Alcohol and drug use differences by behaviorally versus perinatally HIV-infected adolescents in care

Background:Substance use among HIV-infected adolescents is associated with sexual transmission-risk-behavior and suboptimal antiretroviral-therapy adherence. Since little is known about substance use patterns among HIV-infected youth, particularly in relation to mode of HIV-acquisition, understanding specific substances they are using will help inform intervention efforts around HIV-self-care. Methods:Eighteen HIV-infected adolescents in care completed a survey as part of a 2010/2011 pilot study, including questions on demographics, substance use, and route of HIV infection (i.e., perinatal/mother-to-child versus behavioral). Frequencies were calculated to determine the past 6-month prevalence of (1)binge drinking≥1 times/week; (2)marijuana use≥1 times/week; and (3)use of other drugs. Fisher's exact tests were conducted to determine differences in substance use by route of infection. Results:The mean age of the sample was 20 years (min=14/max=24). 61.1% reported drinking alcohol, 22.2% reported binge drinking, and 66.7% reported using marijuana—all at least weekly. Additionally, 38.9% reported using drugs other than marijuana (e.g., methamphetamine, cocaine, hallucinogens, etc.). Half of the sample was infected perinatally and half behaviorally through sexual behavior. There were no differences by route of HIV infection for binge drinking (p=0.08) or marijuana use (p=0.131). For other drugs, 66.7% of those who were behaviorally infected (n=6/9) used drugs, whereas 11.1% of those who were perinatally infected (n=1/9) did (OR=16.0;p=0.04). Conclusions:Alcohol and drug use in the sample was high. Those who became infected with HIV perinatally were less likely to use drugs than those who acquired HIV through sexual behavior. Interventions targeting self-care among HIV-infected youth should consider route of infection in relation to risk behaviors.