A Longitudinal Study of Sexual Risk Behavior Among the Adolescent Children of HIV-Positive and HIV-Negative Drug-Abusing Fathers

Abstract 

Purpose

This is a longitudinal study of the precursors of sexual risk behavior among a cohort of adolescent children of HIV-positive and HIV-negative drug-abusing or drug-dependent fathers.

Methods

Individual structured interviews were administered to 296 drug-abusing or drug-dependent fathers, 43% of whom were HIV positive, and an adolescent child of each father (mean age = 16.3 years; SD = 2.8). Adolescents were reinterviewed approximately 1 year later, at Time 2.

Results

Structural equation modeling showed multiple direct and indirect pathways from psychosocial factors to adolescent sexual risk behavior (sexually active, number of sexual partners, and frequency of condom use). Greater paternal drug addiction and infection with HIV/AIDS, and the youth's perception of environmental hostility (discrimination and victimization), were both related to increased adolescent maladjustment and substance use. Greater paternal drug addiction and infection with HIV/AIDS also were associated with a weaker father–child mutual attachment, which was linked with increased adolescent maladjustment and substance use. Greater perceived environmental hostility (discrimination and victimization), a weak father–child relationship, and greater adolescent maladjustment and substance use had direct pathways to adolescent sexual risk behavior.

Conclusions

Findings suggest complex interrelationships among paternal, environmental, social, personal, and substance use factors as longitudinal predictors of sexual risk behavior in children whose fathers abuse or are dependent upon drugs. The importance of perceived environmental hostility, the father–child relationship, and adolescent maladjustment and substance use may have implications for public policy as well as prevention and treatment programs.

Keywords: Paternal HIV/AIDS, Paternal drug abuse, HIV-affected children, Father–child attachment, Adolescent sexual risk behavior, Discrimination and victimization