Substance Use Disorders and HIV/AIDS Risk Behaviors in Delinquent Youth as They Age into Adulthood

Marquita Stokes

doi:https://doi.org/10.21985/N2X968

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Substance Use Disorders and HIV/AIDS Risk Behaviors in Delinquent Youth as They Age into Adulthood

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Substance use and substance use disorder (SUD) may be variables that influence the course of HIV/AIDS risk behaviors as youth age. To our knowledge, no prospective longitudinal study has examined the association between categories of substance use disorders including alcohol use disorder alone, marijuana use disorder alone, comorbid drug use disorder, as well as “other” illicit drug use disorders with HIV/AIDS risk behaviors in juvenile justice youth as they age into adulthood. The current study addresses these omissions in the literature. This study has 3 aims: (1) Describe the prevalence of HIV/AIDS risk behaviors among youth with any substance use disorder as well as SUD typology up to 14 years after detention; (2) Examine the association between any SUD and HIV/AIDS risk behaviors as youth age into adulthood, controlling for key covariates (e.g., gender, race, incarceration); and (3) Examine the association between SUD typology and HIV/AIDS risk behaviors as youth age into adulthood. We will also examine whether there are gender and racial/ethnic differences in the association between SUD and HIV/AIDS risk behaviors over time. Even after controlling for gender, age, race/ethnicity, and incarceration, having any substance use disorder increased the odds of engaging in every risk behavior. When compared to not having a substance use disorder, every category of SUD except for marijuana, was associated with increased odds of each risk behavior. In general, “other” illicit drug use disorder was associated with the largest odds for most risk behaviors when compared to no substance use disorder or marijuana use disorder. Additionally, gender was an important moderating factor for multiple partners (>1, >3), unprotected vaginal sex, and sex while drunk or high with a high-risk partner. Females consistently had larger odds than males, with the exception of unprotected vaginal sex, where males had larger odds. Time since detention (baseline) was also an important factor in several risk behavior models including multiple partners (>1, >3) and unprotected vaginal sex. Assessment at baseline was associated with the largest odds of engaging in these behaviors; however, risk remained substantial throughout the 14-year follow-up period. Even though minority males—African American & Hispanic—are more likely to engage in certain risk behaviors (e.g., multiple partners, unprotected vaginal sex), race/ethnicity did not interact with SUD to affect its association with risky behavior. Detained youth, an underserved group with a high prevalence of substance use disorder, are at increased risk for engaging in behaviors that increase risk for HIV/AIDS. And they remain at risk as they age into adulthood. Early prevention and intervention, as well as comprehensive treatment are needed to effectively serve these youth

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