeaddressinginthisresearchproposalis:Whatcausessexually
transmitteddiseaseriskinadolescentfemalesintheChicagoneighborhoodofUptown?

D. StatementoftheHypothesisthattheResearchWillTest
ThehypothesisthatIwilltestinmyproposedresearchis:Substanceusecauses
sexuallytransmitteddiseaseriskinadolescentfemalesintheChicagoneighborhoodof
Uptown.
E. Delimitations

ThestudywillnotincludefemaleadolescentsoutsidetheChicagoneighborhoodof
Uptown.

Thestudywillnotincludemaleadolescents.

Thestudywillnotincludefemalesundertheageof13andovertheageof18.

F. DefinitionofTerms
Forthepurposeofthisresearchproject,termsaredefinedasfollows:
Adolescent:
AccordingtoMedlinePlusMerriamWebsteronlinedictionary,adolescenceisdefined
as,theperiodoflifefrompubertytomaturityterminatinglegallyattheageof
majority.Toclarifyfurtherandforthepurposesofthisstudyadolescenceisdefinedas
femalesages1318.Thefemaleadolescentsinthisstudywillbeincludedregardlessof
race,sexualorientation,ethnicity,andincomebackground.

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SubstanceUse:
Substanceusewillbedefinedasusingalcoholorotherdrugs,legalorillegal,toalter
mood.Becausepeoplecanfeeltheeffectsofalcoholbeforebeinglegallydrunk,forthis
study,theamountofalcoholthatwillconstitutedsubstanceuseisoneormoredrinks.
Anyamountofdrugs(besidesalcohol)takenwillbeconsideredsubstanceuseforthis
study.
SexuallyTransmittedDisease:
AccordingtoMedNet.comasexuallytransmitteddiseaseisanydiseasetransmittedby
sexualcontact;causedbymicroorganismsthatsurviveontheskinormucusmembranes
ofthegenitalarea;ortransmittedviasemen,vaginalsecretions,orbloodduring
intercourse.TheyincludeAIDS,chlamydia,genitalherpes,genitalwarts,gonorrhea,
syphilis,yeastinfections,andsomeformsofhepatitis.Anothersexuallytransmitted
diseasethatwillbeincludedinthisstudyisHumanPapillomaVirus(HPV).
SexuallyTransmittedDiseaseRisk:
Engaginginsexualactivitywithoutabarriermethodofbirthcontrol(i.e.maleorfemale
condoms)orengaginginsexualactivitywithoutknowingtheirpartnerssexually
transmitteddiseasestatus.
ChicagoNeighborhoodofUptown:

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TheneighborhoodofUptownincludestheareasbetweenFosterAvenueinthenorth
andRavenswoodAvenuetothewesttoMontroseAvenue.FromMontroseAvenuethe
bordercontinuesfromClarkStreetsouthtoIrvingParkRoadwhichmakesupthesouth
border.LakeMichiganmakesuptheeasternborder(CityofChicagoCommunity
Areas).
G. Assumptions
Forthepurposeofthisresearch:
Iassumethatfemaleadolescentstakesexualrisksandwillcontinuetodoso.
Iassumethatsexuallytransmitteddiseaseswillcontinuetobeamedical
problem.
IassumethattheboundariesoftheneighborhoodofUptownwillnotchange.

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II.REVIEWOFRELATEDLITERATURE
A. MajorIssuesExploredbyScholarswhohaveResearchedthisTopicandSubproblem
Somehypothesesaboutwhyadolescentstakeriskregardingtheirsexualhealthhave
beenidentifiedthroughresearch.Inthisliteraturereviewsomeofthemainriskfactorsfor
adolescentsexualriskbehaviorareexploredwithanemphasisonfemaleadolescentsinthe
Chicagoarea.IchosetoproposethisresearchbecauseIdidnotfindanyresearchthat
specificallytargetedadolescentfemalesintheChicagoareawhowerenotdetainedina
juveniledetentioncenter.Additionally,Ididnotfindanyresearchthatspecificallytargetedthe
Uptownarea.Ithinkthatmyproposedresearchwillhelptofillingapsregardingthesexual
healthoffemaleadolescentsinChicago.Themostresearchedriskfactorsare:alcoholand
substanceuse,juveniledelinquencyandmentalhealth.Otherfactorsthathavebeenexplored
butarelessprominentare:parentalinvolvement,friendsinfluence,multiplepartners,poverty,
genderroles,andchildhoodsexualabuse.

