Alprazolam (Xanax) use among southern youth: beliefs and social norms concerning dangerous rides on "handlebars"

While the epidemiologic trends concerning alprazolam (Xanax) are unknown, the use of benzodiazepines, in general, has increased in popularity among youth within recent years. To shed light on the drug problem, the current pilot study used a qualitative approach to investigate relevant beliefs, norms, and perceived addiction associated with alprazolam initiation among 46 youth who were attending an inpatient drug treatment program during the spring of 2004. Overwhelmingly, most participants stated that addiction to alprazolam occurs as early as initial consumption. Most youth in the study stated that their friends felt it was normal to use alprazolam. In addition, their control beliefs revealed that if someone wanted to stop it would be difficult because of the widespread use in their communities and family social reinforcement involved with its use. In this study, a majority of students stated that medical professionals such as doctors and pharmacists were the greatest facilitator of alprazolam acquisition. Implications for these results are discussed.     

Correlates of Engaging in Survival Sex among Homeless Youth and Young Adults

Using a sample of 1,625 homeless youth and young adults aged 10 to 25 from 28 different states in the United States, this study examines the correlates of having engaged in survival sex. Findings suggest that differences exist based on demographic variables (gender, age, race, and sexual orientation), lifetime drug use (inhalants, Valium?, crack cocaine, alcohol, Coricidin?, and morphine), recent drug use (alcohol, ecstasy, heroin, and methamphetamine), mental health variables (suicide attempts, familial history of substance use, and having been in substance abuse treatment), and health variables (sharing needles and having been tested for HIV). In addition to replicating previous findings, this study's findings suggest that African American youth; gay, lesbian, or bisexual youth; and youth who had been tested for HIV were significantly more likely to have engaged in survival sex than White, heterosexual youth, and youth who had not been tested for HIV, respectively. Implications for interventions with youth and suggestions for future research are discussed.     

Perception of Substance Use Problems in Asian American Communities by Chinese,Indian, and Vietnamese American Youth

SUMMARY

The study was a cross-sectional survey using a convenience sample of 87 Asian American youth respondents to examine their perceptions of substance use problems in the Asian American community. The authors examined respondents' perceptions of the severity of substance use problems in the Asian American community, perceived characteristics of persons with problems of substance use, perceived etiology of substance use problems, beliefs about treatment, perceived help-seeking preferences and helpful services. The youth demonstrated an increased awareness of the severity of substance use problems in the community, although such awareness was more prominent for drinking problems than drug use problems. Respondents showed a positive attitude toward treatment, although such an attitudinal change was not yet accompanied by a change in their behavioral preferences. Findings suggested a tendency for Asian American youth respondents to utilize personal resources rather than professional help or formal treatment programs in response to substance use problems. In addition, respondents shared similar “myths” of Asian problem drinkers and drug users. Implications for developing culturally relevant interventions for prevention and treatment as well as future research are discussed.     

Parental Substance Abuse and Divorce as Predictors of Injection Drug Use and High Risk Sexual Behaviors Known to Transmit HIV

This study examined familial antecedents of high risk sexual and injection drug using behaviors in a population of 100 gay men in one drug treatment program. Multiple logistic regression analyses were used to identify predictors for (1) injection drug use, (2) high risk sexual behaviors and (3) HIV status. Data from this study indicates parental substance abuse and divorce or separation are predictors of both sexual and injection drug using risk behaviors associated with HIV transmission. These results indicate the need to target high risk families and youth to prevent injection drug use, high risk sexual bchaviors and ultirnarely HTV infection.     

Risk and Protective Factors for Early Substance Use Initiation: A Longitudinal Study of Mexican‐Origin Youth

Substance use initiation in adolescence is a critical issue, given its association with substance dependency and associated problems in adulthood. However, due to the dearth of fine‐grained longitudinal studies, the factors associated with early initiation are poorly understood, especially in minority youth. The present study examined substance use initiation in a sample of Mexican‐origin youth (n = 674) assessed annually from age 10 to 16. Using discrete‐time survival analyses, we found that initiation escalated rapidly from late childhood to adolescence, and we identified a wide range of factors, from the individual to the cultural level of analysis, that significantly increased or decreased risk for early initiation. These findings have important implications for programs aimed at preventing early substance use by Mexican‐origin youth.     

Social network characteristics associated with risky behaviors among runaway and homeless youth.

