Parents, peers, and sexual risk in African American youth: The role of substance use

Background: African American youth are disproportionately affected by the HIV epidemic in the US. Understanding youth's larger context in addition to individual-level factors may inform HIV/STI risk reduction programs. We prospectively examined the contribution of parent and peer factors on youth's sexual risk trajectories, and the mediating influence of alcohol and other drug (AOD) use, in a sample of African American, urban youth followed across the four high school years (N=680; 50% female). Methods: Growth curve modeling was used to estimate changes in AOD and sexual risk across adolescence and to test the association of these risk behaviors to parent and peer factors. We employed a path analytic strategy to examine the direct effects of parent and peer factors as well as their indirect effects over time via AOD use. Results: Parent and peer risk factors were associated with increasing AOD use as youth aged. We found evidence to suggest partial mediation of AOD use on the relationship between peer and parent factors and youth condom use. The association between family and peer risk factors and condom use across adolescence was mediated by youth AOD use. Parent and peer protective factors were directly associated with condom use, after accounting for youth AOD. Conclusions: Study findings highlighted the importance of considering multiple influences in youth sexual risk behavior. Our findings also underscore that parent-child relationships during adolescence are renegotiated rather than replaced by peer relationships. Youth HIV risk prevention programs may benefit from directly including both peers and parents.