Oneofthemostprevalenthypothesesregardingadolescentsexualriskbehavioris

substanceuse.AccordingtoTheHenryJ.KaiserFamilyFoundation,Substanceuseincreases
theprobabilitythatanadolescentwillinitiatesexualactivity,andrelatedly,sexually
experiencedadolescentsaremorelikelytoinitiatesubstanceuse.Thissuggestsaverystrong
relationshipbetweensexualbehaviorandsubstanceuse.Additionally,TheKaiserFamily

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Foundationreportedthatapproximately23percentofadolescents,ages1524,donotuse
protectionwhentheyareusingsubstances.Onestudyfollowed9,519adolescentsinsubstance
abusetreatmentbetween2002and2006.Theresearchersofthestudy,Chanandcolleagues,
foundthatfemalesweremorelikelythanmalestohavehadsexwhiledrunkorhighandwere
morelikelytohavehadunprotectedsex(117).Anotherstudyfoundthattheamountofalcohol
consumedwasdirectlyrelatedtoadecreaseincondomuse.Thestudy,conductedoncollege
agedmen,foundthatalcoholuseincreasedwhentheparticipantsinthestudyknewlessabout
thepersontheywerehavingsexwith;however,theyweremorelikelytousecondomswitha
newpartner(LaBrieetal.264).Furthermore,about90%ofadolescentssaythattheirfriends
andpeopleintheirpeergroupusedrugsoralcoholduringsexatleastsomeofthetimeand
condomsarenotusedasoftenwhendrinkingorusingdrugs(TheHenryJ.KaiserFamily
Foundation).

Themajorityofstudiesreportedonalcoholuseamongadolescents.Hendershotand

colleagueswantedtostudytherelationshipbetweenmarijuanauseandriskysexualbehavior.
Theirlongitudinalstudy,whichinterviewedparticipantsatsixmonthintervalsfortwoyears,
wasconductedwithadolescentswhohadbeenenlistedfromjuvenileprobationoffices.They
foundthat49.4percentoftheparticipantshadusedmarijuanabeforesexduringthesixmonth
to12monthperiodandonly34.3percenthadalwaysusedcondoms(407).Subsequently,four
pointninepercentoftheparticipantshadbeendiagnosedwithanSTDatthe12month
assessment(407).
Juveniledelinquencyhasbeenidentifiedasafactorforsexualriskandtherehavebeen
severalstudiesthathavetakenplaceinjuveniledetentioncenters.Onestudy,conductedby

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Romeroandassociates,hypothesizedthatgender,race,ethnicity,andagewereafactorwhen
determiningsexriskwithincarceratedyouth.Theirlongitudinalstudyassessed800juvenile
delinquentsoverathreeyearperiod.Itconcludedthattherewerefewdifferencesintheracial
andethniccategory;however,anotherstudyconductedonjuveniledelinquentsbyMasonand
colleaguesdiscoveredthatyouthfromlowincomefamilieshadanearlieronsetofsexualrisk
behaviors(Romeroetal.1136;Masonetal.1379).Theirlongitudinalstudyfoundacorrelation
betweenalcoholuseinadolescentsandthelikelihoodofriskysexualbehaviorandalcoholism
inyoungadulthood(Masonetal.1381).
Thereweresomedisparitiesamongwhichgenderwasengaginginriskybehavior.A
studythatfolloweddelinquentyouthforthreeyearsfoundthatmalesaremorelikelyto
engageinmorehighriskbehaviorsbut,thebehaviorsthatweremostlikelytoincreasein
femalesastheygrewolderwere:vaginalsex,unprotectedvaginalsex,oralsex,recent
unprotectedoralsex,unprotectedsexwhiledrunkorhigh,andtradingsexanddrugs(Romero
etal.1129).

