AIDS (London, England) 2017 12 12() doi 10.1097/QAD.0000000000001717
To examine trajectories of adolescent psychosocial risk-drug use, depressive and anxiety symptoms, and violence victimization and observation-and the longitudinal relationship between psychosocial risk trajectories during adolescence and HIV risk behaviors in adulthood.
The eighteen-year longitudinal study was conducted from September 1994 through May 2013, in Michigan. Eight-hundred and fifty predominantly (80%) African American adolescents completed demographics and measures of drug use, depressive and anxiety symptoms, violence victimization and observation at Times 1-4, sexual risk behaviors at Times 5 and 6, and social conditions (i.e., family, peer, and community-level factors) between 14.9 and 32.0 years of age.
Growth mixture modeling revealed two trajectories of psychosocial risk factors which can be characterized as a syndemic index: High-Frequency and Low-Frequency. The High-Frequency class was more likely to report HIV risk behaviors, including condomless sex at last sexual intercourse with their primary and secondary partner, sexual intercourse with someone they just met, ≥ 4 sexual partners, and licit and illicit drug use prior to sexual intercourse at Time 5 (mean age 23.1). At Time 6 (mean age 32.0), the High-Frequency class was more likely to report sexual intercourse with someone they just met and ≥ 4 sexual partners, relative to the Low-Frequency class. Additionally, the High-Frequency class was linked to peer and family-level indicators of social conditions.
A syndemic index comprised of co-occurring psychosocial risk factors in adolescence seem to have lasting effects on the vulnerability to engage in HIV risk behaviors in emerging adulthood, some of which extend into middle adulthood.