Skip to main content
Springer Nature Link
Log in

Reductions in HIV Risk Among Runaway Youth

  • Published:
Prevention Science Aims and scope Submit manuscript

Abstract

Runaway youth are 6–12 times more likely to become infected with HIV than other youth. Using a quasi-experimental design, the efficacy of an HIV prevention program was evaluated over 2 years among 2 groups of runaways: (1) those at 2 shelters who received Street Smart, an intensive HIV intervention program, and (2) youth at 2 control shelters. Street Smart provided youth with access to health care and condoms and delivered a 10-session skill-focused prevention program based on social learning theory to youth. Prior to analysis of the intervention's outcomes, propensity scores were used to identify comparable subgroups of youth in the intervention (n = 101) and control conditions (n = 86). Compared to females in the control condition, females in the intervention condition significantly reduced their unprotected sexual acts at 2 years and alcohol use, marijuana use, and the number of drugs used over 12 months. Male adolescents in the intervention condition showed significant reductions in marijuana use over 6 months compared to control youth. Adolescent HIV prevention programs must proactively identify mechanisms for maintaining behavior change over the long-term, and innovative research designs are needed to allow examination of agency-level interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

REFERENCES

  • Allen, D. M., Lehman, J. S., Green, T. A., Lindegren, M. L., Onorato, I. M., & Forrester, W. (1994). HIV infection among homeless adults and runaway youth, United States, 1989-1992. AIDS, 8, 1593-1598.

    Google Scholar 

  • Botvin, G. J., Baker, E., Dusenbury, L., Tortu, S., & Botvin, E. M. (1990). Preventing adolescent drug abuse through a multimodal cognitive-behavioral approach: Results of a 3-year study. Journal of Consulting and Clinical Psychology, 58, 437-446.

    Google Scholar 

  • Brener, N. D., Collins, J. L., Kann, L., Warren, C. W., & Williams, B. I. (1995). Reliability of the Youth Risk Behavior Survey Questionnaire. American Journal of Epidemiology, 141, 575-580.

    Google Scholar 

  • Bryk, A. S., & Raudenbush, S. W. (1992). Hierarchical linear models: applications and data Analysis Methods. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Carlin, E., Miller, L., & Fiona, B. (1994). The hazards of oral sex. Sexually Transmitted Diseases, 21, 241-242.

    Google Scholar 

  • Celentano, D. D., Nelson, K. E., Lyles, C. M., Beyrer, C., Eiumtrakul, S., Go, V. F. L., Kuntolbutra, S., & Khamboonrvam, C. (1998). Decreasing incidence of HIV and sexually transmitted diseases in young Thai men: Evidence for success of the HIV/AIDS control and prevention program. AIDS, 12(5), F29-F36.

    Google Scholar 

  • Centers for Disease Control and Prevention (2000). HIV/AIDS surveillance report: US HIV and AIDS cases reported through December 2000, No. 12(2). Retrieved March 4, 2002, from http://www.cdc.gov/hiv/stats/hasr1202/table1.htm.

  • Craig, N. J. (1996). Importance of intent-to-treat response rates for the clinician. Psychiatric Annals, 26, 8-18.

    Google Scholar 

  • DiClemente, R. J., & Wingood, G. M. (1995). A randomized controlled trial of an HIV sexual risk-reduction intervention for young African-American women. JAMA, 274, 1271-1276.

    Google Scholar 

  • Exner, T. M., Seal, D. W., & Ehrhardt, A. A. (1997). A review of HIV interventions for at-risk women. AIDS and Behavior, 1(2), 93-124.

    Google Scholar 

  • Fishbein, M., & Coutinho, R. (1997). NIMH Multisite HIV Prevention Trial. AIDS, 11, S1-S63.

    Google Scholar 

  • Fullilove, M. T., Golden, E., Fullilove R. E., Lennon, R., Porterfield, D., Schwarcz, S., & Bolan, G. (1993). Crack cocaine use and high-risk behaviors among sexually active Black adolescents. Journal of Adolescent Health, 14, 295-300.

    Google Scholar 

  • Gruen, R., Calderwood, M., Meyer-Bahlburg, H., & Ehrhardt, A. (1989). Psychosexual assessment in AIDS research [Abstract]. Abstracts of the Fifth International Conference on AIDS, 1, 739.

    Google Scholar 

  • Gwadz, M., & Rotheram-Borus, M. J. (1992). Tracking high-risk adolescents longitudinally. AIDS Education and Prevention, 4, 69-82.

    Google Scholar 

  • Jemmott, J. B., & Jemmott, L. S. (2000). HIV risk reduction behavioral interventions with heterosexual adolescents. AIDS, 14(2), S40-S52.

    Google Scholar 

  • Jemmott, J. B., Jemmott, L. S., & Fong, G. T. (1992). Reductions in HIV risk-associated sexual behaviors among Black male adolescents: Effects of an AIDS prevention intervention. American Journal of Public Health, 82, 372-377.

    Google Scholar 

  • Jemmott, J. B., Jemmott, L. S., & Fong, G. T. (1998). Abstinence and safer sex HIV risk-reduction interventions for African American adolescents: A randomized controlled trial. JAMA, 279, 1529-1536.

    Google Scholar 

  • Kamb, M. L., Fishbein, M., Douglas, J. M., Rhodes, F., Rogers, J., Bolan, G., Zenilman, J., Hoxworth, T., Malotte, C. K., Iatesta, M., Kent, C., Lentz, A., Graziand, S., Byers, R. H., & Peterman, T. A. (1998). Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: A randomized controlled trial. JAMA, 280(13), 1161-1167.

    Google Scholar 

  • Kegeles, S. M., Hays, R. B., & Coates, T. J. (1996). The Mpowerment Project: A community level HIV prevention intervention for young gay men. American Journal of Public Health, 86, 1075-1076.

    Google Scholar 

  • Kipke, M. D., Montgomery, S. B., Simon, T. R., & Iverson, E. F. (1997). Substance abuse disorders among runaway and homeless youth. Substance Use and Misuse, 32(7/8), 969-986.

    Google Scholar 

  • Kipke, M. D., O'Connor S., Palmer, R., & MacKenzie, R. G. (1995). Street youth in Los Angeles—Profile of a group at high risk for human immunodeficiency virus infection. Archives of Pediatrics and Adolescent Medicine, 149, 513-519.

    Google Scholar 

  • Koniak-Griffin, D., & Brecht, M. L. (1995). Linkages between sexual risk taking, substance use, and AIDS knowledge among pregnant adolescents and young mothers. Nursing Research, 44, 340-346.

    Google Scholar 

  • Koopman, C., Rosario, M., & Rotheram-Borus, M. J. (1994). Alcohol and drug use and sexual behaviors placing runaways at risk for HIV infection. Addictive Behaviors, 19, 95-103.

    Google Scholar 

  • Laird, N. M., & Ware, J. H. (1982). Random-effects models for longitudinal data. Biometrics 1982, 963-974.

  • Littell, R. C., Milliken, G. A., Stroup, W. W., & Wolfinger, R. D. (1996). SAS system for mixed models. Cary, NC: SAS Institute, Inc.

    Google Scholar 

  • Little, R. J. A, & Rubin, D. B. (1987). Statistical analysis with missing data. New York: Wiley.

    Google Scholar 

  • Marlatt, G. A., & Gordon, J. R. (1985). Relapse Prevention—Maintenance strategies in the treatment of addictive behaviors. New York: Guilford Press.

    Google Scholar 

  • National Institutes of Health (NIH) Consensus Development Conference Panel (2000). Interventions to prevent risk behaviors. AIDS, 14 (Suppl. 2), 85-96.

    Google Scholar 

  • National Institute of Mental Health Multisite (NIMH) HIV Prevention Trial Collaborators (1997). Methodological overview of a multisite HIV prevention trial for populations at risk for HIV. AIDS, 11 (Suppl. 2), S1-S11.

    Google Scholar 

  • National Institute of Mental Health Multisite (NIMH) HIV Prevention Trial Group (1998). The NIMH Multisite HIV Prevention Trial: Reducing HIV sexual risk behavior. Science, 280, 1889-1894.

