Drug Abuse and HIV/AIDS

Research Findings from February, 2000 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.

Preventing Adolescent Health Risk Behaviors

The purpose of this study was to examine 6-year follow-up data on adolescent health-risk from a nonrandomized controlled trial of an intervention combining teacher training, parent education, and social competency training. Two intervention conditions were studied. The full program provided intervention components in grades 1 through 6, the later intervention program was provided in only grades 5 and 6; students in the current follow-up sample were 18 years of age. Results indicate that compared to control group students, the full intervention group students reported significantly fewer violent acts, less heavy drinking, lower incidence of sexual intercourse, and fewer sexual partners. They also reported more commitment and attachment to school, better academic achievement, and less school misbehavior. The late intervention students did not differ significantly from the control group in health risk behaviors. Hawkins, J.D., Catalano, R.F., Kosterman, R., Abbott, R., and Hill, K.G. Preventing Adolescent Health-Risk Behaviors by Strengthening Protection during Childhood. Archives of Pediatric and Adolescent Medicine, 153, pp. 226-234, 1999.

The Impact of Parental AIDS on Adolescent Children

This study examines the problem of adolescent children taking on adult parenting and spousal roles in families where a parent has AIDS (PWA). In Phase 1, relationships among parental AIDS-related illness, parent drug use, parent and adolescent demographics, and parentification indicators (parental, spousal, or adult role-taking) were assessed among 183 adolescent-parent pairs (adolescents aged 11-18 yrs). Adult role-taking was associated with maternal PWAs, female adolescents, and greater parent drug use. Greater parental AIDS-related illness predicted more spousal and parental role-taking. Parent drug use predicted more parental role-taking by adolescents. In Phase 2, the impact of parentification on later adolescent psychological adjustment was examined in 152 adolescents. Adult role-taking predicted more internalized emotional distress; parental role taking predicted externalized problem behaviors such as sexual behavior, alcohol and marijuana use, and conduct problems. Given these dysfunctional outcomes, interventions to mitigate parentification among children of PWAs was discussed. Stein, J.A., Riedel, M., and Rotheram-Borus, M.J. Parentification and its Impact on Adolescent Children of Parents with AIDS. Family Process, 38, pp. 193-208, 1999.

Problem Behavior of Adolescents Whose Parents Have AIDS

Substance use, acts of sexual risk, conduct problems, and internalizing, externalizing, and somaticizing mental health symptoms were examined among 239 adolescents (aged 11-19 yrs) and their parents living with AIDS in New York City. The assessment measures administered were constructs emerging from the creation of latent variables using a structural equational modeling approach. Other factors assessed were parental illicit drug use, health status, and internalizing of emotional distress, as well as adolescent alcohol and marijuana use. Consistent with theories regarding imitative behavior, stress, and anticipatory loss, adolescents' externalizing behavior problems and somatic symptoms were related to their parents' status. Rotheram-Borus, M.J., and Stein, J. A. Problem Behavior of Adolescents whose Parents are Living with AIDS. American Journal of Orthopsychiatry, 69, pp. 228-239, 1999.

Youth Living With HIV as Peer Leaders

Community-based service providers often hire youth living with HIV (YLH) as peer leaders or facilitators for delivering HIV education to uninfected adolescents. Life narratives were collected from 44 YLH during a hypotheses-generating 2-yr ethnographic study. About 30% of the youth were employed as peer educators. While 60% of the 44 youth had lower-class backgrounds, only 23% of the peer leaders were lower class. One-fifth of the sample was female, but more than one-half of the peer leaders were female. After identifying and categorizing difficulties experienced by the peer leaders, a frequency count of each theme was conducted. Issues about professional boundaries were evident in 38.5% of the youth's narratives, indicating conflicts in their roles as peer leaders; 23% of the youth engaged in substance use and sexual behaviors that placed themselves and uninfected youth in their peer educator programs at risk; and 8% of the youth reported relapse while peer leaders. These data suggest reconsideration or restructuring of existing peer education models that employ YLH. Luna, G.C., and Rotheram-Borus, M.J. Youth Living with HIV as Peer Leaders. American Journal of Community Psychology, 27, pp. 1-23, 1999.

Impact of Early Adolescent Marijuana Use On Late Adolescent Problem Behaviors

The purpose of this study was to assess the impact of early adolescent marijuana use on late adolescent problem behaviors, drug-related attitudes, drug problems, and sibling and peer problem behavior. African American (n = 627) and Puerto Rican (n = 555) youths completed questionnaires in their classrooms initially and were individually interviewed 5 years later. Logistic regression analysis estimated increases in the risk of behaviors or attitudes in late adolescence associated with more frequent marijuana use in early adolescence. Early adolescent marijuana use increased the risk in late adolescence of not graduating from high school; delinquency; having multiple sexual partners; not always using condoms; perceiving drugs as not harmful; having problems with cigarettes, alcohol, and marijuana; and having more friends who exhibit deviant behavior. These relations were maintained with controls for age, sex, ethnicity, and, when available, earlier psychosocial measures. Early adolescent marijuana use is related to later adolescent problems that limit the acquisition of skills necessary for employment and heighten the risks of contracting HIV and abusing legal and illegal substances. Hence, assessments of and treatments for adolescent marijuana use need to be incorporated in clinical practice. Brook, J.S., Balka, E.B., and Whiteman, M. The Risks for Late Adolescence of Early Adolescent Marijuana Use. Am J Public Health, 89(10), pp. 1549-1554, 1999.