Youth living with HIV and problem substance use: elevated distress is associated with nonadherence and sexual risk.

<p><b>PURPOSE: </b>To examine health risk behaviors in distressed youth living with HIV (YLH) with problem substance use.</p><p><b>METHODS: </b>Assessed distress, antiretroviral (ARV) adherence, and unprotected sex in a racially and geographically diverse sample of 122 YLH.</p><p><b>RESULTS: </b>A total of 87% of distressed YLH reported significantly more past-month ARV nonadherence (odds ratio [OR] = 7.15) and were more likely to have unprotected sex under the influence (OR = 5.14) than nondistressed youth.</p><p><b>CONCLUSIONS: </b>Distressed YLH with problem substance use may benefit from interventions to improve adherence and to decrease sexual risk, especially while under the influence of drugs.</p>