Drug Abuse and HIV/AIDS

Research Findings from February, 2003 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate youth drug abuse and HIV/AIDS. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

Condom Use Among Drug-Using Youth in a High HIV-risk Neighborhood

Friedman and colleagues interviewed 196 18-24 year olds living in Bushwick, New York City, who injected drugs or used heroin, cocaine or crack in the prior year with the objective of assessing predictors of consistent condom use in heterosexual relationships in a high HIV-risk environment. Consistent condom use was reported in 26% of 277 non-commercial relationships and in all of 22 commercial relationships. Consistent condom use is more common in relationships that are described as not "very close" for men (but not women) with peers whose norms are more favorable to condom use, and for subjects who had concurrent sex partners in the last 12 months. The authors conclude that: (1) the lack of relationship between the peer norms of drug-using women and their condom use suggests that they may have little control over condom use in their relationships and this indicates a need for the development of programs to empower young female drug users; (2) the positive association of concurrency to consistent condom use suggests that condom use may be restricting HIV spread in the community and the presence of consistent condom use in all of the commercial sexual relationships may also restrict HIV spread; and (3) prevention efforts should attempt to change peer cultures as a way to develop self-sustaining risk reduction. Friedman, S.R., Flom, P.L., Kottiri, B.J., Neaigus, A., Sandoval, M., Fuld, J., Curtis, R., Zenilman, J.M. and Des Jarlais, D.C. Consistent Condom Use Among Drug-using Youth in a High HIV-risk Neighborhood. AIDS Care. 14(4), pp. 493-507, 2002.

Coping in Adolescent Children of HIV-Positive and HIV-Negative Substance Abusing Fathers

This study examines the coping techniques of adolescents whose fathers are at risk for contacting the HIV virus or have the HIV virus. Adolescent coping is an important aspect of the adolescent's vulnerability or resilience to drug use and abuse and associated problems. The data for this study was taken from an epidemiological study of fathers who are substance abusers and their adolescent offspring. Adolescents were asked questions regarding their ability to cope with the knowledge that their fathers have AIDS or may contract it. Adolescent adaptive coping was found to be positively related to the adolescents' conventionality, intrapersonal and interpersonal adjustment, and infrequent or no use of marijuana. Adolescent adaptive coping was also associated with paternal adaptive coping, a close father-child bond, and under some conditions, less paternal drug use. Furthermore, for every additional psychosocial risk factor beyond a minimal number, there is a doubling in the odds ratio of the adolescent using maladaptive techniques of coping. Knowledge of such relationships helps guide intervention and policy procedures for adolescents who are at risk because their fathers are HIV-positive or may contract HIV. Brook, D.W., Brook, J.S., Arencibia-Mireles, O., Whiteman, M., Pressman, M. and Rubenstone, E. Coping in Adolescent Children of HIV-Positive and HIV-Negative Substance Abusing Fathers. The Journal of Genetic Psychology, 163(1), pp. 5-23, 2002.

Mental Health Problems and Sexual Abuse among Adolescents in Foster Care: Relationship to IV Risk Behaviors and Intentions

Although adolescents in foster care present with multiple psychosocial and mental health problems that individually are associated with increased risk for HIV, few studies have examined the interrelationships among these factors. These authors examined sexual abuse histories and mental health problems among 343 youths in foster care to determine associations with HIV-risk behaviors and behavioral intentions. Of the sample, 25% reported internalizing behaviors (withdrawal, somatic complaints, depression), 28% reported externalizing behaviors (delinquency, aggression), and 37% reported prior sexual abuse. Multivariate analyses using simultaneous entry of variables, and controlling for demographic variables and behavioral intentions, showed externalizing behaviors as having the strongest relationship with both HIV risk behaviors and behavioral intentions. Moreover, there was a significant race by gender interaction, with Caucasian females engaging in more risky behaviors than their male counterparts and youths of color. This study begins to address the comparatively understudied issue of the empirical interrelationships among psychosocial problems and HIV risk behaviors in foster care children. Auslander, W.F., McMillen, J.C., Elze, D., Thompson, R., Jonson-Reid, M., and Stiffman, A. AIDS & Behavior, 6(4), pp. 351-359, December 2002.