Researchers found that teens in psychiatric care who used crack and/or cocaine at least once were six times more likely to use condoms inconsistently, which was defined as "sometimes," "never" or "rarely."
The findings suggest that crack cocaine appears to have more of an influence on risky teen behaviors than other factors, like alcohol and marijuana use, which are more routinely incorporated into adolescent HIV prevention interventions.
Nearly 280 teens between the ages of 13 and 18 from therapeutic psychiatric day programs took part in the study. Participants exhibited a range of psychiatric diagnoses, including mood disorders, post-traumatic stress disorder and disruptive behavior disorders. More than half of all adolescents were male, and more than three-quarters were Caucasian. Approximately 13 percent of teens in the study reported trying crack or cocaine at least once.
After controlling for known adolescent HIV risk factors, such as gender, race, age and psychiatric status, researchers found that only 47 percent of teens with a history of crack and/or cocaine use said they used condoms "always or almost always." In addition, 15 percent of these adolescents have a history of sexually transmitted diseases (STD), nearly three-quarters reported using alcohol at least once and more than half indicated prior marijuana use.
In comparison, 71 percent of teens who never used crack or cocaine reported using condoms consistently.
Tolou-Shams says it was important to look at the association between crack and cocaine use and HIV risk behavior in adolescents with psychiatric disorders, since previous research has shown that teens in mental health treatment have high rates of risky sexual behavior and are more likely to engage in substance use.
"Our study clearly shows that youth in psychiatric treatment are using other drugs – and not just alcohol or marijuana – at high rates and that a history of drug use should alert clinicians to a wide variety of possible behavioral risks in their young patients," she adds.
Citation: Tolou-Shams et al., 'Crack and Cocaine Use Among Adolescents in Psychiatric Treatment: Associations with HIV Risk', Journal of Child&Adolescent Substance Abuse, April 2010, 19(2) 122 - 134