Leah J. Floyd

Peer and sibling substance use: predictors of substance use among adolescents in Mexico

OBJECTIVE To examine the extent to which peer drug use and sibling drug use predict alcohol abuse/dependence disorder status and the use of drugs other than alcohol among school-based youth in Mexico. METHODS Data were collected on 1 203 middle and high school students in northern Mexico in May 1998. Participation was voluntary, and responses were confidential. Logistic regression analyses estimated the association that peer drug use and that sibling drug use had with alcohol abuse/dependence diagnosis and the lifetime use of drugs other than alcohol. RESULTS Students who had siblings or peers who used alcohol and other drugs were more likely to meet the standard alcohol abuse/dependence criteria defined by the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), and were more likely to have used drugs other than alcohol. Controlling for potentially important confounders, we found that adolescents with the highest level of peer substance use were eight times as likely to meet alcohol abuse/dependence criteria and four times as likely to use other drugs. Youth who had siblings who used drugs were about twice as likely to meet alcohol abuse/dependence criteria and about 2.5 times as likely to use drugs other than alcohol when compared to youth with no sibling substance use. CONCLUSIONS Consistent with extant findings among youth in the United States of America, peer and sibling substance use are major risk factors for substance use among school-based youth in Mexico. Students in Mexico may benefit from prevention strategies found to be effective among students in the United States.

Patterns of illegal drug use among an adult alcohol dependent population: Results from the National Survey on Drug Use and Health

The use of illegal drugs is common in alcohol dependence and significant psychological and social consequences are associated with the concurrent use of alcohol and illegal drugs. However, little literature has examined the patterns of concurrent-drug use in alcohol dependent individuals. A latent class analysis (LCA) was used to determine whether patterns of past year illegal drug use existed in a national sample of 6059 alcohol dependent respondents of the combined 2005, 2006 and 2007 National Survey on Drug Use and Health. Multinomial logistic regression was then used to determine whether demographic variables, mental health disturbance and social consequences were predictive of drug use classes. Results of the LCA demonstrated a 5-class solution with optimal fit deduced by Bayesian Information Criterion minima. The five classes included: a close to zero probability of illegal drug use (class 1: 65%), medium marijuana, medium sedatives/tranquilizers and high analgesics (class 2: 7%), high marijuana, medium cocaine use (class 3: 21%), high probabilities of marijuana, cocaine, sedatives and analgesic use (class 4: 6%) and a high concurrent-drug use except other hallucinogens (class 5: 1%). Regression results suggest that younger age, comorbidity, engaging in deviant behaviors, sexually transmitted infection and incarceration are associated with concurrent illegal drug use in alcohol dependent individuals. Findings advocate that more intense psychiatric and drug dependence treatment resources may be needed for concurrent-drug using alcohol dependent populations and provide evidence for targeted prevention and treatment interventions.

Screening for “Substance Abuse” Among School-Based Youth in Mexico Using the Problem Oriented Screening Instrument (POSIT) for Teenagers

Indices of classification accuracy of the Substance Use/Abuse scale of a Spanish-language version of the Problem Oriented Screening Instrument for Teenagers (POSIT) were evaluated among school-based youth in Mexico. Participants were 1203 youth attending one middle school (N = 619) and one high school (N = 584) in the third largest city of Coahuila, a northern border state in Mexico in May 1998. More than 94% of youth enrolled in the participating middle school and 89% of youth enrolled in the participating high school completed the International Longitudinal Survey of Adolescent Health. Indices of classification accuracy of the POSIT Substance Use/Abuse scale were evaluated against a “drug abuse” problem severity criterion that combined youth meeting DSM-IV criteria for alcohol abuse/dependence disorders with youth having used other illicit drugs five or more times in their lifetime. The present study findings suggest that using a cut score of one or two on the POSIT Substance Use/Abuse scale generally yields optimal classification accuracy indices that vary somewhat by gender and school subgroups. Further, classification accuracy indices of the POSIT Substance Use/Abuse scale are slightly better when used among high school males due, in part, to the higher base rate of serious involvement among this group compared to others.

Adolescent drug dealing and race/ethnicity: A population-based study of the differential impact of substance use on involvement in drug trade

Background: Among adolescents, peers are an important source of drug procurement. However, little is known about factors associated with youths’ involvement in drug trade. Objectives: The aim of the study is to identify substance use behaviors and contextual factors related to drug dealing among Black and White adolescents. Methods: The sample consisted of 13,706 White and Black youths who completed the National Survey on Drug Use and Health. Separate backward logistic regression was used to identify substance use behaviors and contextual factors associated with drug dealing among Black and White youths. Results: Among White youths, drug dealing was associated with use of marijuana, hallucinogens, cocaine, prescription drug misuse, availability of cocaine, and socioeconomic status (SES). Among Black youths, marijuana use and availability of crack and marijuana were associated with drug dealing. Conclusions and Scientific Significance: For White youths, substance use seems to be more relevant to drug dealing. Consequently, preventing and treating substance abuse may reduce involvement in the illegal distribution of drugs among White youths. More research is needed to identify risk and protective factors for drug dealing among Black adolescents.

