International Journal of Behavioral Medicine

, Volume 6, Issue 4, pp 293–311 | Cite as

Substance use and its relationship to depression, anxiety, and isolation among youth living with HIV

  • Mary Jane Rotheram-Borus
  • Debra A. Murphy
  • Dallas Swendeman
  • Brian Chao
  • Brenda Chabon
  • Susan Zhou
  • Jeffrey Birnbaum
  • Peggy O’Hara
Empirical Contributions

Abstract

Reductions from lifetime to recent levels of substance use, the time since HIV diagnosis, physical health symptoms, CD4 counts, emotional distress, and social supports were examined among 227 (20% female; 22% African American, 27% Anglo, 35% Latino) youth living with HIV pH) ages 13 to 24 years. Substance use pervaded the lives of these youth. Male YLH had used more drugs., more often, and for longer periods than women. However, there had been major reductions in use. Being male, having high emotional distress, and having fewer negative social supports were significantly associated with greater reductions in substance use. There was a trend for the length of time that an individual was seropositive being associated with reductions in substance use. The counterintuitive findings suggest that there must be a re-examination of the role of the social support networks of youth living with HIV, as well as the ways in which emotional distress interacts with risk behaviors.

Key words

adolescents HIV substance use 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Atkinson, H. (1991, May). Suicidal behavior and coping responses to HIV testing. Annual meeting of the American Psychiatric Association. New Orleans, LA.Google Scholar
  2. Benin, M., & Keith, V. M. (1995). The social support of employed African American and Anglo mothers. Journal of Family Issues, 16(3), 275–297.CrossRefGoogle Scholar
  3. Berger, R., & Shechter, Y. (1989). Adolescent girls in distress: A high-risk intersection. Adolescence, 24(94), 357–374.PubMedGoogle Scholar
  4. Bowen, A. M., & Trotter, R (1995). HIV risk in intravenous drug users and crack cocaine smokers: F’redicting stages of change for condom use. Journal of Consulting Clinical Psychology, 63(2), 238–248.CrossRefGoogle Scholar
  5. Bowler, S., Sheon, A. R., D’Angelo, L. J., & Vermund, S. H. (1992). HIV and AIDS among adolescents in the United States: Increasing risk in the 1990s. Journal of Adolescence, 15, 345–371.PubMedCrossRefGoogle Scholar
  6. Bukstein, O. G., Brent, D. A., & Kaminer, Y. (1989). Comorbidity of substance abuse and other psychiatric disorders in adolescents. American Journal of Psychiatry, 146(9), 1131–1141.PubMedGoogle Scholar
  7. Centers for Disease Control and Prevention. (1997). U.S. HIV and AIDS cases reported through June 1997. HIV/AIDS Sweillance Report 9(1).Google Scholar
  8. Chuang, H. T., Devins, G. M., Hunsley, J., & Gill, M. J. (1989). Psychosocial distress and well-being among gay and bisexual men with human immunodeficiency virus infection. American Journal of Psychiatry. 146(7), 876–880.PubMedGoogle Scholar
  9. Compas, B. E., Slavin, L. A., Wagner, B. M., & Vanatta, K. (1986). Relationship of life events and social support with psychological dysfunction among adolescents. Journal of Youth and Adolescence, 15, 205–221.CrossRefGoogle Scholar
  10. Derogatis, L. R. (1993). Brief Symptom Inventoy: Administration, scoring, and procedures manual. Mieapolls, MN: National Computer Systems, Inc.Google Scholar
  11. DiClemente, R. J. (1992). Psychosocial determinants of condom use among adolescents. In R. J. DiClemente (Ed.), Adolescents and AIDS: A generation in jeoparrfy (pp. 34–51). Newbury Park, CA: Sage.Google Scholar
  12. Dixon, W. J., & Massey, F. J. (1983). Introductron to statistical analysis (4th ed.). New York: McGraw-Hill.Google Scholar
