Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116349

Larry K. Brown, MD¹, Christopher D. Houck, PhD¹, Celia M. Lescano, PhD¹, Wendy Hadley, PhD¹, and Project Shield². (1) School of Medicine, Brown University, Rhode Island Hospital, 1 Hoppin Street, Coro West 2.104, Providence, RI 02903, 401-444-8539, LKBrown@lifespan.org, (2) Center for Mental Health Services, SAMHSA, Office of the Associate Director for Med. Affairs, One Choke Cherry Rd, Rm 2-1009, Rockville, MD 20857

Objective: Determine profiles of adolescents at risk for HIV using cluster analysis. Methods: During a HIV prevention study of at-risk youth from three states, ethnically/racially diverse adolescents 15 to 21 years old (N=1153) all of whom had a history of unprotected sex, were assessed in five domains of risk (number of unprotected sex acts in the past 90 days; alcohol/marijuana use; other drug use; a history of suicide attempts or psychiatric hospitalization; arrest or school drop-out) 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 1) a history of suicide attempts (77% of cluster) or psychiatric hospitalization (44%), with frequent unprotected sex acts (Mean=26.9 in past 90 days), 2) frequent alcohol/marijuana use and moderate levels of unprotected sex acts (Mean=18.9), and 3) lower risk in all domains. Among females, clusters were distinguished by 1) frequent unprotected sex acts (Mean=64.2), 2) frequent substance use and a history of suicide attempts (54%) or psychiatric hospitalization (36%), and 3) lower risk in all domains. Cluster membership was associated with several demographic and life context variables. Conclusions: Even within populations of high risk adolescents, subgroups exist for which specific risk factors co-occur, particularly sexual risk, a history of suicide attempts or psychiatric hospitalization, 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.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Identify subgroups of adolescents at high-risk for unprotected sex based on the occurence of other risk behaviors.
• Articulate the importance of a history of suicide attempts and psychiatric hospitalization in its association with sexual risks.
• Discuss HIV prevention intervention strategies that acknowledge the role of non-sexual risk behaviors.

Keywords: Sexual Risk Behavior, Adolescents

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation