Addiction and Related Psychosocial Issues among Young HIV-Positive Women

L. A. Melchior, Ph.D., The Measurement Group, Culver City, California; E. Woods, M.D., Children’s Hospital of Boston, Boston, Massachusetts; M. Wallace, Indiana Department of Health, Indianapolis, Indiana; S. Tierney, Ed.D., Health Initiatives for Youth, San Francisco, California; M. Sturdevant, M.D., University of Alabama, Birmingham, Alabama; A. Schneir, M.P.H., Childrens Hospital Los Angeles, Los Angeles, California; G. Remafedi, M.D., Minnesota Youth and AIDS Project, Minneapolis, Minnesota; B. Greenberg, Ph.D., Walden House, San Francisco, California; R. Feudo, Ph.D., Greater Bridgeport Adolescent Pregnancy Project, Bridgeport, Connecticut; R. Burch, Ph.D., YouthCare, Seattle, Washington; T. Bettencourt, BAY Positives, San Francisco, California; K. Marconi, Ph.D., Health Resources and Services Administration, Rockville, Maryland; B. Singer, J.D., Health Resources and Services Administration, Rockville, Maryland; R. Brady, Health Resources and Services Administration, Rockville, Maryland; A. T. Panter, Ph.D., University of North Carolina; A. K. Kawata and G. J. Huba, Ph.D., The Measurement Group, Culver City, California.

ADDICTION AND RELATED PSYCHOSOCIAL ISSUES AMONG YOUNG HIV-POSITIVE WOMEN

The Health Resources and Services Administration (HRSA) Special Projects of National Significance (SPNS) Program recently funded a group of 10 national demonstration projects targeting adolescents and youth for HIV/AIDS services. The projects were focused on services for youth who were HIV-positive and those at-risk for HIV. As part of a cross-cutting evaluation of these 10 projects, a Brief Natural History Interview (BNHI) was administered to project clients shortly after enrollment into services. The BNHI consisted of 15 sections, each focused on a specific topic, including demographic characteristics, substance use history, HIV risk behaviors, and service utilization history. Data from these interviews provide detailed information about the psychosocial characteristics and service needs of this group of young women (n=161). The majority of women who provided data about their substance use history reported lifetime alcohol use (86%), with 64% of the adolescent females reporting alcohol use in the past six months. The majority of young women also reported having used marijuana (67%), and other drug use reported included amphetamines (24%), crack (15%), other cocaine (19%), and heroin (8%). A total of 17% of the women had ever been in substance abuse treatment, and 30% reported a history of mental health treatment, with 26% having ever been prescribed psychiatric medication. Physical and sexual abuse are all too common among the women: 30% reported having been physically hurt by a sex partner, 17% had been forced to have sex with a family member, and 20% had been forced to have sex with a stranger (all of which are significantly greater percentages than those reported by the young males in the sample, n = 153). Results from this cross-cutting evaluation suggest that young women living with HIV are likely to face a number of psychosocial stressors. The present findings confirm that youth living with HIV face a number of barriers in obtaining services and it is likely that comorbid issues of substance abuse and mental illness may increase those barriers.

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