PEDIATRICS Vol. 88 No. 4 October 1991, pp. 846-852
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Psychosocial Influences on Acquired Immunodeficiency Syndrome-Risk Behaviors Among High School Students

Heather J. Walter MD, MPH1, Roger D. Vaughan MS2, and Alwyn T. Cohall MD3

1 From the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
2 From the New York State Psychiatric Institute, New York, New York
3 From the Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York

A survey measuring acquired immunodeficiency syndrome (AIDS)-related behaviors and selected psychosocial factors was administered to 1091 tenth grade students residing in or near an AIDS epicenter. The purpose of the survey was to identify salient risk factors that could be targeted in AIDS prevention programs. By 15 years of age, one quarter of students reported engaging in behaviors that placed them at higher risk for acquiring infection with human immunodeficiency virus, and 3% of students reported engaging in very high-risk behaviors. Students exposed to certain psychosocial stressors (ie, adverse life circumstances and poor parental support), who engaged in other problem behaviors (ie, substance use and academic problems) and who had higher self-esteem, were more likely to engage in higher risk behaviors. Pediatricians and other clinicians, particularly those working in or near AIDS epicenters, who encounter adolescents with multiple psychosocial problems, should be alert to the possibility that these youths also are engaging in behaviors that place them at risk for AIDS. Comprehensive care for these teenagers must include an assessment of involvement in AIDS-risk behaviors and appropriate behavioral counseling.

Key Words: adolescents • acquired immunodeficiency syndrome prevention • risk factors

Submitted on December 27, 1990
Accepted on March 5, 1991


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