"Islands of Risk": subgroups of adolescents at risk for HIV.
OBJECTIVE
To use cluster analysis to determine profiles of adolescents at risk for HIV.


METHODS
Adolescents 15-21 years old (N = 1153) with a history of unprotected sex were assessed in five domains of risk (unprotected sex, alcohol/marijuana use, other drug use, mental health crises, and arrest/school dropout) as well as demographic, contextual, and behavioral variables.


RESULTS
Cluster analysis revealed separate three-cluster solutions for males and females. Among males, clusters were characterized by (a) mental health crises and unprotected sex, (b) alcohol/marijuana use and unprotected sex, and (c) lower risk. Among females, clusters were distinguished by (a) unprotected sex, (b) substance use and mental health crises, and (c) lower risk. Cluster membership was associated with secondary variables related to sexual risk.


CONCLUSIONS
Even within populations of high-risk adolescents, subgroups exist for which specific risk factors co-occur, particularly unprotected sex, mental health crises, and substance use. These patterns suggest that effective HIV prevention interventions may need to target the association between mental health and/or substance abuse with sexual risk for some adolescents.
Houck
Christopher D
CD
Rhode Island Hospital and Brown Medical School, USA. chouck@lifespan.org
Lescano
Celia M
CM
Brown
Larry K
LK
Tolou-Shams
Marina
M
Thompson
Jonathon
J
Diclemente
Ralph
R
Fernandez
M Isabel
MI
Pugatch
David
D
Schlenger
William E
WE
Silver
Barbara J
BJ
D000293:Adolescent; D000328:Adult; D016000:Cluster Analysis; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D012309:Risk-Taking; D012725:Sexual Behavior; D047568:Unsafe Sex / Q000706:statistics & numerical data*