Out of school and on the streets: HIV risk among young substance abusing African American women

Background: Young African American women are at high risk for HIV infection. The Young Women's CoOp is a five-year, CDC-funded randomized trial to adapt an evidence-based HIV prevention intervention (Women's CoOp) and test its efficacy among high-risk African American young women aged 16 to 19. Methods: A total of 237 young African American women (mean age 17.6 years) were enrolled in an HIV/STI prevention intervention located in Raleigh and Durham, North Carolina. At study enrollment, participants completed a computer-based interview and biological testing for alcohol, drugs and pregnancy. Baseline data were analyzed using descriptive methods. Results: Two-thirds (66%) of the young women dropped out of school at least once, and 32% dropped out multiple times (mean=1.5, range 1-14). Forty percent reported consuming 3 to 4 drinks per occasion; 76% reported any drug use in the past month; and 44% tested positive for marijuana, 4% for cocaine, and 2% for opiates. Thirty percent had children and 7% had a positive pregnancy test. Compared to young women never reporting homelessness, those who had ever been homeless (26%) were significantly more likely to report higher levels of alcohol consumption; physical and sexual abuse; forced vaginal, anal or oral sex; and prior arrest. Conclusion: At-risk African-American young women, particularly those who report homelessness, are exposed to a myriad of social factors that can increase their risk for HIV. It is critical that prevention interventions, like the Young Women's CoOp, address social determinants to improve the health and well-being of at-risk young African American women.