    Google Scholar 

  • National Network of Runaway and Youth Services (1991). To whom do they belong?: Runaway, homeless and other youth in high-risk situations in the 1990's. Washington, DC: Author.

    Google Scholar 

  • Orr, D. P., Fortenberry, J. D., & Blythe, M. J. (1997). Validity of self-reported sexual behaviors in adolescent women using biomarker outcomes. Sexually Transmitted Diseases, 24, 261-266.

    Google Scholar 

  • Ostrow, D. G. (1994) Substance abuse and HIV infection. Psychiatric Clinics of North America, 17, 69-89.

    Google Scholar 

  • Paikoff, R. L. (1995). Early heterosexual debut: Situations of sexual possibility during the transition to adolescence. American Journal of Orthopsychiatry, 65(3), 389-401.

    Google Scholar 

  • Pedersen, W., Mastekaasa, A., & Wichstrom, L. (2001). Conduct problems and early cannabis initiation: A longitudinal study of gender differences. Addiction, 96(3), 415-431.

    Google Scholar 

  • Pennbridge, J. N., Freese, T. E., & MacKenzie, R. G. (1992, Fall). High-risk behaviors among male street youth in Hollywood, California. AIDS Education and Prevention, (Suppl.), 24-33.

  • Pennbridge, J. N., Yates, G. L., David, T. G., & Mackenzie, R. G. (1990). Runaway and homeless youth in Los Angeles County, California. Journal of Adolescent Health Care, 11, 159-165.

    Google Scholar 

  • Quinn, T. C., Glasser, D., Cannon, R., Matuszak, D. L., Dunning, R. W., Kline, R. L., Campbell, C. H., Israel, E., Fauci, A. S., & Hook, E. W. (1988). Human immunodeficiency virus infection among patients attending clinics for sexually transmitted diseases. New England Journal of Medicine, 318, 197-203.

    Google Scholar 

  • Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70, 41-55.

    Google Scholar 

  • Rosenbaum, P. R., & Rubin, D. B. (1984). Reducing bias in observational studies using subclassification on the propensity score. Journal of the American Statistical Association, 79, 516-524.

    Google Scholar 

  • Rotheram-Borus, M. J., Gwadz, M., Fernandez, M. I., & Srinivasan, S. (1998). Timing of HIV interventions on reductions in sexual risk among adolescents. American Journal of Community Psychology, 26, 73-96.

    Google Scholar 

  • Rotheram-Borus, M. J., Koopman, C., & Ehrhardt, A. A. (1991a). Homeless youths and HIV infection. American Psychologist, 46(11), 1188-1197.

    Google Scholar 

  • Rotheram-Borus, M. J., Koopman, C., Haignere, C., & Davies, M. (1991b). Reducing HIV sexual risk behavior among runaway adolescents. JAMA, 266, 1237-1241.

    Google Scholar 

  • Rotheram-Borus, M. J., Lee, M. B., Gwadz, M., & Draimin, B. (2001). An intervention for parents with AIDS and their adolescent children. American Journal of Public Health, 91, 1294-1302.

    Google Scholar 

  • Rotheram-Borus, M. J., Meyer-Bahlburg, H., Rosario, M., Koopman, C., Haignere, C., Exner, Exner, T., Matthien, M., Henderson, R., & Gruen, R. (1992). Lifetime sexual behaviors among runaway males and females. Journal of Sexual Research, 29, 15-29.

    Google Scholar 

  • Rotheram-Borus, M. J., Rosario, M., Reid, H., & Koopman, C. (1995). Predicting patterns of sexual acts among homosexual and bisexual youths. The American Journal of Psychiatry, 152, 588-595.

    Google Scholar 

  • Shew, M. L., Remafedi, G. J., Bearinger, L. H., Faulkner, P. L., Taylor, B. A., Potthoff, S. J., & Resnick, M. D. (1997). The validity of self-reported condom use among adolescents. Sexually Transmitted Diseases, 24, 503-510.

