Marijuana Use and Psychiatric Disorders in Perinatally HIV-Exposed Youth: Does HIV Matter?

OBJECTIVE:  To examine longitudinal reciprocal relationships between marijuana use and psychiatric disorders, and identify the role of HIV in a sample (N = 340) of youth perinatally infected with HIV (PHIV+) and youth perinatally exposed but uninfected with HIV (PHIV-) (60.6% PHIV+; 9-16 years at baseline; 51% female). METHODS: Cross-lagged structural equation modeling was used to examine longitudinal associations between changes in marijuana use and changes in any behavioral, mood, and anxiety disorders at three time points across adolescence. RESULTS: Marijuana use predicted behavioral and mood disorders in youth, regardless of HIV status. Behavioral and mood disorders predicted marijuana use for PHIV- youth; behavioral disorders predicted marijuana use for PHIV+ youth. Anxiety disorders and marijuana use were not associated for either group. CONCLUSIONS: For PHIV+ and PHIV- youth, interventions that target early marijuana use may reduce later psychiatric disorders. Similarly, treatment for early behavioral disorders may prevent subsequent marijuana use.

Youth in transition: life skills among perinatally HIV-infected and HIV-exposed adolescents.

OBJECTIVE: To examine mastery of life skills necessary for independent adulthood among perinatally HIV-infected (PHIV+) and perinatally HIV-exposed but uninfected (PHIV-) youth. METHODS: Participants were recruited from four medical centers in New York City as part of a longitudinal study. Data for this article came from interviews of 150 PHIV+ and 95 PHIV- youth (age 13-24 years) and their caregivers. Life skills mastery was assessed using the Ansell-Casey Life Skills Assessment (ACLSA). RESULTS: PHIV+ youth had lower daily living skill mastery than PHIV- youth according to both youth and caregivers, and lower self-care mastery according to caregiver report. No HIV-status group differences were found in social relationships scores, but PHIV- youth had higher scores than an ACLSA benchmark sample. CONCLUSIONS: PHIV+ youth may need supportive services in daily living and self-care needs to transition into adulthood. Normal-to-high functioning in social relationships may be important for learning to live independently.

Peer network drinking predicts increased alcohol use from adolescence to early adulthood after controlling for genetic and shared environmental selection.

Research consistently links adolescents' and young adults' drinking with their peers' alcohol intake. In interpreting this correlation, 2 essential questions are often overlooked. First, which peers are more important, best friends or broader social networks? Second, do peers cause increased drinking, or do young people select friends whose drinking habits match their own? The present study combines social network analyses with family (twin and sibling) designs to answer these questions via data from the National Longitudinal Study of Adolescent Health. Analysis of peer nomination data from 134 schools (n = 82,629) and 1,846 twin and sibling pairs shows that peer network substance use predicts changes in drinking from adolescence into young adult life even after controlling for genetic and shared environmental selection, as well as best friend substance use. This effect was particularly strong for high-intensity friendships. Although the peer-adolescent drinking correlation is partially explained by selection, the present finding offers powerful evidence that peers also cause increased drinking.