Drug Abuse and HIV/AIDS

Research Findings from February, 2002 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.

Enhanced Cognitive-Behavioral HIV Prevention Intervention for Adolescents Abusing
Alcohol and Other Drugs

Dr. Robert Malow and colleagues at the University of Miami have designed an intervention to reduce HIV risk
behaviors among adolescents in inpatient substance abuse treatment. An initial efficacy study showed that,
compared to a Health-Promotion group intervention, an enhanced cognitive-behavioral intervention produced
significantly better condom use skills and more favorable attitudes toward condoms. Malow, Deviux, and
Rosenberg, Addictions Newsletter, 8, pp. 2 –14, 2001.

Sex-related HIV Risk Reduction Behavior Among Adolescents in DATOS-A

This study examines changes in levels of HIV-related risky sexual behaviors pre- and post- treatment in relation both to patient characteristics and treatment services, received among 796 adolescents entering drug treatment programs in four cities in the United States. More than half of the adolescents (54%) reported reductions in risky sex behavior after treatment or sustained low levels of risk. Conduct-disordered adolescents with abuse history, unmet physical and emotional needs, and low commitment to school were associated with lack of improvement. Furthermore, conduct-disordered adolescents who perceived treatment to be effective were more likely to show posttreatment improvement, with the exceptions that those who scored high on hostility or low in self-perception were not likely to improve. Among adolescents without conduct disorder, receipt of mental health services was associated with improvements in their risky sex behavior The effect of drug treatment on HIV risk reduction can be increased when attention is focused on adolescents' pretreatment risk factors, service needs, in treatment responses, and key personality characteristics. Joshi, V., Hser, Y.I., Grella, C.E., and Houlton, R. Journal of Adolescent Research, 16(6), pp. 642-660, 2001.

Drug Use, Sex Partners, and Behaviors of 18-24 Year-Olds in a High Risk Neighborhood

Researchers sought to determine how stigmatized drug use is related to sexual risk behaviors and network characteristics among youth. They conducted in-person interviews with a probability household sample (n=363) and a targeted, street-recruited sample of cocaine, heroin, crack, or injecting drug users comprising 18-24 year-olds in an inner city neighborhood. Drug use in the preceding 12 months was scaled hierarchically on the basis of lowest to highest social stigma, from none, to marijuana, non-injected cocaine, non-injected heroin, crack, and injected drugs. Findings indicate that users of the more stigmatized drugs had more sex partners. They were more likely to report a history of concurrent sex partners, sex with someone who also had engaged in sex with a network member, commercial sex work, and unprotected sex. Findings also showed crack use and drug injection to be associated more strongly with increased sex risk among women than among men. Young users of the more stigmatized drugs are at much greater network and behavior risk for sexually transmitted diseases. Drug use prevention and treatment programs can help to reduce sex risk because young people who use drugs engage in more sex risk behaviors and are more likely to have concurrent or shared partners than those who do not use drugs. Risk reduction interventions that address sex risk of drug users can also help to encourage condom use and fewer sex partners, and to refer drug users to screening and treatment services for sexually transmitted infections. Flom, P., Friedman, S., Kottiri, B., Neaigus, A., Curtis, R., Des Jarlais, D., Sandoval, M., and Zenilman, J. Stigmatized Drug Use, Sexual Partner Concurrency, and Other Sex Risk Network and Behavior Characteristics of 18- to 24-Year Old Youth in a High-Risk Neighborhood. Sexually Transmitted Diseases, 28(10), pp. 598-607, 2001.