Multiple risk behaviors among youth living with human immunodeficiency virus in five U.S. cities.

TitleMultiple risk behaviors among youth living with human immunodeficiency virus in five U.S. cities.
Publication TypePublication
Year of Publication2010
AuthorsTanney MR, Naar-King S, Murphy DA, Parsons JT, Janisse H
Corporate AuthorsATN 004 Protocol Team
JournalJ Adolesc Health
Volume46
Issue1
Pagination11-6
Date Published2010 Jan
ISSN1879-1972
KeywordsAdolescent, Female, HIV Infections, HIV Long-Term Survivors, Humans, Male, Patient Compliance, Risk-Taking, Substance-Related Disorders, Surveys and Questionnaires, United States, Unsafe Sex, Urban Population, Young Adult
Abstract

<p><b>PURPOSE: </b>To describe multiple risk behaviors (substance use, sexual risk, and medication adherence) in a multi-site sample of youth living with human immunodeficiency virus (HIV) in five U.S. cites.</p><p><b>METHODS: </b>Youth (N=352) were recruited from four Adolescent Trials Network (ATN) sites (Philadelphia, Fort Lauderdale, Baltimore, and Los Angeles) and one non-ATN site in Detroit and screened for multiple problem behaviors for an intervention study. A substance abuse problem was determined with the CRAFFT, a six-item adolescent screener. Single items were used to screen for current sexual risk and for an HIV medication adherence problem. Of the youth, 239 (68%) had at least one of the three risk behavior problems based on the screener. A total of 186 (52.8%) completed longer, in-depth questionnaires for each problem behavior.</p><p><b>RESULTS: </b>Of the 352 youth screened, 60% had problem level substance use and 42% had a sexual risk problem. Of the 165 (47%) who were prescribed medications, 91 (55%) reported an adherence problem. A total of 112 (32%) reported no problem behavior, 123 (35%) reported 1 problem behavior, 95 (27%) reported 2 problem behaviors, and 20 (6%) reported 3 problem behaviors. Males were more likely to have a substance use problem. Younger youth living with HIV and those perinatally infected were more likely to have an adherence problem. Among the 186 (52.8%) completing longer measures, those with a substance abuse problem had higher substance use on a timeline follow-back procedure than those without. Participants who screened positive for a sexual risk problem reported more unprotected sex on an in-depth interview than those without. Those who screened positive for an adherence problem had higher viral loads than those without an adherence problem.</p><p><b>CONCLUSIONS: </b>Results suggest high rates of problem behaviors among youth living with HIV, particularly in older youth. Younger and perinatally infected youth may require specialized adherence interventions. Associations between the screener and more in-depth assessment measures suggest potential clinical utility of screening youth for high-risk behaviors.</p>

DOI10.1016/j.jadohealth.2009.05.017
Alternate JournalJ Adolesc Health
PubMed ID20123252
PubMed Central IDPMC2818022
Grant ListU01 HD040481-09 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States
U01-HD040474 / HD / NICHD NIH HHS / United States
U01 HD040481-08 / HD / NICHD NIH HHS / United States
U01 HD040481 / HD / NICHD NIH HHS / United States
U01-HD040533 / HD / NICHD NIH HHS / United States