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  • Title: Adolescents, sex and injecting drug use: risks for HIV infection.
    Author: Barnard M, McKeganey N.
    Journal: AIDS Care; 1990; 2(2):103-16. PubMed ID: 2085532.
    Abstract:
    In this paper we present data on the HIV-related risks for adolescents growing up in an area where injecting drug use is prevalent and HIV infection has been identified among local injecting drug users. We report on young peoples' knowledge, attitudes and perceptions of drug use and injectors; HIV and AIDS; sex, safer sex and condom use. These adolescents had an extensive and practically oriented knowledge of illicit drugs and drug injectors. The majority of adolescents contacted had an unsophisticated but approximate understanding of HIV transmission dynamics and how to guard against infection. Our data suggest that many adolescents find issues relating to sex awkward, embarrassing and difficult subjects for discussion. In a final section we consider some of the policy implications of our work focussing in particular on the prevention of injecting, the promotion of condom use, and the necessity of avoiding a focus upon risk groups. A study was conducted of adolescents in close contact with groups at high risk of HIV infection for information on their knowledge, attitudes, and perceptions regarding drug use and intravenous (IV) drug use, HIV and AIDS, sex, safer sex, and condoms. The study was implemented out of concern over the heterosexual transmission of HIV between IV-drug users and their non-injecting sex partners. Specifically, youths largely between ages 14-16 from a squalid inner city section Northwest of Glasgow formed the target population under investigation. Since a large number of youths have initiated IV-drug use since 1981, and HIV infection has already been identified among local users, this area was an appropriate locale to study HIV-related risks for adolescents growing up where IV drug use is prevalent. Semi-structured interviews, group interviews, street interviews, and direct observation were employed mainly among adolescents in a Catholic school, a non-denominational school, a community center, and an intermediate treatment (IT) social work group to gain pertinent study answers. 64 in-school students of both sexes in group discussions over a 2-month period formed the bulk of the sample, while an informal approach of a more random nature was used at the community center. Only 5 girls were involved from the IT group. The youths demonstrated an extensive, current knowledge of illicit drugs and IV-drug users in the community. Virtually all interviewed personally knew an IV-drug user. The majority also had an approximate understanding of HIV transmission dynamics and how to protect themselves, albeit with a certain degree of misinformation and confusion. Sex issues were generally difficult to broach and discuss, with most adolescents feeling awkward and embarrassed. Health education programs must be more broadly based to include outside contacts of high risk groups. Locally-targeted, school-based classes and campaigns led by health professionals and ex-IV users may be most appropriate and effective in communicating HIV infection prevention messages, clarifying misconceptions of transmission dynamics, dissuading IV-drug experimentation and use, and gaining acceptance for negotiating safer sex practices among sexually active youths. Moreover, attitudinal gender differences between boys and girls toward relationships and condoms should be recognized, with consideration given to designing educational campaigns according to sex.
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