Psychosocial Factors and Substance Use in High-Risk Youth Living With HIV: A Multi-Site Study

The team undertook the current study to test relationships between psychosocial factors and alcohol and illicit drug use among high-risk youth living with HIV (YLH). In five cities, 186 YLH (ages 16-24) classified as high-risk (defined as having problems with substance use, sexual risk or medication adherence) were enrolled.

An alcohol, smoking and substance involvement screening test and a timeline follow-back interview were used to assess subjects' use of alcohol and illicit drugs. Constructs from the adapted Transtheoretical Model (TTM), including a continuous measure of motivational readiness in response to criticism of the stage component, were assessed by questionnaire. Path analysis was employed to fit cross-sectional data collected via computer-assisted personal interviewing (baseline data from intervention study). Separate models were fit for each commonly used substance.

The results indicated that in the previous month, 47 percent of YLH used alcohol, 37 percent used cannabis, and 9 percent used other illicit drugs. "Path models fit the data well and accounted for 30 percent of the variance in alcohol use and 47 percent in cannabis use," the authors wrote.

"Higher self-efficacy predicted lower alcohol and cannabis use, but motivational readiness was only directly related to cannabis use," the team concluded. "A reduction in pros of substance use was indirectly related to use. Social support and psychosocial distress were associated with TTM constructs. Interventions focusing on improving motivation and self-efficacy for healthy behaviors may reduce substance use in YLH."

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