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July 2005 Monthly Monitor
Advocates for Youth's Youth of Color Initiative
Feature: Substance Use/Abuse and HIV Prevention
Youth of color are disproportionally infected with HIV and affected by the HIV and AIDS epidemic. Of the estimated 3,897 young people that received a diagnosis of HIV or AIDS in 2003, more than half were young people of color, even though youth of color represent less than 27 percent of the United States’ youth.[1] Many factors contribute to high rates of HIV among youth of color, factors that include poverty, oppression, stigma, and lack of access to HIV information and prevention services. Some people point to the use of drugs and alcohol use as a major factor. Indeed, intravenous drug use (IDU) is a high risk mode of transmission for HIV, not just for the intravenous drug user but also for his/her sexual partners.
A great deal of research links sexual risk-taking and substance use. However contrary to common myth, research fails to demonstrate a causal effect between substance use and use or nonuse of contraceptives or condoms. In fact, studies that specifically looked for a causal effect showed that inconsistent condom users tended to be inconsistent in their use of condoms, regardless of whether or not they were drinking alcohol or using other substances.[2,3] Consistent users of condoms remained consistent users, regardless of whether or not they were drinking or using other drugs.[2,3] Nonusers remained nonusers, regardless of whether or not they were drinking or using other drugs.[2,3] At the same time, research shows an association between risk behaviors. That is, youth who take many risks take these risks across several domains. For example in one study, youth who reported binge drinking were also more likely to report multiple sexual partners and unprotected sexual intercourse than youth who did not binge drink.[3] One study found that sexually active high school students were more likely than students who had not had sexual intercourse to also report use of cigarettes, alcohol, marijuana, and cocaine.[4] Another study found that students who reported fighting twice or more in the past month were also more likely than were other students to report attempting suicide, carrying weapons, using cocaine, driving drunk, having multiple sex partners, and not using condoms.[5]
According to the Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Surveillance (YRBS) for 2003, young people of color sometimes use drugs and alcohol at higher rates than their white peers. For example, 80 percent of Hispanic/Latino students reported using alcohol at some time in their life, compared to 75 percent of white and 71 percent of African American/black students. Heavy, episodic drinking, on the other hand, was higher among white students (32 percent) than among Hispanic/Latino (29 percent) or African American/black students (15 percent). Forty-three percent of African American/black and Hispanic/Latino students reported ever having used marijuana compared to 40 percent of white students. Lifetime use of cocaine was reported by 13 percent of Hispanic/Latino students, compared to nine percent of white and three percent of African American/black students.[6]
Youth of color also tend to idealize hip hop entertainment celebrities and their lifestyles, which often seem to encourage sex, drugs and alcohol use. Videos and programs geared toward youth of color sometimes portray drugs and alcohol as cool or ‘sexy.’ At house parties and clubs, youth sometimes use illegal substances, often referred to as club drugs, such as MDMA (ecstasy), methamphetamine (crystal meth or speed), GHB (liquid X), Ketamine (special K) and, less often, amyl nitrites (poppers). Youth may also use controlled substances, such as Viagra and codeine, in ways they were not intended to be used. Many drugs are easily accessible, especially in those communities of color that are plagued by poverty and high rates of unemployment.
Physical and psychological effects of these drugs can include elevated mood; altered vision, sensations, and emotions; hyper alertness; unnaturally strong sense of self-confidence; and decreased appetite. They can also cause torpor (extreme relaxation) or a hyper-active state. These alterations in mood frequently affect users’ judgment, possibly contributing to their willingness to engage in sexual risk-taking, such as having sex without a condom.
In an attempt to mitigate the HIV epidemic among youth of color, some propose that effective programs should involve an integrated component to prevent substance use and abuse. To date, the programs that have been most effective in reducing both sexual risk behaviors and substance use have been programs that targeted neither. They were, in fact, programs that address early childhood development and socialization skills.[7,8,9] While experts have devised a range of HIV interventions as well as a range of substance use interventions, these programs have not yet been evaluated. Evaluation for long-term behavior change is very important for programs that are currently attempting to change both substance use and sexual risk behaviors among participants.
In the meantime, program planners should continue to look to effective programs that offer culturally appropriate prevention education designed to change behaviors of youth who are at risk of acquiring or transmitting HIV infection. Prevention programs for young people may offer the greatest potential for changing the course of the HIV epidemic, and those for youth of color should be culturally appropriate and provide youth development and life skills training.