Accordingtoonestudy,inwhichresearchersinterviewed280sexuallyactivefemale

youthwhowerebeingdetainedinajuveniledetentioncenter,sevenfactorsthathaveaneffect
onhigherlevelsofSTIsinclude:risktakingattitude,substanceuse,perceivedriskypeernorms,
gendernormsfavoringmaledominance,parentalmonitoring,familialsupport,andstudent
teacherconnectedness(Voisinet.al76).Eightyninepercentoftheparticipantsinthestudy
hadusedmorethanonemoodalteringchemicalinthepastyear,while37percenthadused
fourormoredrugsduringthesametimespan(75).AccordingtoanotherstudybyElkingtonet
al.,inwhichjuveniledetaineesages1018hadbeeninterviewed,98.3percentwhohad

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substanceusedisordersweresexuallyactiveand82.5%hadengagedinunprotectedsexwhile
theywerehighordrunk(HIV/SexuallyTransmittedInfection907).Thesamestudyconcluded
thatthebehaviorsmostlikelytoincreaseHIV/STIriskwerehavingvaginalsex,engaginginsex
whilehighordrunk,andhavingunprotectedsexwhilehighordrunk(908).Whilethese
studieswereconductedonadolescentswhowerebeingdetaineditcanbeassumedthatthese
riskbehaviorswillaffectmostadolescentswhoengageinsexualactivitywhileusingsubstances.

Elkington,Bauermiester,andZimmermanlookedatasampleoveraneightyeartime

periodthatstudiedyouthfrommidadolescencetoyoungadulthood.Theyfoundthatinearly
adolescence,femaleshavefewerpartnersthanmaleswhilemaleshavefewerpartnersoverthe
periodofadolescence.Similarly,AfricanAmericansreportedmorepartnersthanCaucasian
youthduringearlyadolescence,whileCaucasianyouthhavemorepartnersacrossadolescence
(521).Thesesameyouthreportedmorepartnerswhentheirlevelofpsychologicaldistress
increased(521).Thestudyalsofoundthatsubstanceusepartiallymediatedtherelationship
betweenpsychologicaldistressandsexualintercoursefrequency(522).Inotherwords,sexual
frequencywaspartiallydependentonsubstanceuseinadolescentswhohadsufferedfrom
psychologicaldistress.

Anotherareathathasbeenstudiedregardingsexualriskismentalhealth.Several

studieshavebeenconductedinsubstanceabuseandmentalhealthtreatmentfacilities.One
study,conductedbyChanandcolleagues,with9,519adolescentsinsubstanceabusefacilities
between2002and2006foundthatadolescentswithanxietydisordersendorsedthehighest
riskofhavingsexwhiledrunkorhigh(121).Thisstudyfoundthatadolescentswhohad
historiesoftraumaweremorelikelytohaveriskierattitudesandbehaviorsingeneral.They

