title: Substance use and the development of sexual risk behaviors in youth perinatally exposed to HIV.
abstract: OBJECTIVE
  To examine the longitudinal association between sexual behavior and substance use in perinatally HIV-infected (PHIV+) and perinatally HIV-exposed-but-uninfected (PHIV-) youth.
  
  
  METHODS
  Growth curve modeling was used with data from N = 340 PHIV-exposed youth (60.6% PHIV+; 9-22 years) to estimate the onset of penetrative and unprotected sex across time, adding alcohol and marijuana use trajectories as time-varying covariates and examining HIV-status differences.
  
  
  RESULTS
  The odds of penetrative or unprotected sex more than doubled across time. Alcohol and marijuana use significantly increased the odds of engaging in sex and unprotected sex, with no HIV-status differences. The association between unprotected sex and alcohol use was less salient for PHIV+ than PHIV- youth.
  
  
  CONCLUSIONS
  Similar to youth from other populations, PHIV+ and PHIV- youth are increasingly engaging in sex and substance use as they age. Targeted interventions to prevent sexual risk behavior and further HIV transmission should address the influence of substance use.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University and Center for Sexuality & Health Disparities, School of Public Health, University of Michigan ke2143@columbia.edu.
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Elkington
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University and Center for Sexuality & Health Disparities, School of Public Health, University of Michigan.
authors.forename: José A
authors.initials: JA
authors.lastname: Bauermeister
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University and Center for Sexuality & Health Disparities, School of Public Health, University of Michigan.
authors.forename: E Karina
authors.initials: EK
authors.lastname: Santamaria
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University and Center for Sexuality & Health Disparities, School of Public Health, University of Michigan.
authors.forename: Curtis
authors.initials: C
authors.lastname: Dolezal
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University and Center for Sexuality & Health Disparities, School of Public Health, University of Michigan.
authors.forename: Claude A
authors.initials: CA
authors.lastname: Mellins
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D005260:Female; D015658:HIV Infections / Q000523:psychology* / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology / Q000523:psychology*; D009519:New York City; D012309:Risk-Taking; D047568:Unsafe Sex / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: adolescent HIV; longitudinal; perinatal HIV; sexual risk behavior; substance use