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Black women and men in the US are hard hit by HIV, and have been since the beginning of the epidemic. In 2006, Black women accounted for 61% of new HIV cases among women, but make up only 12% of US female population. The rate of HIV diagnoses for Black women is 15 times the rate for White women. Black women also have high rates of sexually transmitted diseases (STDs), which can facilitate transmission of HIV. Among Black women in 2006, the rate of chlamydia was 7 times higher, gonorrhea 14 times higher, and syphilis 16 times higher than the rate among White women. These numbers and statistics, however, don’t show the richness and diversity of Black women’s lives. Black women can be White collar and working class, Christians and Muslims. They live in inner-city and suburban neighborhoods, are the descendants of slaves and recent Caribbean immigrants. They work, go to school, raise families, fall in love. HIV among Black women is not simply about individual behavior, but a complex system of social, cultural, economic, geographic, religious and political factors that combine to affect health.

Childhood sexual abuse may be defined in many ways, but this fact sheet refers to unwanted sexual body contact prior to age 18, the age of consent to engage in sex. CSA is a painful experience on many levels that can have a profound and devastating effect on later physiological, psychosocial and emotional development. CSA experiences can vary with respect to duration (multiple experiences with the same perpetrator), degree of force/coercion or degree of physical intrusion (from fondling to digital penetration to attempted or completed oral, anal or vaginal sex). The identity of the perpetrator–ranging from a stranger to a trusted figure or family member–may also impact the long-term consequences for individuals. To distinguish CSA from exploratory sexual experimentation, the contact should be unwanted/coerced or there should be a clear power difference between the victim and perpetrator, often defined as the perpetrator being at least 5 years older than the victim. Many more children are sexually abused than are reported to authorities. Estimates of the prevalence of CSA in the US are about 33% for females under the age of 18 and 10% in males under 18 years of age. Men are significantly less likely than women to report CSA when it occurs. CSA is more likely to occur in families under duress. Children are at risk for CSA in families that experience stress, poverty, violence and substance abuse and whose parents and relatives have histories of CSA.

Sex and HIV education programs have multiple goals: to decrease unintended pregnancy, to decrease STDs including HIV and to improve sexual health among youth. In 2005, almost two-thirds (63%) of all high school seniors in the US had engaged in sex, yet only 21% of all female students used birth control pills before their last sex and only 70% of males used a condom during their last sexual intercourse. In 2000, 8.4% of 15-19 year old girls became pregnant, producing one of the highest teen pregnancy rates in the western industrial world. Persons aged 15-24 had 9.1 million new cases of STDs in 2000 and made up almost half of all new STD cases in the US. There are numerous factors affecting adolescent sexual behavior and use of protection. Some of these factors have little to do with sex, such as growing up in disadvantaged communities, having little attachment to parents or failing at school. Other factors are sexual in nature, such as beliefs, values, perceptions of peer norms, attitudes and skills involving sexual behavior and using condoms or contraception. It is these sexual factors that sex/HIV education programs can potentially affect, thereby impacting behavior. Sex/HIV education programs alone cannot totally reduce sexual risk-taking, but they can be an effective part of a more comprehensive initiative.

• To provide the rationale and framework for applying weighted time-series to serial cross-sectional data.
• To use simulation (created data) to apply and test the use of weighted time-series in a setting where the distribution of demographic characteristics and the health status of the population changes over time.
• To use existing clinical data to compare the effect of introducing family-centered HIV care, VCT and prevention services on the transmission of HIV among the families served by participating clinics using cohort analysis, time-series analysis and weighted time-series.

1. Assess and select measures for the degree of variation they exhibit.
2. Conduct bivariate measures of association in order to assess unadjusted associations between the psychological well-being measures and those economic factors that demonstrate sufficient variation.
3. Conduct logistic or multinomial logistic regressions in order to assess the extent of the relationship between the psychological well-being and the economic factors after accounting for potential confounders and effect modifiers.