- CDC. HIV/AIDS Surveillance Report, 2003. 2004; 15:1-40.
- Mahoney CA, Thombs DL, Ford OJ. Health belief and self-efficacy models: their utility in explaining college student condom use. AIDS Education & Prevention 1995; 7:32-49.
- Graves KL, Leigh BC. The relationship of substance use to sexual activity among young adults in the United States. Family Planning Perspectives 1995; 27:18-22+.
- Levy SR et al. Correlates of HIV risk among young adolescents in a large metropolitan Midwestern epicenter. Journal of School Health 1995; 65:28-32.
- Valois RF et al. Correlates of aggressive and violent behaviors among public high school adolescents. Journal of Adolescent Health 1995; 16:26-34.
- Centers for Disease Control & Prevention. Youth Risk Behavior Surveillance, United States, 2003. Morbidity and Mortality Weekly Report: Surveillance Summaries 2004; 53(SS-2): 1-96.
- Alford S et al. Science and Success: Sex Education and Other Programs that Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections. Washington, DC: Advocates for Youth, 2003. http://www.advocatesforyouth.org/programsthatwork/index.htm
- Lonczak HS et al. Effects of the Seattle Social Development Project on sexual behavior, pregnancy, birth, and sexually transmitted disease outcomes by age 21 years. Archives of Pediatrics & Adolescent Medicine 2002; 156:438-447.
9. Campbell FA et al. Early childhood education: young adult outcomes from the Abecedarian Project. Applied Developmental Science 2002; 6(1):42-57.
For more information on programs that affect substance and sexual risk behaviors among youth of color, visit http://www.advocatesforyouth.org/programsthatwork/index.htm Click on:
- Abecedarian Project
- Seattle Social Development Project
For more information on programs that affect sexual health outcomes and/or sexual risk behaviors, visit http://www.advocatesforyouth.org/programsthatwork/index.htm
For a series of teen brochures which provide facts and dispels myths about substance use, including information on long-term and short-term effects, physical and psychological risks, impact on sexual performance, and legal implications, please visit http://ncadi.samhsa.gov/promos/tipsforteens.aspx
Youth of Color Initiative Partner Programs
Foothill AIDS Project, Claremont, CA
Foothill AIDS Project (FAP) is dedicated to serving individuals and families affected by the HIV and AIDS epidemic and/or infected with HIV through comprehensive and specialized support services. Eighty-five percent of FAP’s staff and a majority of its Board of Directors represent communities of color. Forty-five percent of FAP's clientele are African American/black and 28 percent are Latino/Hispanic. Since 1987, FAP has served the communities of San Bernardino County and eastern Los Angeles County in California. Each year, the agency serves over 700 men, women, and children with services which include case management, mental health and substance abuse counseling, food, transportation, and housing and utility assistance. Each year, the agency also reaches thousands of men, women, and children with education and prevention.
This year, FAP is starting two new programs that aim to incorporate substance abuse/mental health treatment and HIV prevention among young people. The first, is the agency's SWEET (Safe, Wise, Empowered, Educated, Tested) Program. The Program will target young women color ages 18 through 24 living in San Bernardino County. To combat increasing HIV infection in this population, the SWEET Program will incorporate trained peer counselors and a community-wide youth summit that will highlight connections between substance abuse and HIV infection. Activities in the SWEET program will focus on changing community-wide norms and attitudes to reduce sexual risk and prevent the spread of HIV.
Progressive Life Center, Washington, DC
Progressive Life Center, an African American, nonprofit, human services organization, provides comprehensive HIV and substance abuse prevention services for adolescents in foster care, adjudicated youth, and family preservation programs, through its Rites of Passage Program. These services are also offered to middle school students in Washington, DC, and suburban Maryland. Called Project Amani, the Rites of Passage Program curriculum, along with comprehensive HIV and substance abuse prevention services, is expected to: strengthen core cultural values, collective and personal worth, and responsibility; promote positive life choices; and prevent HIV and substance use among adolescents and young adults. Project Amani is in its second year, and there are plans to continue the project for another year.
Capacity Building & Professional Development
Sixth Annual Institute for Program Development and Evaluation Conference
Lasting two and a half days, the Conference will provide hands-on, introductory training in science-based program development and evaluation to teen pregnancy and STI/HIV prevention program staff. Scheduled for August 25-27, 2005, in Palo Alto, California, the cost of attendance is $695, which includes tuition and all course materials. Deadline for registration for IPDE 2005 conference is Friday, July 22, 2005. For more information, please visit http://www.socio.com/ipde/index.htm or contact Denise Hill, IPDE Coordinator at 650-949-3282 x 203 or 800-846-3475 x203.
