High-Risk Subgroups for Teens at Risk for HIV

Teens who engage in unsafe sex exhibit different patterns of behavior, with some subgroups at a significantly higher risk of HIV infection than others, results from a new study show.

To determine whether it is possible to characterize different subgroups among at-risk youth, Dr. Christopher D. Houck of the Bradley/Hasbro Children's Research Center in Providence, R.I., and colleagues surveyed 1,153 people ages 15-21 who reported having unprotected sex in the past 90 days. Three distinct subgroups were found among boys: those who had mental health crises and frequently engaged in unprotected sex (10 percent of males); those who used alcohol and marijuana and had unprotected sex (about half the group); and a lower-risk group that engaged in unprotected sex less frequently. Boys in the first group averaged about 27 unprotected sex acts in the past 90 days, compared to about 19 for the second group and 7 for the third group.

Risk factors were different for girls. Fourteen percent reported having had unprotected sex 64 times in the past 90 days, though they did not report heavy drug and alcohol use or mental health crises. Eleven percent reported 13 acts of unprotected sex during the past 90 days and higher drug and alcohol use and more mental health crises. The remaining 75 percent of girls reported about eight events of unprotected sex and did not report heavy substance use or mental health crises.

Houck noted that 43 percent of the girls in the first group were living with their sexual partner, which may explain the high number of reported unprotected sex. However, he said, the reasons behind the other patterns revealed by the study were not so easily explained.

The findings suggest that prevention programs tailored to the needs of these subgroups could be more apt to succeed, said Houck. "If we can develop programs to target adolescents' sexual risk in the context of having mental health crises, or also using substances, those are the ways that we're more likely to have an effect on their risk behavior," he said.

"We have to really understand who the audience for these programs is, the better we understand that audience the more we can target the programs to them," Houck added.

The study, "'Islands of Risk': Subgroups of Adolescents at Risk for HIV," was published in the Journal of Pediatric Psychology (2006;31(6):619-629).

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