Runaway and homeless youth are at high risk for substance abuse and unsafe sexual behavior. Our study describes the personal social networks of these youth and examines network characteristics associated with risky behaviors. In 1995 and 1996, we interviewed a purposive sample of youth aged 14 through 21 who were living in Washington, DC and were identified on the streets or through shelters or other service agencies (N = 327). Although we found that most youth reported current social relationships, a significant minority (26%) did not. Youth without a social network were significantly more likely to report current illicit drug use, multiple sex partners, and survival sex than youth with a network. For youth with a network, the networks were small, strong in affective and supportive qualities, comprised primarily of friends, typically included an alcohol or illicit drug user, and usually were not a source of pressure for risky behaviors. Our results indicate that networks had risk-enhancing and risk-decreasing properties in that network characteristics were associated in both positive and negative directions with risky behaviors.     

The Impact of Childhood Sexual Abuse on Later Sexual Victimization among Runaway Youth

Path analysis was used to investigate the impact of childhood sexual abuse on later sexual victimization among 372 homeless and runaway youth in Seattle. Young people were interviewed directly on the streets and in shelters by outreach workers in youth service agencies. High rates of both childhood sexual abuse and street sexual victimization were reported, with females experiencing much greater rates compared with their male counterparts. Early sexual abuse in the home increased the likelihood of later sexual victimization on the streets indirectly by increasing the amount of time at risk, deviant peer affiliations, participating in deviant subsistence strategies, and engaging in survival sex. These findings suggest that exposure to dysfunctional and disorganized homes place youth on trajectories for early independence. Subsequently, street life and participation in high‐risk behaviors increases their probability of sexual victimization.     

Cumulative Risk for Early Sexual Initiation Among American Indian Youth: A Discrete‐Time Survival Analysis

Approximately 3 million teens are diagnosed with a sexually transmitted disease (STD) annually; STDs rates for American Indian young adults are among the highest of any racial/ethnic group. An important risk factor for STDs is early initiation of sex. In this study, we examined risk for early initiation with 474 American Indian youth ages 14–18, using 11 risk factors from three developmentally important microsystems (family, school, peers) along with several individual characteristics; a cumulative risk index was also calculated. Discrete‐time survival analyses showed that predictors of early initiation differed by gender. For young men, younger initiation of sex was predicted by lower grades, liking school less, having peers with less prosocial attitudes, a greater likelihood of having used alcohol or drugs at first sex, and having higher sensation‐seeking. For young women, earlier initiation was related to having mothers who had their first child at an early age and who had less formal education, to having parents who had divorced, dropping out of high school, using alcohol/drugs at first sex, and higher sensation‐seeking. Higher cumulative risk was associated with elevated risk of sexual initiation, although the degree of added risk varied with age for women. Cumulative risk deserves broader attention in understanding the early initiation of sexual intercourse.     

Homeless youths' perceptions of services and transitions to stable housing

Use of available services is low among homeless youths, and how youth make decisions to access services or seek housing is unclear. This study explored perspectives of current and former street youth about these processes. Recruited from the streets and a drop-in center, 27 youth ages 16–24, participated in individual qualitative interviews. Findings from consensual qualitative analyses indicated choices to use services were embedded within developing autonomy and identification with street lifestyles. Themes of self-reliance, substance use, and relationships with street and housed persons were expressed as critical for both using services and transitioning to stable housing. Agency-related factors such as caring staff, a nonjudgmental atmosphere, and flexible policies were perceived as important for service use while youth-related factors such as experiencing major events, being internally motivated, and embracing mainstream values were seen as conducive to transitioning off the streets. Implications for service providers and future research are discussed.     

Mental disorder, subsistence strategies, and victimization among gay, lesbian, and bisexual homeless and runaway adolescents

This study compares participation in deviant subsistence strategies, street victimization, and lifetime prevalence of five mental disorders (conduct disorder, major depressive disorder, post-traumatic stress disorder, alcohol abuse, and drug abuse) among heterosexual males and females (n = 366) and gay, lesbian, and bisexual (n = 63) homeless and runaway adolescents from the first wave of a longitudinal study of homeless youth in four Midwestern states. The results indicate that gay, lesbian, and bisexual adolescents were more likely to have been physically and sexually abused by caretakers, we more likely to engage in risky survival strategies when on their own (including survival sex), were more likely to be physically and sexually victimized when on the streets, and were more likely to meet criteria for mental disorder than were their heterosexual counterparts.     