The Institute for Program Development and Evaluation Online
The Institute for Program Development and Evaluation Online (IPDE Online) training program provides teen pregnancy and STI/HIV prevention program staff from schools, community-based organizations, clinics and other agencies with online professional training in developing and evaluation program models. IPDE Online will teach participants the comprehensive skills necessary to integrate evaluation into the planning and operation of effective prevention programs. IPDE Online includes four courses: 101: Introduction to IPDE: Developing and Evaluating Programs That Meet Your Community Needs; 201: Looking In: Developing your Program Model; 202: Are We Delivering What We Said We Would? Conducting a Process Evaluation; and 203: Are We Making a Difference? Conducting an Outcome/Impact Evaluation The maximum cost for the online curriculum is $125. For more information, please visit http://www.socio.com/srch/summary/misc/ipdeonl.htm
Funding Opportunities
Drug Policy Foundation
The Drug Policy Foundation (DPF) is an independent, nonprofit organization that publicizes alternatives to current drug strategies. DPF makes grants to organizations and individuals to support harm reduction programs, advocacy efforts that support drug policy reform, and public education on drug policy reform issues. Maximum amount of awards is $25,000; awards can be used toward projects focused on: advocacy; education and prevention; HIV and AIDS prevention; and injection drug use and risk reduction. Eligible applicants must be 501(c)(3) organizations. For more information, please contact Neil Moran at 202-537-5005 or by fax at 202-537-3007.
The US Department of Health and Human Services, the National Institutes of Health, and the National Institute of Child and Human Development are providing funding for research on Men's Heterosexual Behavior and HIV Infection. This program announcement seeks research that will contribute to a better understanding of how culturally defined meanings of gender and expectations about men's sexual behaviors influence risk of HIV infection in heterosexual men and their sexual partners. The announcement focuses on men 18 years of age or older, and on men who have sex with women (including men who may also have sex with men). Eligible organizations include city agencies, colleges/universities, community-based organizations, federal government agencies, nonprofit organizations religious organizations, and tribal organizations. Applications are due September 1, 2005, and projects will begin July 1, 2007. For more information, please visit http://www.fedgrants.gov/Applicants/HHS/NIH/NIH/PA-05-033/Grant.html (no longer available) or contact Victoria Connors of the National Institute of Child Health and Human Development at 301-496-5482 or connorsv@mail.nih.gov
Public Welfare Foundation
The Public Welfare Foundation is dedicated to supporting organizations that provide services to disadvantaged populations, and to those working for lasting improvements in delivering services that meet basic human needs. The funding focuses in eight program areas: community economic development and participation; criminal justice; disadvantaged elderly; disadvantaged youth; environment; health; human rights and global security; and population and reproductive health. Eligible applicants must be 501(c)(3) organizations. For more information, please visit http://www.publicwelfare.org
Announcements
The Youth Angle 2005 Conference, Back to the Basics: Youth and the Invisible Epidemic, will be held August 24-26, 2005, in Dallas, Texas. Given the silence inherent in the HIV epidemic and the widespread climate of denial, young people have little incentive to learn their HIV status or to be open about it. Those living in the shadow of the epidemic, those at the forefront of change must create a new language that makes more visible the new realities of life in the era of HIV. The Conference’s goal is to provide updated information, practical tools, and an opportunity for participants to gain increased insight on HIV and AIDS prevention, interventions, and clinical care that address the needs of adolescents. The Conference also offers FREE Youth Leadership Training for youth ages 13 to 24. This intensive training session, facilitated by AIDS Alliance, will be held in conjunction with the conference to prepare youth to assume leadership roles among their peers. Continuing education credits will be available for nurses, nurse practitioners, and social workers. Registration is $195. For more information, please contact June Trimble at 214-456-1641 or june.trimble@utsouthwestern.edu
Resources
Center for Substance Abuse Prevention
http://www.health.org/sa-hiv/new.aspx
National Institute on Alcohol Abuse and Alcoholism
http://www.niaaa.nih.gov/
The National Institute on Drug Abuse
http://www.nida.nih.gov/
http://hiv.drugabuse.gov/
Office of Minority Health
http://www.omhrc.gov/
You can help Advocates for Youth with a contribution today. To donate, visit http://www.advocatesforyouth.org/about/donatetoday.htm
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