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Denise Hallfors, Bonita Iritani, Daniel Bauer, Carolyn Halpern, Martha Waller

STD/HIV Risk from Adolescence to Adulthood: Longitudinal Risk Behavior Patterns and Infection Status. Denise Hallfors, Bonita Iritani, Daniel Bauer, Carolyn Halpern, Martha Waller Funded by NIH-NIDA, Denise Hallfors, PI. National Longitudinal Study of Adolescent Health (Add Health).

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Denise Hallfors, Bonita Iritani, Daniel Bauer, Carolyn Halpern, Martha Waller

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  1. STD/HIV Risk from Adolescence to Adulthood: Longitudinal Risk Behavior Patterns and Infection Status Denise Hallfors, Bonita Iritani, Daniel Bauer, Carolyn Halpern, Martha Waller Funded by NIH-NIDA, Denise Hallfors, PI

  2. National Longitudinal Study of Adolescent Health (Add Health) • Nationally representative sample • Survey of adolescents in Grades 7-12 (Wave I,1995) • Wave II conducted about 1 year later • Wave III conducted in 2002 • HIV, chlamydia, gonorrhea, trichomoniasis bio-assays collected at Wave 3 • 10,776 youth were included in all three waves, had valid sample weights, and data on key variables

  3. Purpose • Examine the persistence (Wave I-II) of sex and drug behaviors among adolescents • Describe the prevalence of HIV and other STDs among young adults (Wave III), by behavior pattern • Trace the modal behavior pathways associated with HIV/STD infection, from young adulthood (Wave III) to adolescence (Wave II).

  4. Risk Behavior Clusters (K-Means) • Clustered individuals by sex and drug behavior patterns • Used 12 Variables: type, frequency, risk • 4 a priori clusters (Abstainers, IV Drug Users, MSM, Sex for Drugs or Money) • Derived 12 clusters analytically, using K-Means • Assigned each adolescent to one cluster only • Compared 4- to 16-cluster solutions within and across sex, race, and age groups • About 80% of variance accounted for by 16 clusters • Clusters replicated at Wave II

  5. MSM .20 MSM IV Drug Users .17 IV Drug Users Marijuana & Other Drugs .10 Marijuana & Other Drugs Sex for Drugs or Money .09 Sex for Drugs or Money Multiple Partners .02 Multiple Partners WAVE1 High Marijuana & Sex .27 High Marijuana & Sex WAVE2 Marijuana Users .26 Marijuana Users Heavy Dabblers .29 Heavy Dabblers Sex & Drugs Combined .24 Sex & Drugs Combined Binge Drinkers .20 Binge Drinkers Grade 7-12 Grade 8-12 Alcohol & Sex Dabblers .30 Alcohol & Sex Dabblers Smokers .42 Smokers Drinkers .38 Drinkers Sex Dabblers .51 Sex Dabblers Light Substance Dabblers .62 Light Substance Dabblers Abstainers .65 Abstainers

  6. MSM MSM IV Drug Users IV Drug Users Marijuana & Other Drugs Marijuana & Other Drugs Sex for Drugs or Money Sex for Drugs or Money Multiple Partners Multiple Partners WAVE1 High Marijuana & Sex High Marijuana & Sex WAVE2 .14 Marijuana Users Marijuana Users Heavy Dabblers Heavy Dabblers .14 Sex & Drugs Combined Sex & Drugs Combined Binge Drinkers Binge Drinkers Alcohol & Sex Dabblers .12 Alcohol & Sex Dabblers Smokers Smokers Drinkers Drinkers Sex Dabblers Sex Dabblers .13 Light Substance Dabblers Light Substance Dabblers .19 Abstainers Abstainers

  7. MSM MSM IV Drug Users IV Drug Users Marijuana & Other Drugs Marijuana & Other Drugs Sex for Drugs or Money Sex for Drugs or Money .36 .17 Multiple Partners Multiple Partners .21 WAVE1 High Marijuana & Sex .21 High Marijuana & Sex WAVE2 Marijuana Users Marijuana Users .10 Heavy Dabblers .22 Heavy Dabblers .23 Sex & Drugs Combined Sex & Drugs Combined Binge Drinkers .15 Binge Drinkers Alcohol & Sex Dabblers Alcohol & Sex Dabblers .23 Smokers Smokers Drinkers Drinkers .19 Sex Dabblers .18 Sex Dabblers Light Substance Dabblers Light Substance Dabblers Abstainers Abstainers

  8. STI/HIV Infection .05 .07 .05 .06 .07 .17 .09 .06 .09 .11 .06 .13 .11 Sexually Active, Few Partners, Low ATOD Light Alcohol & Sex Smokers Regret AOD w/ Sex, Mod. AOD Regret AOD w/ Sex, High AOD Heavy Dabblers Marijuana Users High Marijuana & Sex Multiple Partners Sex for Money Marijuana & Other Drugs IV Drug Users MSM WAVE3 (Ages 18-26)

  9. STI/HIV Infection .11 .17 .13 .11 WAVE3 Sexually Active, Few Partners, Low ATOD (19%) Sex for Money IV Drug Users MSM .19 .22 .31 WAVE2 Abstainers Light Substance Dabblers Sex Dabblers Drinkers Smokers Marijuana Users MSM

  10. STI/HIV Infection .11 .17 .13 .11 WAVE3 Sexually Active, Few Partners, Low ATOD Sex for Money (2%) IV Drug Users MSM .22 .22 WAVE2 Abstainers Light Substance Dabblers Sex Dabblers Drinkers Smokers Marijuana Users MSM

  11. STI/HIV Infection .11 .17 .13 .11 WAVE3 Sexually Active, Few Partners, Low ATOD Sex for Money IV Drug Users (1%) MSM .10 .12 .25 WAVE2 Abstainers Light Substance Dabblers Sex Dabblers Drinkers Smokers Marijuana Users MSM

  12. STI/HIV Infection .11 .17 .13 .11 WAVE3 Sexually Active, Few Partners, Low ATOD Sex for Money IV Drug Users MSM (1%) .17 .13 .21 WAVE2 Abstainers Light Substance Dabblers Sex Dabblers Drinkers Smokers Marijuana Users MSM

  13. Conclusions • Most adolescents engage in no, or low levels, of sex and drug behaviors • Adolescents who engage in risky behavior rarely persist in a set behavior pattern. Rather, they tend to move back towards more normative behavior patterns. • In young adulthood, both normative and high risk groups are susceptible to HIV/STD infections.

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