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alsofoundthat39percentofthepatientshadintentionallycutthemselvesandthiswasahigh
predictorofsexualriskalongwithotherselfharmbehaviors(Chanetal.333).Inthesame
studytheyfoundthatfemalesweremorelikelytobesexuallyactive,haveabuseorselfharm
behaviors,andactingoutbehaviors(331).
Elkington,Bauermeister,andZimmermanalsofoundthatmentalhealthwasassociated
withanincreaseinsubstanceuse,increaseinnumberofsexualpartners,andadecreasein
condomuseduringadolescence(519;521).Theyfoundthat,psychologicaldistressis
associatedwithsexualriskbecauseyouthwithgreaterpsychologicaldistressaremorelikelyto
usesubstances(514).Psychiatricdisordersthatwerestudiedwerefourmutuallyexclusive
diagnosticgroupsthatincludedmajormentaldisorder,substanceusedisorder,comorbid
majormentaldisorderandsubstanceusedisorder,andneitherdisorder(901).
Daneen,Henry,andSchoenyfoundacorrelationbetweenparentchildrelationshipsand
riskysexualbehavior.Thefactorstheystudiedwereparentadolescentrelationship,parental
involvement,educationalaspirations,allowedindependence,sexualcommunication
attitudes,discussionsofsexualcost,andparentaldisapproval(734).Theresearchers
foundthatthebettertherelationshiptheparentshadwiththeiradolescentsthemorelikely
theadolescentswillusecondomsandhavesexlaterinlife(736).Theyalsofoundthatthe
adolescentswhohadbetterrelationshipswiththeirparentshadalowerrateofSTDs(736).
Similarly,Voisonetal.foundthatadecreaseofparentandfamilysupportyieldedahigherSTD
ratefordetainedfemaleadolescents(74).InthebookBehavioralInterventionsforPrevention
andControlofSexuallyTransmittedDiseases,authorsKatherineEitherandDonaldOrrmention
intheirsectionentitledBehavioralInterventionsforPreventionandControlofSTDsAmong

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Adolescentsfoundthatbetterfamilyrelationshipsareassociatedwithdelayedcoitaldebut
andgreatercontraceptiveuseamongadolescents(290).
InthebooksIreviewedanumberofinfluencesweregivenforriskyadolescentsexual
behaviors,howeveroriginalresearchwasnotconductedbytheseauthors.Inthebook
BehavioralInterventionsforPreventionandControlofSexuallyTransmittedDiseasestwo
sectionswereofparticularinteresttomysubjectarea,BehavioralInterventionsforPrevention
andControlofSTDsAmongAdolescentsandBiologicalandBehavioralRiskFactorsAssociated
withSTDs/HIVinWomen:ImplicationsforBehavioralIntervention.EitherandOrr,authorsof
thesectionentitled,BehavioralInterventionsforPreventionandControlofSTDsAmong
Adolescents,identifiedthefollowingfactorsassociatedwithadolescentsexuallytransmitted
diseaserisk:earlyinitiationofsex,multiplepartners,unprotectedsex,andinfluenceofpartner
andmedia.McCreeandRompalo,authorsofthesectionentitledBiologicalandBehavioral
RiskFactorsAssociatedwithSTDs/HIVinWomen:ImplicationsforBehavioralIntervention,
discussedfactorsthatinfluenceriskysexualbehaviorinwomenwhichincludealcoholanddrug
use,poverty,genderrolesfavoringmaledominance,andahistoryofsexualabuse.Additionally,
inthebookAdolescentsandRisk,JohnsonandMalowIroffemphasizedtherolesthatmedia,
friendsandalcoholandotherdruguseplayinriskyadolescentbehaviors.
Valuableresearchhasbeenconductedregardingthesexualhealthofadolescents;
however,noneoftheresearchhasfocusedonfemaleadolescentsintheUptownneighborhood
ofChicago.Myproposedresearchwillfillinthegapsfrompriorresearch.
B. MethodologiesUtilizedbyScholarstoResearchtheTopicandProblem

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TherewereseveralmethodologiesusedbytheauthorswhoseworkIreviewedtoreport
onadolescentsexualriskbehavior.Themostpopularmethodforresearchwasfacetoface
structuredinterviews,followedbyaudiocomputerassistedselfinterviewing,andpaperand
pencilquestionnaires.Othermethodsthatwereusedwereselfadministeredquestionnaires,
motivationalinterviewing,selfreporting,andselfreportusingtheGlobalAppraisalof
IndividualNeeds(GAIN)assessment.GAINisastandardizedbiopsychosocialassessment
developedforuseinclinicalandresearchsettingswithyouthandadultspresentingto
substanceabuseandotherbehavioralhealthtreatmentandassesseseightareas:
background,substanceuse,physicalhealth,riskbehaviors,mentalhealth,environment,legal,
andvocational(Chanetal.115).

