Prevalence and predictors of injection drug use and risky sexual behaviors among adolescents in substance treatment

• Published in: The American journal on addictions 2013-11, Vol.22 (6), p.558-565
• Main Authors: Thurstone, Christian, Salomonsen-Sautel, Stacy, Mikulich-Gilbertson, Susan K., Hartman, Christie A., Sakai, Joseph T., Hoffenberg, Analice S., McQueen, Matt B., Min, Sung-Joon, Crowley, Thomas J., Corley, Robin P., Hewitt, John K., Hopfer, Christian J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Behavior; Adolescents; Case-Control Studies; Child; Condoms - utilization; Female; HIV; HIV Infections - prevention & control; HIV Infections - transmission; Humans; Intravenous drug addiction; Intravenous drug addicts; Longitudinal Studies; Male; Prevalence; Risk Factors; Risk-Taking; Safe sexual practices; Sexual Behavior - statistics & numerical data; Sexual Partners; Substance Abuse, Intravenous - epidemiology; Substance-Related Disorders - epidemiology; Unsafe Sex - statistics & numerical data; Young Adult
• ISSN: 1055-0496; 1521-0391
• DOI: 10.1111/j.1521-0391.2013.12064.x

Background and Objectives The longitudinal risk for human immunodeficiency virus (HIV) infection following adolescent substance treatment is not known. Therefore, it is not known if adolescent substance treatment should include HIV prevention interventions. To address this important research gap, this study evaluates the longitudinal prevalence and predictors of injection drug use (IDU) and sex risk behaviors among adolescents in substance treatment. Methods Participants were 260 adolescents (13–18 years) in substance treatment and 201 community control adolescents (11–19 years). Participants were assessed at baseline and follow‐up (mean time between assessments = 6.9 years for the clinical sample and 5.6 years for the community control sample). Outcomes included self‐report lifetime history of IDU, number of lifetime sex partners and frequency of unprotected sexual intercourse. Results At baseline, 7.5% of the clinical sample, compared to 1.0% of the community control sample had a lifetime history of IDU (χ12=10.53, p = .001). At follow‐up, 17.4% of the clinical sample compared to 0% of the community control sample had a lifetime history of IDU (χ12=26.61, p = .0005). The number of baseline substance use disorders and onset age of marijuana use significantly predicted the presence of lifetime IDU at follow‐up, after adjusting for baseline age, race, and sex. The clinical sample reported more lifetime sex partners and more frequent unprotected sex than the community control sample at baseline and follow‐up. Conclusions Many adolescents in substance treatment develop IDU and report persistent risky sex. Effective risk reduction interventions for adolescents in substance treatment are needed that address both IDU and risky sex. (Am J Addict 2013;22:558–565)