 |
|||||||||||
Figure 6-50 shows the percentage of youth who indicated they have ever
been physically harmed by a sex partner.
 |
Figure 6-50. Ever physically hurt by a sex partner (N=115 males, N=66 females).
About one in three females and one in six males reported having been hurt by a sex partner.
In light of the rates of reported abuse in this section, it should be noted that data on this phenomenon tend to underreport the prevalence of such problems.
Health and Medical History
To capture the health and medical history of respondents in this sample, a detailed
set of questions were asked about overall health, specific illnesses, symptoms experienced
for multiple systems in the body, and medications taken. Figures 6-51 through 6-64
describe some of these medical indicators. Figure 6-51 shows the clients’ ranking of
his or her health.
 |
Figure 6-51. Clients’ rating of overall health (N=152 males, N=159 females).
Approximately three-fourths of the youth rated their physical health as "excellent" or "good."
Figure 6-52 summarizes the youths’ history of having ever been diagnosed with a set of opportunistic infections and other health indicators related to HIV disease.
 |
Figure 6-52. Lifetime history of specific HIV-related health indicators (N=152 males, N=159 females).
About two out of three males and over half of the females reported having had a TB test in the past year.
In Figures 6-53 through 6-58, the respondents’ histories of having experienced a range of HIV-related symptoms are summarized. Figure 6-53 addresses whether clients had ever experienced any chronic symptoms.
 |
Figure 6-53. Ever had chronic symptoms (N=152 males, N=159 females).
Less than a third of the males and one out of five females indicated that they suffered from chronic fatigue.
Males were more than two times as likely as females to have reported having had night sweats, fevers, and enlarged lymph nodes.
Figure 6-54 summarizes the clients’ history of symptoms related to the head, eyes, nose, and throat.
 |
Figure 6-54. Ever have problems with head/eyes/mouth/throat (N=152 males, N=159 females).
Approximately two in five youth have suffered serious headaches.
One in 10 males reported having thrush.
Figure 6-55 summarizes the youths’ experience with sexually transmitted diseases and urinary infections.
 |
Figure 6-55. Ever have STD and urinary infections (N=152 males, N=159 females).
About one respondent in 10 reported having ever had a sexually transmitted disease.
Females were more likely to report having ever had gonorrhea, chlamydia, syphilis, urinary tract infection, and yeast infection. (Please note that this is probably due to the fact that women tend to exhibit symptoms for these STD’s more frequently than men).
Figure 6-56 shows the prevalence of respiratory problems reported by the youth who were interviewed.
 |
Figure 6-56. Ever have had lung or breathing problems (N=152 males, N=159 females).
About one in six respondents reported respiratory problems.
In Figure 6-57, two indicators of the clients’ histories of stomach and digestive problems are summarized.
 |
Figure 6-57. Ever have stomach or bowel problems (N=152 males, N=159 females).
Less than three out of 10 respondents stated that they experienced pain in their stomach or abdomen.
Approximately one in five males reported having experienced chronic or recurrent diarrhea.
Figure 6-58 summarizes the percentage of youth who indicated a history of nerve or muscle problems.
 |
Figure 6-58. Ever have nerve or muscle problems (N=152 males, N=159 females).
Approximately three out of 25 respondents reported a history of limb weakness.
Figure 6-59 summarizes the percentage of males and females who reported having ever taken a number of HIV-related medications.
 |
Figure 6-59. Ever taken any of the above medications (N=152 males, N=159 females).
Males were more than three times as likely as females to have reported taking zidovudine (AZT).
Figure 6-60 summarizes the responses concerning the youths’ history of taking prophylactic medications.
 |
Figure 6-60. Ever taken any of these medications to prevent the following conditions (N=152 males, N=159 females).
- More than one out of 10 males reported having taken Bactrim for PCP prophylaxis.
- Approximately one out of 10 males have taken Acyclovir to prevent herpes infection.
- Close to one in five female have taken medication to prevent a yeast infection.
Figure 6-61 summarizes the reported prevalence of selected gynecological problems among the females interviewed.
 |
Figure 6-61. Ever have these gynecological problems (N=159 females).
Less than one out of five females reported having an abnormal Pap smear.
Figure 6-62 shows information about the pregnancy histories of the young women interviewed.
 |
Figure 6-62. Pregnancy history (N=159 females).