  13. Doll, L. S., & Kennedy, M. B. (1994). HIV testing and counseling: What is it and how does it work? In G. Schochetman & J. R. George (Eds.), AIDS testing: A comprehensive guide to technical, medical, social, legal, and management issues (2nd ed., pp. 302–319). New York: Springer-Verlag.Google Scholar
  14. Donlou, J. N., Wolcott, D. L., Gottlieb, M. S., & Landsverk, J. (1985). Psychosocial aspects of AIDS and AIDS-related complex: A pilot study. Journal of Psychosocial Oncology, 3(2), 39–55.CrossRefGoogle Scholar
  15. Fox, R., Odaka, N. J., Brookmeyer, R., & Polk, B. F. (1987). Efrect of HIV antibody disclosure on subsequent sexual activity in homosexual men. AIDS, 1, 241–246.PubMedGoogle Scholar
  16. Futterman, D., Rogers, A., D’Angelo, L., & Levin, L. (1995). Transmission dynamics and clinical status of HIV+ youth. Journal of Adolescent Health. 16, 134Google Scholar
  17. Garrison, C. Z., Jackson, K. L., Marsteller, F., McKeown, R., & Addy, C. (1990). A longitudinal study of depressive symptomatology in young adolescents. .Journal of the American Academy of Child and Adolescent Psychiatry. 29(4), 581–585.PubMedCrossRefGoogle Scholar
  18. Gruen, R., Calderwood, M., Meyer-Bahlburg, H., & Ehrhardt, A. (1989). Psychosexual assessment in AIDS research. Abstracts of the Fifth International Conference on AIDS, 739. Ottawa, Ontano, Canada.Google Scholar
  19. Gwadz, M., & Rotheram-Borus, M. J. (1992). Tracking high risk adolescents longitudinally. AIDS Education and Prevention, 4, 69–82.Google Scholar
  20. Hanis, L., Blum, R. W., & Resnick, M. (1991). Teen females m Minnesota: A portrait of quiet disturbance. Women & Therapy, 11(3–4), 119–135.CrossRefGoogle Scholar
  21. Hein, K., Dell, R., Futterman, D., Rotheram-Borus, M. J., & Shaffer, N. (1995). Comparison of HIV+ and HIV- adolescents: Risk factors and psychosocial determinants. Pediatrics, 95(1), 96–104.PubMedGoogle Scholar
  22. Henry, B., Feehan, M., McGee, R., Stanton, W., Mofitt, T. E., & Silva, P. (1993). The importance of conduct problems and depressive symptoms in predicting adolescent substance use. Journal of Abnormal Child Psychology, 21, 469–480.PubMedCrossRefGoogle Scholar
  23. Higgins, E., Galavottie, C., O’Reilly, K. R., Schnell, D. J., Moore, M., Rugg, D., & Johnson, R. (1991). Evidence for the effects of HIV antibody counseling and testing on risk behaviors. Journal of the American Medical Association, 266, 2419–2429.PubMedCrossRefGoogle Scholar
  24. Holtgrave, D. R., Valdiserri, R. O., Gerver, A. R., & Hinman, A. R. (1993). Human immunodeficiency virus counseling, testing, referral, and partner notification services: A cost benefit analysis. Archives of Internal Medicine, 153, 1225–1230.PubMedCrossRefGoogle Scholar
  25. Homer, B. R., & Scheibe, K. E. (1997). Prevalence and implications of attention-deficit hyperactivity disorder among adolescents in treatment for substance abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 36. 30–36.CrossRefGoogle Scholar
  26. Johnston, L. D., O’Malley, P. M., & Bachman, J. G. (1995). National survey results on drug use fiom the Monitoring the Future Study, 1975-1994 (Vol. 1). Washington, DC: National Institute on Drug Abuse.Google Scholar
  27. Kalichman, S. C., Kelly, J. A., & Rompa, D. (1997). Continued high-risk sex among HIV seropositive gay and bisexual men seeking HIV prevention services. Health Psychology, 16, 369–373.PubMedCrossRefGoogle Scholar
  28. Kandel, D. B., & Logan, J. A. (1984). Patterns of drug use from adolescence to young adulthood: I. Periods of risk for initiation, continued use, and discontinuation. American Journal of Public Health, 74, 660–666.PubMedCrossRefGoogle Scholar
  29. Kandel, D. B., Raveis, V. H., & Davies, M. (1991). Suicidal ideation in adolescence: Depression, substance use, and other risk factors. Journal of Youth and Adolescence, 20(2), 289–309.CrossRefGoogle Scholar
  30. Kann, L., Warren, C. W., Harris, W. A., Collins, J. L., Williams, B. I., Ross, J. G., Kolbe, L. J., & State and Local YRBSS Coordinators. (1996). Youth risk behavior surveillance-United States, 1995. In CDC Surveillance Summaries, September 27, 1996. Morbidity and Mortality Weekly Report, 45 (SS-4), 1–27.Google Scholar
  31. Kelly, J. A., Murphy, D. A., Bahr, G. R., Koob, J. J., Morgan, M., Kalichman, S. C., Stevenson, L. Y., Brasfield, T. L., Bemstein, B. M., & St. Lawrence, J. S. (1993). Factors associated with severity of depression and high risk sexual behavior among persons diagnosed with human immunodeficiency vim (HIV) infection. Health Psychology, 12(3), 215–219.PubMedCrossRefGoogle Scholar
  32. Koniak-Griffm, D., Lominska, S., & Brecht, M.-L. (1993). Social support during adolescent pregnancy: A comparison of three ethnic groups. Journal of Adolescence, 16(1), 43–56.CrossRefGoogle Scholar
  33. Landry, M. J., Smith, D. E., & Steinberg, J. R. (1991). Anxiety, depression, and substance use disorders: Diagnosis, treatment, and prescribing practices. Journal of Psychoactive Drugs, 23(4), 397416.Google Scholar
  34. Maton, K. I., Teti, D. M., Corns, K. M., Vieira-Baker, C. C., Lavine, J. R., Gouse, K. R., & Keating, D. P. (1996). Cultural specificity of support sources, correlates and contexts: Three studies of African- American and Caucasian youth. American Journal of Community Psychology, 24(4), 551–587.PubMedCrossRefGoogle Scholar
  35. Munsch, J., & Wampler, R. S. (1993). Ethnic differences in early adolescents’ coping with school stress. American Journal of Orthopsychiatry, 63(4), 633–646.PubMedCrossRefGoogle Scholar
  36. Murphy, D. A., Bahr, G. R., Kelly, J. A., Bernstein, B. M., & Morgan, M. (1992). A needs assessment survey of HIV-infected patients. Wisconsin Medical Journal, 91(6), 291–295.PubMedGoogle Scholar
  37. Nyamathi, A., & Vasquez, R. (1995). Impact of poverty, homelessness, and drugs on Hispanic women at risk for HIV infection. In A. M. Padilla (Ed.), Hispanic psychology: Critical issues in theoy and research (pp. 213–227). Thousand Oaks, CA: Sage.Google Scholar
  38. Nyamathi, A., Wayment, H. A., & Dunkel-Schetter, C. (1993). Psychosocial correlates of emotional distress and risk behavior in African-American women at risk for HIV infection. Anxiety. Stess & Coping: An International Journal, 6(2), 133–148.CrossRefGoogle Scholar
  39. Olievenstein, C. (1988). Drug addiction and AIDS in France in 1987. National Institute on Drug Abuse: Research Monograph Series, 80, 114–118.Google Scholar
  40. Ostrow, D. G., Monjan, A., Joseph, J., VanRaden, M., Fox, R., Kingsley, L., Dudley, J., & Phair, J. (1989). HIV-related symptoms and psychological functioning in a cohort of homosexual men. American Journal of Psychiaby, 146(6), 737–742.Google Scholar
  41. Peny, S., Fishman, B., Jacobsberg, L., Young, J., & Frances, A. (1991). Effectiveness of psychoeducational interventions in reducing emotional distress after human immunodeficiency virus antibody testing. Archives of General Psychiaby, 48, 143–147.Google Scholar
  42. Phillips, K. A., & Coates, T. J. (1995). HIV counseling and testing: Research and policy issues. AIDS Care, 7(2), 115–124.PubMedCrossRefGoogle Scholar
  43. Resnick, M. D., Bearman, P. S., Blum, R. W., Bauman, K. E., Harris, K. M., Jones, J., Tabor, J., Beuhring, T., Sieving, R. E., Shew, M., Ireland, M., Bearinger, L. H., & Udry, J. R. (1997). Protecting adolescents from hann: Findings from the Nanonal Longitudinal Study on Adolescent Health. Journal of the American Medical Association, 278, 823–832.PubMedCrossRefGoogle Scholar