ThemajorityoftheresearchIlookedatcontainedquantitativeresearch;however,two

studiescontainedqualitativeresearch.Oneofthestudiesthatusedqualitativeresearchwas
conductedwith280sexuallyactiveyouthinthejuvenilejusticesystemusingacrosssectional
approach.TheywereassessedforSTDriskbehaviorusingcomputerassistedselfinterviewing
procedure(Voisonetal.71).Theresearcherhypothesizedthat10factorswouldindicate
higherSTDrisk;however,onlysevenofthe10factorsprovedtobeindicators.Becausethe
researchersofthisstudyknewwhatvariableswouldberelevant,thisresearchstudycanbe
designatedasdescriptiveresearch.Thisstudycontainedcrosssectionalanalysiswhichwillbe
importantformystudy;however,itusedaqualitativeapproach.Iwillnotbereplicatingthis
studybecauseIwanttoknowtheamountofwomenwhousesubstancespriortoengagingin
sexualactivity.

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Theotherstudythatcontainedqualitativeresearch,conductedbyElkington,

Bauermiester,andZimmerman,wasastudythatlookedatadolescentsduringaneightyear
longitudinalstudy.Theyusedtwomethodsforcollectingdata:structured,closeendedfaceto
faceinterviewsandselfadministeredquestionnaires(517).Thisresearchfollowedyouthfrom
midadolescencetoyoungadulthood(516).Thisstudycanbedescribedasexplanatory
researchbecausetheyhadtwohypothesesandtheyweretryingtounderstandthereason
substanceuseoccurredwithadolescentswhohadpsychologicaldistressandHIV/STDsexual
riskbehavior(515).ThemethodofusingquestionnaireswiththisstudyisimportantandIwill
bereplicatingitinmystudy,butIwillnotbeusingfacetofaceinterviews.Facetoface
interviewingcanbeintrusiveanditwillnotyieldhonestanswersfromtheyoungwomen.I
thinkusingquestionnaireswillincreasethereliabilityofthefemalesanswers,soIintendtouse
thismethod.

TwostudiesthatweresimilarinvolvedadolescentsattheCookCountyJuvenile

TemporaryDetentionCenter.Bothofthestudiesusedfacetofacestructuredinterviewsin
theirlongitudinalstudy.Eachstudyincluded800participants;however,onestudywantedto
seeifgender,race/ethnicity,andagewereafactorwhendeterminingsexualrisk(Romero
1127).Theotherwantedtodetermineifyouthwithpsychiatricdisordershadahigherlevelof
sexualrisk(HIV/SexuallyTransmittedInfection901).Thedataandvariablesthatwere
prevalentinbothstudiesweregender,race/ethnicity,andage,alongwithincarcerationstatus.
Again,IdontthinkthatinterviewingyoungadultscanyieldtruthfuldatasoIwillnotbe
interviewingtheyoungwomeninmyproposedstudy.Also,alongitudinalstudywouldnotbe
appropriateformystudybecauseIonlywantasnapshotofwhatishappeninginUptown.

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ThemajorityofscholarlyarticlesIreviewedcontainedlongitudinalstudieswhichcanbe