The moderating effects of culture on peer deviance and alcohol use among high-risk African-American Adolescents

African-American adolescents have lower rates of alcohol consumption than White youth. However, African-American youth suffer disproportionately more adverse social, mental, and physical health outcomes related to alcohol use. Affiliating with negative peers is a risk factor for alcohol initiation and consumption. Cultural variables have shown moderating effects against other risk factors for African-American youth and therefore were the focus of this study. Specifically, we tested whether three culturally-relevant variables, Africentric beliefs, religiosity, and ethnic identity were promotive or protective for alcohol initiation and use within the context of negative peer affiliations. The sample consisted of 114 at-risk African-American adolescents whose ages ranged from 13 to 20. Participants were administered a questionnaire with measures of alcohol initiation and use, peer risk behaviors, ethnic identity, Africentric beliefs, religiosity, and demographic items. Peer risk behaviors accounted for significant percentages of the variance in age of alcohol initiation, lifetime use, and current and heavy alcohol use after adjusting for age and gender. Cultural variables showed both promotive and protective effects. Africentric beliefs were promotive of delayed alcohol initiation, whereas both Africentrism and religiosity moderated peer risk behaviors effect on alcohol initiation. Africentric beliefs were also inversely related to lifetime alcohol use revealing a promotive effect. Moreover, there were significant protective effects of ethnic identity and religiosity on heavy alcohol consumption. One implication of these findings is that prevention programs that infuse cultural values and practices such as Africentrism, ethnic identity, and religiosity may delay alcohol initiation and reduce use especially for youth with high risk peers.     

Mental disorder,subsistence strategies,and victimization among gay,lesbian, and bisexual homeless and runaway adolescents

This study compares participation in deviant subsistence strategies, street victimization, and lifetime prevalence of five mental disorders (conduct disorder, major depressive disorder, post‐traumatic stress disorder, alcohol abuse, and drug abuse) among heterosexual males and females (n = 366) and gay, lesbian, and bisexual (n = 63) homeless and runaway adolescents from the first wave of a longitudinal study of homeless youth in four Midwestern states. The results indicate that gay, lesbian, and bisexual adolescents were more likely to have been physically and sexually abused by caretakers, were more likely to engage in risky survival strategies when on their own (including survival sex), were more likely to be physically and sexually victimized when on the streets, and were more likely to meet criteria for mental disorder than were their heterosexual counterparts.     

Social control correlates of arrest behavior among homeless youth in five U.S. cities

This study identified homelessness, substance use, employment, and mental health correlates of homeless youths' arrest activity in 5 cities. Two hundred thirty-eight street youth from Los Angeles, Austin, Denver, New Orleans, and St. Louis were recruited using comparable sampling strategies. Ordinary least squares (OLS) regression results reveal that being arrested for criminal activity is associated with length of homelessness, history of juvenile detention and incarceration, receiving income from theft, substance abuse, and mental illness. Arrests are also associated with interactions between lack of formal employment income and receiving income from theft and between drug and alcohol abuse/ dependency. Understanding the health and situational factors associated with homeless youths' delinquent activity has implications for providing more comprehensive health, mental health, and substance abuse services.     

Gender Minority Social Stress in Adolescence: Disparities in Adolescent Bullying and Substance Use by Gender Identity

Bullying and substance use represent serious public health issues facing adolescents in the United States. Few large-sample national studies have examined differences in these indicators by gender identity. The Teen Health and Technology Study (N = 5,542) sampled adolescents ages 13 to 18 years old online. Weighted multivariable logistic regression models investigated disparities in substance use and tested a gender minority social stress hypothesis, comparing gender minority youth (i.e., who are transgender/gender nonconforming and have a gender different from their sex assigned at birth) and cisgender (i.e., whose gender identity or expression matches theirs assigned at birth). Overall, 11.5% of youth self-identified as gender minority. Gender minority youth had increased odds of past-12-month alcohol use, marijuana use, and nonmarijuana illicit drug use. Gender minority youth disproportionately experienced bullying and harassment in the past 12 months, and this victimization was associated with increased odds of all substance use indicators. Bullying mediated the elevated odds of substance use for gender minority youth compared to cisgender adolescents. Findings support the use of gender minority stress perspectives in designing early interventions aimed at addressing the negative health sequelae of bullying and harassment.     

