Academic journal article Journal of Alcohol & Drug Education

Latent Model Analysis of Substance Use and HIV Risk Behaviors among High-Risk Minority Adults

Academic journal article Journal of Alcohol & Drug Education

Latent Model Analysis of Substance Use and HIV Risk Behaviors among High-Risk Minority Adults

Article excerpt

Abstract

Objectives: This study evaluated substance use and HIV risk profile using a latent model analysis based on ecological theory, inclusive of a risk and protective factor framework, in sexually active minority adults (N=1,056) who participated in a federally funded substance abuse and HIV prevention health initiative from 2002 to 2006.

Methods: Data were collected locally from community-based organizations using a common baseline instrument that was administered within 30 days of program entry. The latent variables included were social support; neighborhood attachment; family cohesion; intimate abuse; alcohol tobacco/other drugs (ATOD) use; and HIV risk behaviors.

Results: The model-fit indices met acceptable standards for African Americans (CFI = 0.962, TLI = 0.956, RMSEA = 0.033) and for Hispanic/Latinos (CFI = 0.927, TLI = 0.917, RMSEA = 0.047). For African Americans, neighborhood attachment was significantly related to intimate abuse (coefficient = .126, p<.01) and family cohesion (coefficient = .281, p<.01). Social support was not significantly related to either family cohesion or intimate abuse. Family cohesion was negatively related to ATOD use, which was also related to sex with risk partners and drug-related sex. For Hispanics, neighborhood attachment was significantly related to intimate abuse (coefficient = .209, p<.01) and family cohesion (coefficient = .209, p<.01). Social support was significantly related to family cohesion (coefficient = .274, p<.01), but not related to intimate abuse. Intimate abuse was negatively related to ATOD use.

Conclusions: The results support the inclusion of protective factors as a standard implementation approach for prevention programs targeted to the reduction of ATOD use and HIV risk among sexually active minority adults.

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Since the first report of HIV 25 years ago, worldwide more than 65 million persons have been infected with HIV and more than 25 million have died of AIDS (Merson, 2006). Moreover, AIDS is now the leading cause of premature death among people 15 to 59 years of age. Through 2005, a total of 249,950 persons were reported as having HIV infection (not AIDS) and 956,019 persons had been reported as having AIDS in the United States (CDC, 2005). Among the several routes of transmission, drug use/abuse has been an important mode of transmission of HIV/ AIDS in the United States and around the world. Persons who use substances participate in behaviors that place them and others at substantial risk for HIV/AIDS infections (Brown et al, 2006; Francis, 2003). Drug use behaviors that contribute to HIV transmission include sharing contaminated injection equipment, risky sexual behaviors among injection drug users or their noninjecting sex partners, and perinatal transmission to their offspring (Winstanley, Gust, & Strathdee, 2006). For example, injection drug use was the mode of transmission in approximately 17% of the HIV diagnoses reported among adolescents and young adults aged 13 to 24 (Center for Disease Control and Prevention, 2004). Previous studies have attempted to identify risk factors for needle sharing among injection drug users. Most studies, however, have focused on demographic and psychosocial characteristics of the individual (Unger et al, 2006). In addition, correlational research suggests that substance use is associated with increased HIV-related risk taking (Carey et al, 2003). The study by Carey and colleagues (2004) found that intoxicated men had less favorable condom attitudes and reported lower self-efficacy to initiate condom use in comparison to their sober counterparts. In a follow-up study, they found that men who drank alcohol demonstrated a lower skillfulness in negotiating for condom use relative to their sober counterparts. Finally, in a recent study, results indicated that men who drank alcohol had poorer negotiation skills and greater intentions to engage in risky sex than those who did not consume alcohol (Maisto et al 2004a; 2004b). …

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