Predicting the Onset of Sexual and Drug Risk Behaviors in HIV-Negative Youths with HIV-Positive Mothers: The Role of Contextual,Self-Regulation,and Social-Interaction Factors

HIV-negative, inner-city adolescents with HIV-infected parents are considered to be at high risk for acquiring HIV themselves. Using a modified theory of health behavior, this study examined the effects of maternal HIV infection and psychosocial variables on the onset of sexual and drug risk behavior in 144 HIV-negative adolescents with and without HIV-positive mothers. Adolescents and their mothers were interviewed when the youths were 10–14 years old and again when they were 13–19 years old. By follow-up, 42% of youths reported the onset of vaginal sex (vs 5% at baseline). Marijuana and alcohol use increased from 6 and 38%, respectively, at baseline to 25 and 60% at follow-up. Among those reporting risk behaviors, 40--50% reported onset prior to 14 years. Youth and family psychosocial variables, but not maternal HIV status, were associated with risk behaviour outcomes. Claude A. Mellins research interests include mental health, psychosocial, and public effects of maternal and pediatric HIV; interventions for HIV-affected families; and adherence. Curtis Dolezal research interests include HIV-related sexual behavior in a variety of populations with a particular emphasis on methodology/measurement issues. Elizabeth Brackis-Cott research interests include impact of HIV/AIDS on the lives of children and families directly affected by the disease. Ouzama Nicholson research interests include international public health and pediatric HIV infection and operational issues in developing effective prevention of mother-to-child transmission of HIV infection and pediatric HIV care programs. Patricia Warne research interests include program development, structural interventions for HIV, and policy. Heino F. L. Meyer-Bahlburg research interests include psychosexual assessment, the development and determinants of sexual risk behavior, and the effects of HIV disease on sexual functioning.     

Key Risk Factors for Relapse and Rearrest Among Substance Use Treatment Patients Involved in the Criminal Justice System

Substance use treatment programs for criminal justice populations have great potential for crime reduction, if they can effectively manage patients’ risk for relapse and rearrest. The current study used data drawn from the Comprehensive Assessment and Treatment Outcome Research (CATOR) system, a national registry of substance use treatment programs, which collected patient outcome data at 6- and 12-month intervals following discharge from treatment. The primary objective was to examine sets of factors that may compromise relapse and rearrest outcomes among patients who were court mandated to participate in treatment. Findings demonstrated that patients’ clinical severity of substance use was associated with relapse, which also significantly increased the probability of post-treatment arrest. Adolescent risk behaviors represented another set of risk factors, particularly among patients who experienced the most severe pattern of relapse and arrest outcomes. Additionally, demographic risk factors, including age, marital status (i.e., single or unmarried relative to married), employment (i.e., being unemployed compared to employed), and lower educational attainment were consistently linked to higher probabilities of relapse and rearrest. Treatment programs for criminal justice populations should consider incorporating appropriate clinical risk assessment measures, behavioral risk assessments, and appropriate employment interventions into standard treatment programming in an effort to improve outcomes.