    Google Scholar 

  • Shure, M. B. (1992). I Can Problem Solve: An interpersonal cognitive problem-solving program. Intermediate elementary grades. Champaign, IL: Research Press.

    Google Scholar 

  • Song, J., Belin, T. B., Lee, M. B., Gao, X., & Rotheram-Borus, M. J. (2001). Handling baseline differences and Missing Items in a Longitudinal Study about Reductions in HIV Risk among Runaway Youth. Health Services and Outcomes Research Methodology, 2, 317-329.

    Google Scholar 

  • Stanton, B. F., Li, X., Ricardo, I., Galbraith, J., Feigelman, S., & Kaljee L. (1996). A randomized, controlled effectiveness trial of an AIDS prevention program for low-income African-American youths. Archives of Pediatric Adolescent Medicine, 150, 363-372.

    Google Scholar 

  • St. Lawrence, J. S., Jefferson, K. W., Alleyne, E., & Brasfield, T. L. (1995). Comparison of education versus behavioral skills training interventions in lowering sexual HIV-risk behavior of substance-dependent adolescents. Journal of Consulting and Clinical Psychology, 63, 154-157.

    Google Scholar 

  • St. Louis, M. E., Hayman, C. R., Miller, C., Anderson, J. E., Petersen, L. R., & Dondero, T. J. (1989). HIV infection in disadvantaged adolescents in the US: Findings from the Job Corps Screening Program [Abstract]. Abstracts of the Fifth International Conference on AIDS, 1, 711.

    Google Scholar 

  • Stricof, R. L., Kennedy, J. T., Nattell, T. C., Weisfuse, I. B., & Novick, L. F. (1991). HIV seroprevalence in a facility for runaway and homeless adolescents. American Journal of Public Health, 81 (Suppl.), 50-53.

    Google Scholar 

  • Sweeney, P., Lindegren, M. L., Buehler, J. W., Onorato, I. M., & Janssen, R. S. (1995). Teenagers at risk of human immunodeficiency virus type 1 infection. Results from seroprevalence surveys in the United States. Archives of Pediatrics and Adolescent Medicine, 149, 521-528.

    Google Scholar 

  • Trautman, P., & Rotheram-Borus, M. J. (1988). Cognitive-behavior therapy with children and adolescents. In J. Rush & F. Allen (Eds.). Review of psychiatry (Vol. 7, pp. 584-607). Washington, DC: American Psychiatric Association Press.

    Google Scholar 

  • Udry, J., & Billy, J. O. (1987). Initiation of coitus in early adolescence. American Sociological Review, 52(6), 841-855.

    Google Scholar 

  • Wells, K. (1980). Gender role identity and psychological adjustment in adolescence. Journal of Youth and Adolescence, 9, 59-73.

    Google Scholar 

  • Williams, B. G., Gouws, E., Colvin, M., Sitas, F., Ramjee, G., & Abdool Karim, S. S. (2000). Patterns of infection: Using age prevalence data to understand the epidemic of HIV in South Africa. South African Journal of Science, 96(6).

  • Witkin, A., Milburn, N., & Rotheram-Borus, M. J. (2001, February). Homeless and runaway youth: Characteristics and trajectories. Paper presented at the Universitywide AIDS Research Program. Translating Research into Local and Global Action, California AIDS Research. Los Angeles, California.

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of California, Los Angeles, California

    Mary Jane Rotheram-Borus, Juwon Song & Martha Lee

  2. Institute for AIDS Research, National Development and Research Institutes, New York

    Marya Gwadz

  3. Department of Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands

    Ronan Van Rossem

  4. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Standford, California

    Cheryl Koopman

Authors
  1. Mary Jane Rotheram-Borus
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Juwon Song
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Marya Gwadz
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Martha Lee
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Ronan Van Rossem
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Cheryl Koopman
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Mary Jane Rotheram-Borus.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rotheram-Borus, M.J., Song, J., Gwadz, M. et al. Reductions in HIV Risk Among Runaway Youth. Prev Sci 4, 173–187 (2003). https://doi.org/10.1023/A:1024697706033

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1024697706033