Psychosocial factors and substance use in high-risk youth living with HIV: a multi-site study.
The purpose of the study was to test relationships between psychosocial factors and alcohol and illicit drug use among high-risk youth living with HIV (YLH). One hundred eighty-six high-risk youth with HIV (defined as those with a substance use problem, sexual risk problem, or medication adherence problem) were enrolled across five cities (ages 16-24). Alcohol and illicit drug use were measured with the alcohol, smoking, and substance involvement screening test and a timeline follow-back interview. Questionnaires assessed constructs from the adapted Transtheoretical Model (TTM) including a continuous measure of motivational readiness in response to criticisms of the stage component. Path analysis was utilized to fit cross-sectional data collected via computer assisted personal interviewing (baseline data from intervention study). Separate models were fit for each commonly used substance. In the previous month, 47% used alcohol, 37% used cannabis, and 9% used other illicit drugs. Path models fit the data well and accounted for 30% of the variance in alcohol use and 47% in cannabis use. Higher self-efficacy predicted lower alcohol and cannabis use, but motivational readiness was only directly related to cannabis use. A reduction in pros of substance use was indirectly related to use. Social support and psychological distress were associated with TTM constructs. Interventions focusing on improving motivation and self-efficacy for healthy behaviors may reduce substance use in YLH.
Department of Pediatrics, Wayne State University, Detroit, MI, USA. snaarkin@med.wayne.edu
Sylvie
S
Naar-King
Karen
K
Kolmodin
Jeffrey T
JT
Parsons
Debra
D
Murphy
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006679:HIV Seropositivity / Q000150:complications* / Q000523:psychology; D015438:Health Behavior; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D009042:Motivation; D020377:Self Efficacy; D012944:Social Support; D013315:Stress, Psychological; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult