Concurrent prediction of drug use among high-risk youth.

Correlates of drug use were examined in a continuation high school sample (n = 1.315), using canonical correlation analysis. Fourteen demographic, attitudes/belief, and psychosocial pressure/ anxiety-type variables were included as concurrent predictors. Eight drug-use-related measures were also placed into the analysis as outcome variables. Two factors were revealed. White ethnicity, not being Latino, all attitude/belief measures, and family conflict and depression showed relatively high loadings on the first predictor factor, and were associated with all drug-use measures. Latino ethnicity and being relatively unacculturated (i.e., tending to speak Spanish), most of the attitude/belief measures (but not sensation seeking or spirituality), and perceived peer approval to use drugs, trait anxiety, and depression showed relatively high loadings on the second predictor factor, and were associated with the hard-drug-use measures. These results suggest that there is a subgroup of unacculturated Latino youth who are anxious, who perceive they will achieve peer approval by using drugs, and who tend to use hard drugs. Indicated drug abuse prevention strategies may need to be tailored to this subgroup when developing and implementing programming.

Efficacy of a culturally congruent HIV risk-reduction intervention for behaviorally bisexual black men: results of a randomized trial.

OBJECTIVES: Black men who have sex with men and women (MSMW) experience high HIV rates and may not respond to interventions targeting gay-identified men. We tested the efficacy of the Men of African American Legacy Empowering Self (MAALES), a multisession, small-group holistically framed intervention designed to build skills, address sociocultural issues, and reduce risk behaviors in black MSMW. DESIGN: From 2007 to 2011, we enrolled 437 black MSMW into a parallel randomized controlled trial that compared MAALES to the control condition, a single, individualized HIV risk-reduction session. METHODS: Participants completed surveys at baseline, 3 months, and 6 months postintervention. We used multiple regressions to compare risk behaviors at follow-up between the intervention and control groups while adjusting for baseline risk behaviors, time between assessments, other covariates, and clustering. We used inverse probability weighting (IPW) to adjust for loss-to-follow-up while carrying out these regressions with the 291 (76.4%) randomized participants who completed at least one follow-up. RESULTS: Participants were largely low-income (55% reported monthly incomes <$1000); nearly half had previously tested HIV positive. At 6 months of follow-up, unadjusted within-group analyses demonstrated reduced risk behaviors for the MAALES but not the control group. Adjusted results indicated significant intervention-associated reductions in the numbers of total anal or vaginal sex acts [risk ratio = 0.61; 95% confidence interval (CI) 0.49­0.76], unprotected sex acts with women (risk ratio = 0.50; 95% CI 0.37­0.66), and female partners (risk ratio = 0.56; 95% CI 0.44­0.72). Near significant reductions were observed for number of male intercourse partners. CONCLUSION: The MAALES intervention was efficacious at reducing HIV risk behaviors in black MSMW.

Factors in marijuana cessation among high-risk youth.

The rise in marijuana use among high school students has generated considerable concern. The apparent failure of current marijuana control efforts may be due in part to ignorance about why students use marijuana and what influences them to consider quitting. This article utilized both open-ended and multiple-choice surveys as well as health educator-led focus groups to assess issues related to marijuana use and cessation among a population of high-risk youth. A total of 842 students participated, assessed as two separate samples from eleven continuation high schools in southern California. Approximately 70 percent of the students are current marijuana users. Interpreting results across both samples, it is apparent that interest in quitting marijuana use among continuation high school students is high. Over half of the marijuana users surveyed have tried to quit and failed. Still, several social images associated with marijuana smokers are positive and subjects express a lack of confidence in the efficacy of marijuana cessation clinic programs. Subjects believe that either self-help or punitive methods are the most effective types of marijuana cessation activities. A reportedly high rate of failed quit attempts suggests that effective marijuana cessation programs are needed in this population. Future programs must address both reasons users resist change, including use of marijuana as a stress reliever, and the particular motivations that subjects report regarding why they desire to quit using marijuana, including legal, vocational, and health consequences.