  44. Roberts, R. E., Andrews, J. A., Lewinsohn, P. M., & Hops, H. (1990). Assessment of depression in adolescents using the Center for Epidemiologic Studies Depression Scale. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2(2), 122–128.Google Scholar
  45. Roberts, R. E., & Sobhan, M. (1992). Symptoms of depression in adolescence: A comparison of Anglo, African, and Hispanic Americans. Journal of Youth and Adolescence, 21, 639–651.CrossRefGoogle Scholar
  46. Rotheram-Borus, M. J., & Futterman, D. A. (m press). Promoting early detection of human immunodeficiency virus infection among adolescents. Archives of Petatrics and Adolescent Medicine.Google Scholar
  47. Rotheram-Borus, M. J., & Koopman, C. (1991). HIV arid adolescents. The Journal of Primary Prevention, 12(1), 68–82.CrossRefGoogle Scholar
  48. Rotheram-Borus, M. J., Luna, G. C., Marotta, T., & Kelly, H. (1994). Going nowhere fast: Methamphetamine use and HIV infection. In R. Battjes, Z. Sloboda, & W. C. Grace (Eds.), The context of HIV risk among drug users and their sexual partners (pp. 155–182). Washington, DC: National Institute of Drug Abuse Monograph Series No. 143.Google Scholar
  49. Rothem-Borus, M. J., & Miller, S. (1998). Secondary prevention for youths living with HIV. AIDS Care, 10(1), 17–34.Google Scholar
  50. Rotheram-Borus, M. J., Murphy, D. A., Coleman, C. L, Kennedy, M., Reid, H. M., Cline, T. R., Bimbaum, J. M., Futterman, D. Levin, L., Schneir, A., Chabon, B., O’Keefe, Z., & Kipke, M. (1997). Risk acts, health care, and medical adherence among HIV+ youths in care over time. AIDS and Behavior, 1(1), 43–52.CrossRefGoogle Scholar
  51. Rotheram-Borus, M. J., Murphy, D. A., & Miller, S. (1996). Intervening with adolescent girls living with HIV. In A. O’Leary & L. S. Jemmott (Eds.), Women ond AIDS: Coping and care (pp. 87–108). New York: Plenum.Google Scholar
  52. Rotheram-Borus, M. J., O’Keefe, Z., Kracker, R., & Foo, H.-H. (2000). Prevention of HIV among adolescents. Prevention Science, 1(1), 15–30.PubMedCrossRefGoogle Scholar
  53. Rotheram-Borus, M. J., Rosario, M., Reid, H., & Kasen, S. (1995). Determinants of safer sex patterns among gay/bisexual male adolescents. Journal of Adolescence, 18, 3–15.CrossRefGoogle Scholar
  54. Rotheram-Borus, M. J., Rosario, M., Van Rossem, R., Reid, H., & Gillis, J. R. (1995). Prevalence, course, and predictors of multiple problem behaviors among gay and bisexual male adolescents. Developmental Psychology. 31(1). 75–85.CrossRefGoogle Scholar
  55. St. Lawrence, J. S., Brasfield, T. L., Jefferson, K. W., Allyene, E., & Shirley, A. (1994). Social support as a factor in African-American adolescents’ sexual risk behavior. Journal of Adolescent Research, 9(3), 292–310.CrossRefGoogle Scholar
  56. Wolf, T. M., Balson, P. M., Morse, E. V., Simon, P. M., Gamer, R. H., Dralle, P. W., & Williams, M. H. (1991). Relationship of coping style to affective state and perceived social support in asymptomatic and symptomatic HIV-infected persons: Implications for clinical management. Journal of Clinical Psychiatry. 52, 171–173.PubMedGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 1999

Authors and Affiliations

  • Mary Jane Rotheram-Borus
    • 1
  • Debra A. Murphy
    • 1
  • Dallas Swendeman
    • 1
  • Brian Chao
    • 2
  • Brenda Chabon
    • 3
  • Susan Zhou
    • 4
  • Jeffrey Birnbaum
    • 5
  • Peggy O’Hara
    • 6
  1. 1.Department of PsychiatryUniversity of CaliforniaLos AngelesUSA
  2. 2.RANDUSA
  3. 3.Department of PsychiatryMontefiore Medical centerUSA
  4. 4.Center for Devices and Radiological HealthU.S. Food and Drug AdmmistrationUSA
  5. 5.Kings County Hospital CenterUSA
  6. 6.Middle Tennessee State UniversityUSA

Personalised recommendations