usefultodetermineandpredictsexualriskbehavior.Thelongitudinalstudieshadinitialcontact
withtheparticipantsandthendifferenttimeperiodswhentheycontactedthemagain.Astudy
conductedbyHendershotandassociatesinterviewedparticipantsatsix,twelve,eighteen,and
twentyfourmonthsaftertheinitialinterview(406).Atthe12monthpointtheydidacross
sectionalanalysisonsomeofthebehaviorsthatwerereported(408).Thedatatheycollected
wasonsexrelatedmarijuanaexpectancies,marijuanarelatedproblems,marijuana
dependence,andbehavioralintentions(406407).Thiscanbetermedasdescriptiveresearch
becausetheresearchersknewthevariablesbeforetheybegantheresearch.Descriptive
researchisthemethodthatIwillbereplicatingbecauseIwanttoaccuratelydescribewhatis
happeninginUptown.However,IwillnotbeusingalongitudinalapproachbecauseIamnot
lookingforthattypeofdata.
Hendershotandcolleaguesconductedalongitudinalstudywhichusedaudiocomputer
assistedselfinterviewsforthatstudy.Thismaybeanexcellentwayofcollectingdataon
adolescentsbecauseadolescentschangequicklyandinterviewingthematsixmonthintervals
wouldprovideimportantdata.But,reportsamongadolescentsmaynotbeasaccuratewhen
reportingsexualandsubstanceusebehaviorbecausetheymaynotfeelthattheywillretain
theiranonymity(JohnsonandMaslowIroff48).However,accordingtoTourangeauandSmith,
whentalkingaboutreportedgenderdiscrepanciesamonggirlsandboys,whensexual
behaviors,suchasthoserelatedtonumberofsexualpartners,wereassessedusinganaudio
computerassistedselfreport,amoreanonymousmethodofobtainingselfreportsthanpaper

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andpencilselfinterviewsorfacetofaceinterviews,genderdiscrepancywassharplyreduced
(qtd.inJohnsonandMalowIroff49).
Crosssectionalanalysiswillbeimportantformystudybecause,forthisproject,Ionly
wantasnapshotofwhattheproblemissothatsubsequentstudiescanbuilduponit.One
articlethatcontainedcrosssectionaldatacollectionusedaudiocomputerassistedself
interviewingandanotherusedapaperandpencilquestionnaire.Lescanoandcolleagues
conductedthestudythatusedpaperandpencilquestionnaires(325).Theywereactuallytrying
totesttheefficiencyofashorteradolescentriskinventorythanhadbeenpreviouslyused
(325).AnAdolescentRiskInventoryisatestthatisdesignedtoassessadolescentrisk
behaviorsandattitudesinapsychiatricsetting(325).AlthoughtheshorterAdolescentRisk
Inventorywasbeingtestedagainstlongerformsofthetest,itmaybeusefulifitwere
transferredtoacomputerprogramtoallowcomputerassistedselfinterviewingbecauseitwill
providemoreprivacyforadolescents.Itmaybemoreaccuratealso.Althoughtheseresearchers
weretestingtheefficiencyofashorterformofatest,itprovidedmanyvaluablevariablesand
dataaboutsexuallytransmitteddiseaserisk.
NodatahasbeencollectedonUptownregardingfemaleadolescentsexuallyhealth
usingthemethodologyIpropose.Therefore,Ithinkthatmystudywillhelptofillinthegaps
thataremissingfromthistypeofresearch.

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III.PROPOSEDRESEARCHMETHODOLOGY
A. DataorEvidencetobeCollected
ThedataIwillbecollectingwillbefromadolescentfemalesintheChicagoneighborhoodof
Uptown.Theresearchprojectwillbefromapositivistapproach.Iwillbeconducting
descriptiveresearchtodiscoverthewhoandhowofsexuallytransmitteddiseaseriskin
femaleadolescents.Inotherwords,Iwillberesearchingwhoisgettingsexuallytransmitted
diseasesandhowtheyaregettingit;thedatawilldescribethecharacteristicsofthefemale
adolescentpopulationinUptownregardingsexualrisk.ThedataIcollectfromadolescent
femalesinUptownwillhelpmedetermineifsubstanceusewasaprecursortosexthatcould
causesexuallytransmitteddiseases.
1. DescriptionoftheData
TherearetwoplacesfromwhichIwillcollectdata.First,Iwillcollectinformationabout
schoolsintheUptownneighborhood.Iwillthendeterminewhichgradelevelshavefemale
studentsintheagerangeof1318.Becausethesamplewillberestrictedtofemaleadolescents
ages1318,thisstudywillcontainanominalscaleofmeasurement.Iintendtohaveastratified
randomsamplefromeachschoolandgradelevelintheUptownarea.Withthestratified
randomsampleIhopetoensureexternalvaliditybecausethesamplewillbefromdifferent

