Risk of polysubstance use and co-occurring internalizing and externalizing symptoms among adolescent sexual minority girls

s / Drug and Alcohol Dependence 146 (2015) e202–e284 e263 HIV among Puerto Rican people who inject drugs: Health disparities continue Sherry Deren1, C. Gelpi-Acosta2, C. Albizu-Garcia3, A. Gonzalez5, D. Des Jarlais4, S. Santiago-Negron5 1 NYU, New York, NY, United States 2 NDRI, New York, NY, United States 3 UPR, San Juan, United States 4 BIMC, New York, NY, United States 5 ASSMCA, San Juan, United States Aims: To describe health disparities related to HIV among Puerto Rican people who inject drugs (PRPWID) in the Northeast US (NE) and Puerto Rico (PR), and provide recommendations to address them. Methods: Higher HIV risk behaviors, prevalence, incidence and mortality among PRPWID have been reported in the NE and PR since early in the epidemic. Now that advances in HIV prevention and care have raised the possibility of an AIDS-free generation in the US, an examination of HIV prevention and care for PRPWID in these regions is needed. Results: Sustained Disparities: In 2010, drug injection accounted for about 9% of incident HIV infections in the US, 16% in the NE and 20% in PR. Data from the NE and PR continue to show that Hispanics (primarily Puerto Rican) are more likely to have HIV attributed to injection drug use. In NYC Hispanics represent over 50% of all IDUs, and 45% of PWID who are newly infected (over one-third born in Puerto Rico). Numerous studies have documented the lower availability of HIV prevention tools (e.g., NEPs) in PR, as compared with the NE, and the narrower range of drug treatment services. ART provision in PR has been inconsistent, and higher mortality rates among PLWH in NY is reported among those born in Puerto Rico. Importantly, related comorbidities among PWID, including overdose deaths and Hepatitis C, also have high prevalence among PRPWID. Conclusions: PRPWID continue to be over-represented in the HIV/AIDS epidemic, and have not received maximum benefit from advances in prevention and treatment. Despite recent efforts to expand services in PR, more severe disparities are found there than in the NE. While the “airbridge” from PR to the mainland enables PRPWID to access services, inadequate serviceprovision inPR influences the success of prevention/care efforts in the NE, for HIV and other comorbidities of PWID. To address these disparities and reach thegoalsof thenationalHIV/AIDSstrategy, innovativecollaborative approaches that span geographic areas are needed. Financial support: Financial Support: NIDA Grant P30DA011041. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.181 Risk of polysubstance use and co-occurring internalizing and externalizing symptoms among adolescent sexual minority girls Sarah S. Dermody1, Michael P. Marshal2, JeeWon Cheong3, T. Chung2, Stephanie Stepp2, Alison Hipwell2 1 Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States 2 Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States 3 Department of Health Behavior, University of Alabama, Birmingham, AL, United States Aims: Lesbian, gay, and bisexual adolescents are at risk of alcohol, cigarette, and marijuana use, particularly sexual minority girls (SMGs); however, little is known about polysubstance use among SMGs. We examined polysubstance use patterns among SMGs and heterosexual girls and their associations with mental illness using cross-sectional data. Methods: Mixture modeling described patterns of past year alcohol, cigarette, and marijuana use in a sample of urban adolescent girls (Pittsburgh Girls Study; N=2064; mean age=17). Approximately 8% endorsed a lesbian or bisexual identity. Membership in each substance use class was predicted by sexual orientation, internalizing symptoms (i.e., depression, anxiety), and externalizing symptoms (i.e., conduct problems, oppositional defiant disorder). Substance use was also examined as a predictor of mental health profiles identified in mixture models. Results: SMGs exhibited various use patterns: low substance use (61%), marijuana use (6%), cigarette use (14%), alcohol use (8%), and polysubstance use (12%). SMGs were at an increased risk for polysubstance use (OR=6.69, p< .001), cigarette use (OR=6.26, p< .001), and marijuana use (OR=3.86, p< .001) relative to heterosexual girls. The disparities remained after controlling for mental health symptoms. Specifically, externalizing, but not internalizing, symptoms independently predicted polysubstance use over and above sexual orientation.More thanone-third (36%)of SMGsexhibitednormativementalhealth, but somewereat riskof externalizing (8%) or internalizing (23%) symptoms, or a combination of both (14%). Substance use consistently predicted externalizing symptoms and co-occurring internalizing and externalizing symptoms. Conclusions: Substanceuse interventions for SMGsmaybenefit from targeting risk factors that cut-across several substances, such as externalizing symptoms. Financial support: NIDA R01 DA030385, NIDA R01 DA012237, NIMH R01 MH056630. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.182 Does effective combined prevention reduce racial/ethnic and sex disparities in HIV infection among PWID Don C. Des Jarlais1, Kamyar Arasteh1, Courtney McKnight1, Jonathan P. Feelemyer1, Hannah L. Cooper2, H. Hagan3, David Perlman1 1 Beth Israel Medical Center, New York, NY, United States 2 Emory University, Atlanta, GA, United States 3 New York University, New York, NY, United States Aims: Significant racial/ethnic disparities in HIV infection among persons who inject drugs (PWID) exist in many areas, with ethnic minority group members usually having higher HIV prevalence. “Combined” prevention programming has greatly reduced