“This may suggest that the influence of psychiatric problems, although certainly a risk factor for both males and females, may be more closely related to risky sexual decision making for males,?the authors write.
Age and race were also factors in distinguishing the clusters of males, but in contrast to the authors?hypothesis, African Americans did not represent the greatest proportion of those at high sexual risk. In fact, more than half (52 percent) of the boys in the cluster reporting the most unprotected sex, and with the most mental health problems were white, and on average 20.46 years old; 27 percent were African American, and 27 percent were Latino. By contrast, the group of boys who reported only moderate numbers of unprotected sex acts, but with higher amounts of substance abuse were, on average, 20.90 years old; 43 percent were African American, 36 percent white, and 27 percent Latino. Those in the lowest-risk group were predominantly African-American (66 percent) (25 percent Latino and 14 percent White) and younger than the other two groups at 19.17 years old.
These patterns suggest that effective HIV prevention needs to target the association between mental health and substance abuse with sexual risk for some adolescents, the authors say.
There were also significant demographic differences between the groups of females. Girls in the group at highest risk for HIV (those reporting the most unprotected sex) were 38 percent African-American, 37 percent white, and 30 percent Latino. Females in the group reporting moderate numbers of unprotected sex acts, but high levels of substance use and mental health crises were less likely to identify themselves as heterosexual (57 percent identified themselv