Two-thirds of the females have ever been pregnant.
Three out of five females indicated that they had at least one miscarriage.
The next section summarizes the reported prevalence of other health and mental health issues among the youth interviewed. This set of questions was an optional portion of the interview, and thus, responses are available from only a subset of youth. Figure 6-63 shows the distribution of the clients that have ever had one of the indicated health related conditions.
 |
Figure 6-63. Ever had any of the above health related conditions (N=127 males, N=67 females).
Approximately two out of five males and half of the female respondents stated that they had ever experienced psychological problems like depression, anxiety, or fear.
About one in three females indicated a history of family problems that required counseling. This compares with approximately one male in five who reported this in their history.
More than one out of 10 males reported having ever experienced a learning problem that required special help.
Figure 6-64, this same set of indicators is summarized for the youth as having occurred in the past six months.
 |
Figure 6-64. Health-related conditions in the past six months (N=127 males, N=67 females).
Approximately two out of five females and one out of four males reported an identifiable psychological problem in the past six months.
One out of four females indicated they had experienced family problems that required counseling in the past six months.
Characteristics of Youth Identified with HIV
The following section presents analyses of service needs and utilization based on
whether the youth are known to have HIV or not. Additional information based on HIV status
is included at the end of this chapter in the Technical Appendix to Chapter 6.
In Table 6-3, the self-reported service needs are compared for males known to be HIV-positive and those not identified as such.
Table 6-3
Self-reported Services Needed in the Last Six Months for
Young Males Who Are and Who Are Not Identified as Having HIV (N=153)
| Services Needed in Last 6 Months | Not Identified as Having HIV (N=116) |
Identified as Having HIV (N=37) |
|
| Counseling | 55.7% |
81.1% |
** |
| Visit to doctor, nurse, or health care provider | 48.9% |
83.8% |
** |
| Help for a medical problem at an ER | 21.1% |
32.4% |
|
| Overnight stay in a hospital | 11.1% |
18.9% |
|
| Prescribed medication | 61.8% |
78.4% |
|
| Alternative health care | 17.6% |
70.3% |
** |
| Help getting food and clothing | 33.8% |
29.7% |
|
| Long term housing | 22.2% |
32.4% |
|
| Overnight shelter or short term housing | 18.4% |
5.4% |
|
| Vocational training | 46.1% |
29.7% |
|
| Family counseling | 23.1% |
16.7% |
|
| Individual or group mental health services | 38.8% |
50.0% |
|
| Inpatient mental health services (overnight) | 5.4% |
11.1% |
|
| Residential treatment for alcohol or drugs | 11.0% |
27.8% |
* |
| Outpatient treatment for alcohol or drugs | 9.9% |
8.6% |
|
| Self-help or 12-step groups | 25.7% |
60.0% |
** |
| Case management | 39.4% |
71.4% |
** |
Asterisks indicate statistically significant differences across HIV status (* p<.05; ** p<.001).
Among males, a higher percentage of those identified as having HIV than those not identified as HIV-positive reported needing the following services:
Counseling
Medical care
Alternative therapy
Residential drug abuse treatment
Self-help groups
Case management
Table 6-4 illustrates the services reported as having been received in the past six months by males known to have HIV and those not identified as having HIV.
Table 6-4
Self-reported Services Received in the Last Six Months
for Young Males Who Are and Who Are Not Identified as Having HIV (N=153)
| Services Received in Last 6 Months | Not Identified has Having HIV (N=116) |
Identified as Having HIV (N=37) |
|
| Counseling | 43.6% |
55.6% |
|
| Visit to doctor, nurse, or health care provider | 55.7% |
86.5% |
** |
| Help for a medical problem at an ER | 25.8% |
34.3% |
|
| Overnight stay in a hospital | 14.3% |
18.2% |
|
| Prescribed medication | 64.3% |
81.8% |
|
| Alternative health care | 15.4% |
44.4% |
** |
| Help getting food and clothing | 30.2% |
29.4% |
|
| Long term housing | 16.1% |
8.8% |
|
| Overnight shelter or short term housing | 13.6% |
6.1% |
|
| Vocational training | 26.8% |
11.8% |
|
| Family counseling | 10.4% |
6.1% |
|
| Individual or group mental health services | 27.4% |
32.4% |
|
| Inpatient mental health services (overnight) | 6.3% |
3.0% |
|
| Residential treatment for alcohol or drugs | 9.2% |
25.7% |
* |
| Outpatient treatment for alcohol or drugs | 3.2% |
6.3% |
|
| Self-help or 12-step groups | 22.4% |
61.8% |
** |
| Case management | 38.8% |
57.1% |
Asterisks indicate statistically significant differences across HIV status (* p<.05; ** p<.001).
