# Presentation: 305864

## Youth: Interconnections that RiskInterconnections that Protect

- Alma L. Golden, MD
- Deputy Assistant Secretary of Population Affairs
- March 29, 2004

## What Places Our Teens at Risk for HIV?

- Immediate risks are drug use and sexual involvement
- Patterns are an interplay of both risk factors and protective factors
- Risks generally occur in interconnected clusters
- Protective  patterns also exist in interconnected clusters

- How can we provide _***more***_ protection and _***less***_*** ***risk to our youth?

## Who are our youth?

## Who are our youth?

## Who Is Doing What7th-12th Grade Teens

- 11% of males and 5% of females perpetuated violence in the past year
- 10% if males and 9% of females smoke 6 or more cigarettes a day
- 20% of males and 16% of females drink alcohol  2 or more days a month
- 14% of males and 12% of females use marijuana at least once a month
- 40% of males and 37% of females have ever had sexual intercourse

## Risks are interconnected

- Because behaviors tend to cluster
- Because decision pathways are similar
- Because one risk may dis-inhibit for another risk
- Because personal management or self-control may not be well developed
- Because there is no clear advantage for avoiding risks
- Because most risky behaviors have common risk factors

## Relationship of Risks

## Co-Risks With Substance Use

- Use of one substance significantly increases the chances of others
- Regular or binge use is associated with more violent and delinquent acts
- Increases vulnerability to sexual risks
- Both behavioral patterns and personal health consequences can be life-long

## Co-Risks With Drug Use

## Other Co-Risks With Drugs

## Co-Risks With Tobacco Use

## Co-Risks With Sexual Activity

- Sexually active teens have higher rates of most other risk behaviors, particularly those who initiate sex at a young age

## Teen Choices 

## Age at Initiation of Sex and Risk of STDs/HIV/AIDS

- The younger the teen is when he or she initiates sex, the more partners he or she will have by age 20
- Number of partners is a risk factor for STDs and HIV/AIDS

## Connections for Protections

- Family
- Faith
- Friends
- Future
- School

## Parents and Family

- Most teens say that parents have the most influence on their decisions about sex.
- Most teens say that their parents are their role models.

## How Parents Influence Teens

- Parent/Child Connections
- Shared Parent/Adolescent Activities
- Parental Presence
- Household Access to Substances
- Parents Disapproval of Sex
- Parent Disapproval of Contraception
- Parental Expectations
- Parental School Expectations

## Faith

- “When asked what factors most affect their decisions about whether to have sex, teens – by a wide margin – said morals, values, and/or religious beliefs.”
- 83% of teens said that religion is important in their lives
- 51% of teens ages 12-17 attend church weekly

## Friends

**After parents, teens say their friends have the most influence on their decisions about sex**
**Peer influence can be both positive and negative, depending on the friends**
**Friends model behaviors and set norms**
**Having older friends is a risk factor**
**Parents can influence teen’s choice of friends**

## Schools

**Teens who feel connected to their schools are:**** **
**Less likely to engage in risky behaviors **
**Less likely to be violent**
**Less likely to smoke, drink and use marijuana**
**More likely to delay sexual activity**

## Factors Influencing School Connectedness:

- Perceived lack of prejudice
- Perceived fair treatment by teachers
- Feeling part of the school
- Feeling closeness with others
-  Average daily attendance

## Vision for the Future 

- Teens who have a positive vision for their future are less likely to engage in risky behaviors.
- Perception of hopelessness and lack of goals are powerful risk factors
- Parents and other adults can help teens identify and work toward goals

## Challenge

- Youth who engage in multiple risk behaviors tend to be those youth who lack “clusters” of protective factors.
- Challenge is to increase the number of  protective factors in the lives of at-risk youth.

## Strategies for Increasing Protective Factors

**Facilitate parental and family involvement**
**Provide positive examples and role models**
**Encourage respect for self, others and the law**
**Promote self management**
**Teach decision making**
**Promote healthy relationships**
**Establish expectations**