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gradelevelsanddifferentschools.IndoingthismethodIthinkthatthedatacanbegeneralized
tothesamegradelevelsindifferentareasofChicagoorthecountry.
Also,IwillcollectinformationaboutsexualhealthclinicsinUptown.Iwilldetermine
wholivesinUptownandwhoisvisitingtheclinicsfromaneighboringarea.FromthereIwill
usepurposivesamplingtodeterminesexuallytransmitteddiseaseriskinadolescentfemales
whousesubstancesbeforeintercourse.Withstratifiedrandomsamplesandpurposiverandom
samplesIwillbeusingbothprobabilityandnonprobabilitysampling.Also,Icanhelptoensure
internalvaliditybytestingthetwodifferentgroups.Icancomparetheresultsfromtheschool
dataandthesexualhealthclinicdatatoseeifthereareanyerrorsinthedesignoftheproject
andtoseeifIamreallymeasuringsexualriskbehaviorsrelatedtosubstanceuse.
ThespecificdataIwillcollectaboutsexuallytransmitteddiseasewillbeselfreported
sexualtransmitteddiseasethatthewomenhavecontracted.Thiscanthenbecrossreferenced
withexistingdataavailablefromtheChicagoDepartmentofPublicHealth.Specificdataabout
riskysexualbehaviorwillreportonhowmanytimesthefemalehasengagedinsexualactivity
withoutabarriermethodofbirthcontrol(i.e.maleorfemalecondoms)orengagedinsexual
activitywithoutknowingtheirpartnerssexuallytransmitteddiseasestatus.Substanceuse
datawillbecollectedonthefemaleswhohaveconsumedanyamountalcoholorotherdrugs
priortoengaginginsexualactivity.Subsequentquestionswillaskaboutwhichsubstancewas
consumedandhowmuchwastaken.Forthisstudy,theamountofalcoholthatwillconstituted
substanceuseisoneormoredrinks.AccordingtotheNationalInstituteofDrugAbuse,one
servingofalcoholisequalto0.6ouncesofpureethanol,or12ouncesofbeer;eightouncesof
maltliquor;fiveouncesofwine;or1.5ounces(a"shot")of80proofdistilledspiritsorliquor

Callahan20

(e.g.,gin,rum,vodka,orwhiskey).Additionally,anyamountofdruguse(otherthanalcohol)
willconstitutesubstanceuse.

2. WheretheDataareLocated
Iwillbeusingquestionnairesformyresearch.Subsequently,thedatawillbelocatedin
theanswerstheadolescentfemalesgivetothequestionsasked.
B. TechniqueforCollectionofData
Iwilluseaquantitativemethodforcollectdata.Itwillalsobeacrosssectionalapproach
because,forthisstudy,Ionlywanttogetasnapshotofwhatishappening.Iwillbesurveying
femalesusingquestionnairestocollectthedata.Iamusingthismethodinsteadofinterviewing
becausesexualbehaviorandsubstanceuseamongadolescentsisacontroversialtopic.Iam
hopingthattheparticipantswillbemorehonestwithsurveysthanwithothermoreblatant
measures.
ThequestionnairethatIplantodevelopwillcontaindemographicinformation,weight,
height,sexualactivity,substanceuse,substanceusebeforesexualactivity,andbirthcontrol
methods.ThequestionswillbewellplannedsothatIcandetermineifsubstanceuseprecedes
riskysexualbehavior.Iwillrunapilottestofthequestionnaireinordertodetermineifthe
questionsIamaskingareadequatetocollectthedatathatIwant.
Iwilldistributethequestionnairestostudentsateachschoolthroughteachersineach
oftheclasses.Also,Iwillenlistthehelpofcliniciansatsexualhealthclinicsinorderforthemto