Among males, a higher percentage of those identified as HIV-positive than those not identified as such reported receiving the following medical services:
- Medical care
- Alternative therapy
- Residential drug abuse treatment
- Self-help groups
- Case management
Table 6-5 compares the services reported as needed to those reported as received by males known to have HIV.
Table 6-5
Self-reported Services Needed and Received in the
Last Six Months for Young Men Who Are Identified as Having HIV (N=37)
| Services in Last 6 Months | Needed |
Received |
|
| Counseling | 81.1% |
55.6% |
** |
| Visit to doctor, nurse, or health care provider | 83.8% |
86.5% |
|
| Help for a medical problem at an ER | 32.4% |
34.3% |
|
| Overnight stay in a hospital | 18.9% |
18.2% |
|
| Prescribed medication | 78.4% |
81.8% |
|
| Alternative health care | 70.3% |
44.4% |
** |
| Help getting food and clothing | 29.7% |
29.4% |
|
| Long term housing | 32.4% |
8.8% |
** |
| Overnight shelter or short term housing | 5.4% |
6.1% |
|
| Vocational training | 29.7% |
11.8% |
* |
| Family counseling | 16.7% |
6.1% |
|
| Individual or group mental health services | 50.0% |
32.4% |
* |
| Inpatient mental health services (overnight) | 11.1% |
3.0% |
|
| Residential treatment for alcohol or drugs | 27.8% |
25.7% |
|
| Outpatient treatment for alcohol or drugs | 8.6% |
6.3% |
|
| Self-help or 12-step groups | 60.0% |
61.8% |
|
| Case management | 71.4% |
57.1% |
Asterisks indicate statistically significant differences across HIV status (* p<.05; ** p<.001).
To identify whether there were gaps in the needed and received services in the last six months by young men who are and who are not identified as having HIV, several McNemar tests for correlated proportions were conducted. Out of the 17 services, there were significant gaps between service needs and receipt of services. Services showing discrepancies between need and receipt of services are provided below (p<.001 unless otherwise noted):
- Counseling (Binomial, n=36)
- Alternative health care (Binomial, n=36)
- Long term housing (Binomial, n=34)
- Vocational training (Binomial, n=34, p<.02)
- Individual or group mental health services (Binomial, n=34, p<.04)
In Table 6-6, the self-reported service needs are compared for females known to be HIV-positive and those not identified as such.
Table 6-6
Self-reported Services Needed in the Last Six Months
for Young Females Who Are and Who Are Not Identified as Having HIV (N=161)
| Services Needed in Last 6 Months | Not Identified as Having HIV (N=144) |
Identified as Having HIV (N=17) |
|
| Counseling | 55.8% |
64.7% |
|
| Visit to doctor, nurse, or health care provider | 53.7% |
70.6% |
|
| Help for a medical problem at an ER | 36.3% |
47.1% |
|
| Overnight stay in a hospital | 6.6% | 11.8% |
|
| Prescribed medication | 49.6% |
88.2% |
** |
| Alternative health care | 7.5% |
29.4% |
** |
| Help getting food and clothing | 25.7% |
23.5% |
|
| Long term housing | 16.7% |
17.6% |
|
| Overnight shelter or short term housing | 14.8% |
0.0% |
|
| Vocational training | 34.5% |
47.1% |
|
| Family counseling | 28.1% |
35.3% |
|
| Individual or group mental health services | 27.5% |
47.1% |
|
| Inpatient mental health services (overnight) | 7.3% |
5.9% |
|
| Residential treatment for alcohol or drugs | 5.5% |
5.9% |
|
| Outpatient treatment for alcohol or drugs | 9.0% |
11.8% |
|
| Self-help or 12-step groups | 11.9% |
23.5% |
|
| Case management | 38.2% |
62.5% |
Asterisks indicate statistically significant differences across HIV status (* p<.05; ** p<.001). Note that the sample size for young women with HIV is very small; thus, even large percentage differences across groups will not show statistical significance in the traditional sense.