The Association Between Poly-Substance Use, Coping, and Sex Trade Among Black South African Substance Users

The current study examined the relationship between poly-substance use and sex trade among 343 black South African substance users recruited from the Pretoria region between 2002 and (57% males; mean age 24 years). The assessment comprised a HIV-risk behavior interview, urinalysis to confirm self-report of drug use, and an HIV test. Logistic regression analyses indicated poly-substance use was positively associated with sex trade among persons using drugs to cope with stress. Results indicate the importance of considering coping strategies as modifiable psychosocial factor related to sexual risk-taking behaviors and substance use. The studys implications and limitations are discussed.

Examining Racial/Ethnic Disparities in Sexually Transmitted Diseases Among Recent Heroin-Using and Cocaine-Using Women

BACKGROUND This study examined racial differences in the prevalence of sexual risk behaviors and their associations with sexually transmitted diseases (STDs) among recent heroin-using and cocaine-using women. METHODS Participants were 214 women (59% black, 41% white) who were recruited during 2002-2010 using targeted sampling to participate in a study in Baltimore, Maryland, and reported using heroin, cocaine, or crack during the previous 6 months. Participants completed self-report questionnaires about their drug use, sexual risk behaviors, and lifetime history of one of six STDs, including gonorrhea, syphilis, chlamydia, genital herpes, genital warts, or trichomoniasis. RESULTS More black women (50%) than white women (28%) reported a lifetime STD. Although there were no racial differences in the lifetime prevalence of sexual risk behaviors assessed, there were racial differences in the sexual behaviors associated with ever having a lifetime STD. Simple logistic regressions revealed that ever having a casual sex partner or anal sex were correlates of having a lifetime STD among black women but not among white women. Multiple logistic regression analyses revealed that ever having a casual sex partner was significantly associated with having a lifetime STD among black women, and ever trading sex for money was significantly associated with having a lifetime STD among white women. CONCLUSIONS Findings are consistent with national studies and elucidate racial disparities in STDs and associated sexual behaviors among recent heroin-using and cocaine-using women. Findings underscore the need to tailor STD prevention interventions differently for black and white recent heroin-using and cocaine-using women.

Prevalence and correlates of Hepatitis C among injection drug users: The significance of duration of use, incarceration and race/ethnicity.

The study examined associations between hepatitis C (HCV) seropositivity and a lifetime history of jail or correctional facility incarceration among injection drug users. The sample consisted of 351 injection drug users recruited in inner-city neighborhoods of Baltimore. Multiple logistic regressions were fit to assess associations between HCV seropositivity and a lifetime history of incarceration for the total sample and stratified by race. Analyses demonstrated HCV nearly two times greater for whites than African Americans. In addition, HCV was 2.6 times greater in participants incarcerated in correctional facilities and HCV was 7.4 times greater in participants reporting more than 5 years of injection drug use compared to participants reporting less than 1 year of injection drug use. The study findings suggest that incorporating systematic HCV screening, prevention, and treatment programs within correctional systems represents a vital yet under-utilized strategy to reduce HCV transmission in society as a whole.

Adolescent sexual behaviors at varying levels of substance use frequency.

Combining substance use and sex compounds the risk of contracting sexually transmitted diseases, including HIV. However, the association between substance use and sexual behaviors may vary by substance and sexual behavior. The current study sought to examine the relationship between alcohol and marijuana use frequency and specific sexual behaviors. The International Longitudinal Survey of Adolescent Health was administered to 1432 youths in one middle school and one high school in Minnesota. Results from logistic regression analyses indicated a relationship between alcohol and marijuana use and being sexually active. However, only marijuana use was associated with having multiple partners. To aid researchers in designing more effective HIV prevention interventions, future research should focus on understanding the differential effects of alcohol and marijuana on sexual behaviors.

Adolescent Substance Abuse in Mexico, Puerto Rico and The United States: Effect of Anonymous versus Confidential Survey Formats.

SUMMARY Anonymous surveys have been widely used worldwide to describe adolescent substance use yet cannot elucidate causal drug abuse predictors. Studies in the U.S. have generally found that anonymous and confidential surveys yield comparable levels of self-reported substance use, yet the effect of survey format on youth self-report has not been evaluated in other countries. The present study compared data from the confidential International Longitudinal Survey of Adolescent Health with anonymously collected survey data on alcohol and marijuana use among school-based youth in Mexico, Puerto Rico, and the U.S. The findings suggest that confidential surveys yield valid self-reports of adolescent substance use.

The moderating influence of cognitive performance on risk awareness to predict HIV/AIDS risk-taking behaviors

Conclusion This finding refines the application of the protection motivation theory by specifying that risk awareness alone is insufficient to predict protective behaviors. Above average cognitive performance combined with risk awareness reduced HIV/AIDS risk behaviors. Future research should explore the causal mechanisms linking the interaction between risk awareness and cognitive performance in predicting a reduction in risk behaviors. from 2006 International Meeting of The Institute of Human Virology Baltimore, USA. 17–21 November, 2006