Prevention for Substance-Using HIV-Positive Young People

Abstract

HIV risky behaviors and health practices were examined among young people living with HIV (YPLH) in Los Angeles, San Francisco, and New York over 15 months in response to receiving a preventive intervention. YPLH aged 16 to 29 years (n = 175; 26% black and 42% Latino; 69% gay men) were randomly assigned to a 3-module intervention totaling 18 sessions delivered by telephone, in person, or a delayed-intervention condition. Intention-to-treat analyses found that the in-person intervention resulted in a significantly higher proportion of sexual acts protected by condoms overall and with HIV-seronegative partners. Pre- and postanalyses of YPLH in the delayed-intervention condition alone found that YPLH tended to have fewer sexual partners, used fewer drugs, reported less emotional distress, and decreased their use of antiretroviral therapies. Prevention programs can be delivered in alternative formats while retaining efficacy. When YPLH are using hard drugs, drug treatment may be needed before delivery of preventive interventions.

Predictors of HIV-related stigma among young people living with HIV.

“…Young women living with HIV would appear to benefit from targeted interventions that help them cope with their own feelings and fears about their HIV infection, which may be exacerbated by higher rates of emotional distress. The YPLH in this study have high levels of emotional distress (see Rotheram-Borus et al, 2004). Depressed persons make global, stable, and internal attributions about negative events.…”

Longitudinal Patterns of Methamphetamine, Popper (Amyl Nitrite), and Cocaine Use and High-Risk Sexual Behavior Among a Cohort of San Francisco Men Who Have Sex with Men

“…At least one intervention has been shown to be effective in reducing HIV risk and drug use among younger persons. 24 The within-participant evidence for increases in high-risk sexual behavior during reporting periods characterized by increased use of methamphetamine, poppers, or sniffed cocaine suggests that, to reduce and prevent HIV, no level of use of these drugs should be considered "safe". There was no dose-response for drug use scores above 2, indicating that even intermittent, recreational use of these drugs is associated with high-risk sexual behavior.…”

Who Benefited from an Efficacious Intervention for Youth Living with HIV: A Moderator Analysis

“…From 1999 to 2002, 175 YPLH aged 16 to 29 years (26% African American, 42% Latino; 69% gay young men; Table 1) were recruited with voluntary informed consent in Los Angeles, San Francisco, and New York City (Rotheram-Borus et al, 2004). Across cities, YPLH were recruited from medical providers, social service agencies, needle-exchange programs, a drugtreatment center, other research studies, outreach on the street or at special events, and through newspaper advertisements and word-of-mouth.…”

“…A full description of the study procedures are reported elsewhere (Rotheram-Borus et al, 2004). The intervention consisted of three modules of six sessions each and each session was approximately 2 h long.…”

“…Given the rising rates of HIV infection among young people, it is clear that secondary prevention targeting HIV-positive youth is needed to reduce transmission of the virus (Rotheram-Borus, O'Keefe, Kracker, & Foo, 2000). A successful intervention for young people living with HIV (YPLH) has shown efficacy in reducing the number of sexual partners, increasing the percentage of protected sexual acts, and increasing disclosure of HIV-positive status to sexual partners (CLEAR intervention) (Rotheram-Borus et al, 2004).…”