Out of the females in this sample, a higher percentage of those identified as HIV-positive than those not known to be HIV-positive reported needing medication and alternative therapy.
Table 6-7 shows a comparison of self-reported services received by females identified as HIV-positive and those not identified as such.
Table 6-7
Self-reported Services Received in the Last Six Months
for Young Females Who Are and Who Are Not Identified as Having HIV (N=153)
| Services Received in Last 6 Months | Not Identified as Having HIV (N=144) |
Identified as Having HIV (N=17) |
|
| Counseling | 42.9% |
50.0% |
|
| Visit to doctor, nurse, or health care provider | 57.1% |
75.0% |
|
| Help for a medical problem at an ER | 39.4% |
42.9% |
|
| Overnight stay in a hospital | 10.1% |
15.4% |
|
| Prescribed medication | 57.4% |
93.8% |
** |
| Alternative health care | 7.8% |
23.1% |
|
| Help getting food and clothing | 20.4% |
35.7% |
|
| Long term housing | 10.9% |
7.1% |
|
| Overnight shelter or short term housing | 14.4% |
0.0% |
|
| Vocational training | 24.0% |
14.3% |
|
| Family counseling | 8.6% |
21.4% |
|
| Individual or group mental health services | 21.4% |
25.0% |
|
| Inpatient mental health services (overnight) | 5.6% |
0.0% |
|
| Residential treatment for alcohol or drugs | 1.1% |
7.7% |
|
| Outpatient treatment for alcohol or drugs | 7.6% |
14.3% |
|
| Self-help or 12-step groups | 11.0% |
28.6% |
|
| Case management | 40.0% |
40.0% |
Asterisks indicate statistically significant differences across HIV status (* p<.05; ** p<.001). Note that the sample size for young women with HIV is very small; thus, even large percentage differences across groups will not show statistical significance in the traditional sense.
Of the females, a higher percentage of those known to have HIV than those not identified as HIV-positive received prescribed medication.
Table 6-8 compares the self-reported services needed to those received for females identified as HIV-positive.
Table 6-8
Self-Reported Services Needed and Received in the Last Six
Months for Young Females Who Are Identified as Having HIV (N=17)
| Services Received in Last 6 Months | Needed |
Received |
|
| Counseling | 64.7% |
50.0% |
|
| Visit to doctor, nurse, or health care provider | 70.6% |
75.0% |
|
| Help for a medical problem at an ER | 47.1% |
42.9% |
|
| Overnight stay in a hospital | 11.8% |
15.4% |
|
| Prescribed medication | 88.2% |
93.8% |
|
| Alternative health care | 29.4% |
23.1% |
|
| Help getting food and clothing | 23.5% |
35.7% |
|
| Long term housing | 17.6% |
7.1% |
|
| Overnight shelter or short term housing | 0.0% |
0.0% |
|
| Vocational training | 47.1% |
14.3% |
* |
| Family counseling | 35.3% |
21.4% |
|
| Individual or group mental health services | 47.1% |
25.0% |
|
| Inpatient mental health services (overnight) | 5.9% |
0.0% |
|
| Residential treatment for alcohol or drugs | 5.9% |
7.7% |
|
| Outpatient treatment for alcohol or drugs | 11.8% |
14.3% |
|
| Self-help or 12-step groups | 23.5% |
28.6% |
|
| Case management | 62.5% |
40.0% |
Asterisks indicate statistically significant differences across HIV status (* p<.05; ** p<.001).
McNemar tests for correlated proportions revealed a number of services that were received by young women with HIV compared to their reports of what services they needed in the last six months. Only one out of 17 services, vocational training (Binomial, n=14, p<.04), showed discrepancies between needs and receipt of services using inferential methods. However, with such small sample sizes, these data are best evaluated descriptively.
Summary
Results from detailed Brief Natural History Interviews show a range of issues facing
the group of youth who responded to the interview. In the following technical appendix, a
number of composite indicators from this measure are presented and contrasted on the basis
of HIV status and gender.
Go To Technical Appendix to Chapter 6
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