Drug Abuse and HIV/AIDS

Research Findings from May, 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.

Perceptions of Tuberculosis and Treatment Adherence for Adolescents and Adults with HIV

HIV-infected individuals are a population at very high risk for and often among the least able to afford health care resources. In this study of adolescents and adults infected with HIV, interviews were completed to assess perceptions of tuberculosis (TB) infection rates and physician TB behavior, and patient knowledge of TB transmission and treatment adherence. The sample consisted of HIV-infected youth (N = 199) from adolescent clinical care sites in three cities and HIV-infected adults (N = 133) in New York. Adolescents reported they were significantly less likely to be tested for TB; however, testing rates were high for both samples. Results indicated that approximately 9% of both samples reported infection with TB; the majority reported receiving medication (97%), and consistent medication adherence (93%). The overall mean knowledge score regarding TB was 66% and there were significant age differences, with adolescents less knowledgeable than adults, and young males tending to be less knowledgeable than young females. Age, gender and experience with TB (self-perception of TB, testing history and clinic choice) significantly predicted accuracy of knowledge about TB. Results suggest that education and support from their community health care sources may substantially reduce chances of contracting and spreading TB. Murphy, D.A., Rotheram-Borus, M.J., and Joshi, V. HIV-Infected Adolescent and Adult Perceptions of Tuberculosis Testing, Knowledge and Medication Adherence in the USA. AIDS Care-Psychological and Socio-Medical Aspects of AIDS/HIV, 12(1), pp. 59-63, 2000.

Amphetamine Use in Youths Living with HIV (YLH)

In this study amphetamine use and its correlates were examined among 337 youths living with HIV (YLH) to determine whether its use is associated with increased transmission acts and poor health. One third of YLH engaged in amphetamine use in their lifetime, and 21% reported current use (last 3 months). Results showed that compared with those who never used (never-users), users initiated other drug use at younger ages, used more types of drugs, reported more emotional distress, employed escape coping significantly more frequently, had more sexual partners and more sexual encounters. Although users and never-users did not differ on physical symptoms or whether they have been diagnosed with AIDS, users reported significantly higher T-cell counts than never-users. Despite poor psychosocial functioning, amphetamine users have higher T-cell counts than other YLH. The continued high-risk profile of transmission acts among users suggests that preventive interventions must target specific drugs used by YLH. Rotheram-Borus, M.J., Mann, T., and Chabon, B. Amphetamine Use and Its Correlates Among Youths Living with HIV. AIDS Education and Prevention, 11(3), pp. 232-242, 1999.

Survival Sex Among Runaway and Homeless Youth

Investigators at Research Triangle Institute analyzed data on 12-21-year-olds from a nationally representative sample of shelter youths and a multi-city sample of street youths to determine the prevalence and correlates of survival sex. "Survival sex" refers to the selling of sex to meet subsistence needs, including sex to get drugs or money to get drugs. Results indicated that approximately 28 percent of street youths and 10 percent of shelter youths reported having participated in survival sex, which was associated with age, days away from home, victimization, criminal behaviors, substance use, suicide attempts, sexually transmitted disease, and pregnancy. These findings highlight the need to develop services that provide alternatives to the sex trade as a means of meeting economic needs for runaway and homeless youth. It was concluded that intensive and ongoing services are needed to provide resources and residential assistance for these youth. Green, J.M., Ennett, S.T., and Ringwalt, C.L. Prevalence and Correlates of Survival Sex Among Runaway and Homeless Youth. American Journal of Public Health, 89, pp. 1406-1409, 1999.

Parentification and its Impact on Adolescent Children of Parents with AIDS

Parentification refers to children or adolescents assuming adult roles before they are emotionally or developmentally ready to manage those roles successfully. An assessment of the predictors and outcomes of parentification was made among adolescent children of Parents with AIDS (PWAs) in two phases. 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: 11 to 18 years, M = 14.8 years, 54 percent female; parents: 80 percent female). 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. In Phase 2, the impact of parentification on later adolescent psychological adjustment was examined (N = 152 adolescents). Adult role-taking predicted more internalized emotional distress; parental role-taking predicted externalized problem behaviors, sexual behavior, alcohol and marijuana use, and conduct problems. Given these dysfunctional outcomes, interventions to mitigate parentification among children of PWAs are discussed. Stein, J.A., Riedel, M., Rotheram-Borus, M.J. Parentification and Its Impact on Adolescent Children of Parents with AIDS. Family Process, 38(2), pp. 193-208, 1999.