Callahan21

passoutthequestionnaires.Iwouldlikethequestionnairetobeincludedinanyintakepapers
thattheparticipantsarefillingoutforthesexualhealthclinic.Aletterwillbeincludedwiththe
surveytoassuretheparticipantsanswerswillbekeptconfidentialandthattheywillbeableto
retaintheiranonymitythroughouttheprocess.
C. MethodofAnalysis
1. HowtheDatawillbeExaminedforMeaning
WhenthesurveysarecompleteandthedatahasbeencompiledIwillorganizethedata
accordingtotheindicatorsandvariables.IwillinputthedataintoanExcelspreadsheet.The
Excelspreadsheetwillthenconductquantitativeanalysisonthedatatodeterminefrequencyof
riskysexualbehavioramongfemaleadolescentswhowereundertheinfluenceofasubstance.
Thedemographicinformation,sexualactivity,substanceuse,andbirthcontrolmethodswill
alsobeanalyzedforpatternsthatcorrelatewithsexualintercoursewhileundertheinfluenceof
substancesamongfemaleadolescents.
IwillthenusethetablesandgraphfunctionofExceltoseeifthereareanytrends
evidentfromthedatathatwascollected.Thetablesandgraphswillincludeinformationabout
demographics,sexualactivity,substanceuse,andbirthcontrolmethods.Itwillthenbe
comparedtofemaleadolescentswhohaveansweredyestothequestiontheyhadengagedin
sexualactivitywhileundertheinfluenceofalcoholorotherdrugs.Iwillseeifthereareany
patternspresentamongthedifferentvariables.
2. HowtheDatawillbePresented

Callahan22

ThedatawillbepresentedinchartsandgraphsproducedbyExcel.Thefollowing
documentswillbepresented:

AmapofUptownwithindicationsofwherethedatawascollected.

Chartsshowingfrequencyofsexualactivity,substanceuse,andbirthcontrol
methodsaccordingtodemographicinformation.

Achartshowingsubstanceuseamongfemaleadolescentspriortosexualactivity.

Callahan23

IV.OUTLINEOFFINALREPORT
Thefinalreportwillbepresentedasfollows:

PageNumber

Acknowledgements

ii

TableofContents

iii

ListofTables

iv

ListofFigures

TitlePage

Chapters
I.
II.
III.
IV.

TheProblemandItsSetting
ReviewofRelatedLiterature
ResearchMethodology
TheResults

Appendixes

Callahan24

V.ExpectedOutcomes

IbelievethattheresultsofthisstudywillbenefitUptownandthecityofChicago.By

gainingabetterunderstandingoftheproblemsregardingfemaleadolescentsexually
transmitteddiseaserisk,morehelpwillbeavailabletoyoungwomen.Ithinkthatdoctors,
clinicians,andthegovernmentwillbebetterabletohelpfemaleadolescentsmakebetter
decisionsabouttheirhealth.

Doctorsandnurseswillbebetterabletotreatfemaleadolescentsbecausetheywill

haveabetterunderstandingoffemaleadolescentsbehaviorsandtheriskswhichtheytake.
Theycanwarnfemaleadolescentsofthedangersofsexwhiledrunkorhigh.Substanceabuse
treatmentfacilityclinicianscanteachtheirclientsabouttherisksofusingalcoholorother
drugsandparticipatinginunprotectedsex.Thedoctors,nurses,andsubstanceabusetreatment
clinicianscanhelptheirpatientsplaninterventionsforwhentheyareusingsubstancessothat
theycanstillprotectthemselvesfromsexuallytransmitteddiseases.

Thegovernmentcanalsohelpplaninterventionsforprotectingfemaleadolescentsand

helpingthemadvocateforthemselves.Theycanoffermoresexualeducationclassesgeared
towardstheneedsthataresetforthinresearch.Forexample,ifacertainrace,ethnicity,age,
orgradelevelprovestobemoreatriskthensexualeducationclassescanbetailoredtoeach

Callahan25

individualneed.Ifthegovernmentsetsforththeseinterventionsthenteachersandparentscan
helpwiththeprocessofeducatingyoungwomen.Theeducationthatisprovidedcanhelp
youngwomentotakebettercareoftheirsexualhealthandadvocateforthemselvesregarding
sexuallytransmitteddiseasepreventionandsubstanceuse.
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