Street Youth: Coping and Interventions

A literature review of research into interventions among street youth is presented along with the results of a qualitative analysis of interviews with 80 street youth on the topic of coping. Themes arising from the qualitative analysis include street youths' negative and positive experiences with social support; and attitudes and beliefs such as self-worth, decreased reactivity to other's opinions, hope for the future, pride in self-reliance, anger/non-conformity, and spirituality. Recommendations of this study include the need for outcome research and programme evaluation, inclusion of sociocultural factors as variables, and accessing the experiences of street youth.     

黑暗生存:街角青年新时代街头生活研究

新时代背景下,街角青年的街头生活状态已有了新的变化。鉴于此,笔者使用田野调查的方法,通过参与式观察和深入访谈,对街角青年的街头生存状态进行调研。研究发现:街角青年处于“黑暗生存”状态,呈现出“黑暗的家庭生活、黑暗的街头空间、黑暗的帮派文化、黑暗的资产经营及黑暗的犯罪手段”等五大特征。     

Foster youth and drug use: Exploring risk and protective factors

Substance use and misuse experiences of foster youth remain an under-researched area. Given that early use of drugs is said to be a common factor among 90% of those who develop substance misuse problems in their lifetime, this is an important area of academic study (Dennis, White, & Ives, 2009). By drawing upon primary empirical data from a mixed-methods study, this paper addresses an important gap in the literature and seeks to provide an improved understanding of foster youth, drug use and vulnerability. A total of 261 foster youth, who had exited care, contributed to a quantitative survey, and a further 35 provided qualitative narratives of their lived experience. Key risk factors including experience of homelessness, school exclusion and living setting are identified as strong influences that predict high levels of drug use among foster youth. Targeted social support and interventions in the form of pre-leaving care in the context of a strong practitioner/youth relationship are suggested to help ameliorate poor outcomes to obviate the problem of substance misuse among foster youth.     

The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic

Sexual compulsivity, defined by sexual preoccupation and lack of sexual impulse control, is related to high-risk sexual behaviors. However, little is known about the prevalence and predictors of sexual compulsivity in people at high risk for contracting sexually transmitted infections (STIs). In the current study, patients receiving diagnostic and treatment services (85% African American) at an urban STI clinic completed measures of demographic characteristics, sexual compulsivity, substance use, and sexual behaviors. Measures were administered to 492 men and 193 women using confidential procedures and audio computer-assisted interviewing technology. Results showed that men and women receiving STI clinic services frequently endorsed multiple indicators of sexual compulsivity. In this mostly African American sample, individuals with scores above the 80th percentile on the sexual compulsivity scale (translating to over one standard deviation above the mean) had more sex partners, engaged in higher rates of sexual risk behaviors with casual or one-time sex partners, and were nearly four times as likely to have been recently diagnosed with multiple STIs than were individuals who scored below the 80th percentile. Although sexual compulsivity scores were associated with alcohol and other drug use, associations between sexual compulsivity and sexual risks were not accounted for by substance abuse. Findings suggest an urgent need for interventions to help men and women with sexual preoccupations and poor sexual impulse control to reduce their risks for sexually transmitted infections.     

The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic

Sexual compulsivity, defined by sexual preoccupation and lack of sexual impulse control, is related to high‐risk sexual behaviors. However, little is known about the prevalence and predictors of sexual compulsivity in people at high risk for contracting sexually transmitted infections (STIs). In the current study, patients receiving diagnostic and treatment services (85% African American) at an urban STI clinic completed measures of demographic characteristics, sexual compulsivity, substance use, and sexual behaviors. Measures were administered to 492 men and 193 women using confidential procedures and audio computer‐assisted interviewing technology. Results showed that men and women receiving STI clinic services frequently endorsed multiple indicators of sexual compulsivity. In this mostly African American sample, individuals with scores above the 80th percentile on the sexual compulsivity scale (translating to over one standard deviation above the mean) had more sex partners, engaged in higher rates of sexual risk behaviors with casual or one‐time sex partners, and were nearly four times as likely to have been recently diagnosed with multiple STIs than were individuals who scored below the 80th percentile. Although sexual compulsivity scores were associated with alcohol and other drug use, associations between sexual compulsivity and sexual risks were not accounted for by substance abuse. Findings suggest an urgent need for interventions to help men and women with sexual preoccupations and poor sexual impulse control to reduce their risks for sexually transmitted infections.