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OCR for page 147
AIDS and Adolescents
The committee finds no credible evidence that the threat of HIV infection
or AIDS will cease in the near future in the United States, as noted
in Chapter 1. Therefore, the committee believes it important to sustain
effective HIV prevention programs for young people at or before the age
at which they begin practicing behaviors that risk transmission of this
deadly virus.
Serological studies of HIV infection, surveys of sexual and drug
use behaviors, and reports from clinics for the treatment of Hug use
and sexually transmitted diseases (STDs) all indicate that some young
people begin practicing behaviors that risk HIV transmission during
and in some cases before their early teens. By the end of the teenage
years, the majority of young persons in America report having begun
sexual intercourse, and one-half report some experience with illicit drugs.)
Evidence from HIV seroprevalence studies conducted among patients
admitted to 37 metropolitan hospitals during 1988-1989 suggests that the
HIV prevalence rate is vanishingly small among 11-year-olds but begins
rising at age 12 and continues to rise throughout the teenage years.2
These behavioral and epidemiological facts suggest that HIV pre-
vention efforts should begin at least by early adolescence3 and that they
l See, for example, Tables 3-7 and 3-11.
2 Dr. Michael E. St. Louis, HIV Seroepidemiology Branch, Center for Infectious Diseases, CDC, per-
sonal communication, April 4, 1990.
3Adolescence, as heated in the psychological literature' is not synonymous with the teenage years.
It is generally said to begin between 10 and 13 years of age and to end between 18 and 21 years
(Santrock, 1981). This stage of life is characterized by significant physical, psychological, and social
147
OCR for page 148
148 ~ AIDS: THE SECOND DECADE
should continue throughout this period. Federal funding of such pro-
grams has ample precedent in that this country has supported programs
to prevent other health problems of adolescents (e.g., unintended teenage
pregnancy, drug use). The committee believes that the nation must recog-
nize the importance of and unique opportunities for preventing the spread
of HIV in the teenage population and that federal agencies must inter-
vene accordingly. Adolescents deserve special attention because patterns
of health behavior and risk taking are often established during the teenage
years. By targeting prevention programs to adolescents, the United States
may not only be protecting its youth but also preventing future problems
in the adult population.
Despite the obvious benefits associated with reaching adolescents,
less is known about effective interventions for this age group than for
adults. Much of the accumulated knowledge about AIDS prevention
has been gained from adult programs, primarily programs for adult gay
men. Adolescent health behavior is likely to be different from that of
adults, however, and programs designed for adults require modification to
accommodate the behavioral, social, and developmental diversity found
in the adolescent population.
In this chapter, the committee descnbes the scope of the AIDS prob-
lem among adolescents, insofar as data on AIDS cases and HIV infection
are available for this population. Subsequently, it reviews what is known
about the distribution of nsk-associated behaviors in the adolescent pop-
ulation, as well as the prevalence of sexual intercourse, condom use, and
drug use and the confluence of these high-nsk behaviors. Finally, the
committee considers what should be done to prevent further spread of
HIV infection in this population.
THE EPIDEMIOLOGY OF
AIDS AND HIV AMONG ADOLESCENTS
Before reviewing available data on the scope of the HIV/AIDS problem
among adolescents, the committee notes the inadequacies of those data,
a deficiency leading the committee to the conclusion that the precise
degree of infiltration of HIV infection into the adolescent population is
presently unknown. The relatively few cases reported to date among 13-
to 19-year olds (see Table 3-1) do not accurately reflect the scope of
the problem, nor should these data be taken as grounds for complacency.
changes. Definitions of the exact time of entry into and exit from adolescence vary from study to
study, depending on such factors as the theoretical view that has been adopted, the cultural context
of the adolescent, and biological and social development factors, as well as the issue or problem of
interest. (See Gold and Petronio [1980] for further elaboration of varying definitions of adolescence.)
OCR for page 149
AIDS AND ADOLESCENTS I 149
Rather, the pattern of the epidemic in the adolescent population described
below should be viewed as an opportunity for primary prevention that
should not be overlooked.
AIDS case statistics are probably the most reliable epidemiological
data base currently available. Yet the counts of current AIDS cases repre-
sent HIV infections that were acquired several years before the diagnosis
of AIDS was made. The current best estimates of the mean incubation
period of the disease (i.e., the mean time between HIV infection and the
onset of clinically diagnosable AIDS) are eight to ten years, but as data
spanning more time become available and as more effective prophylac-
tic treatments become available, it seems likely that this estimate will
increased Furthermore, it is possible that the median incubation period
for teenagers may be longer than eight years. Natural history studies of
hemophiliacs infected with HTV suggest that the incubation period may
be longer for chidden (not newborns) and adolescents than it is for adults
(Goedert et al., 19891.s
Yet even assuming that the incubation periods for adolescents and
adults are equivalent, it is likely that few persons that were infected
during their teenage years would also be diagnosed as AIDS cases during
their teens. Even with the assumption of a median incubation period of
eight years, fewer than one-half of persons infected with HIV at age 13
would be expected to develop AIDS dunng their teenage years,6 and even
fewer of those infected in the late teens would develop AIDS before age
4The current estimate is that the majority of HIV-seropositive individuals will go on to develop AIDS,
and it is not impossible that 100 percent of seropositive individuals may eventually develop full-blown
disease (IOM/NAS, 1988:35-36); see also the projections of Lui, Darrow, and Rutherford (1988) and
Longini et al. (1989). However, new evidence suggests that the incubation distribution of the disease
may be quite different for children, adolescents, and adults, as discussed in footnote 5.
SGoedert and colleagues (1989:1144, Table 3) report estimated annual incidence rates for AIDS after
HIV infection as 0.83 per hundred for 1- to 11-year-old children; 1.49 per hundred for 12- to 17-year-
old adolescents; 2.39 per hundred for 18- to 25-year-old adults; 3.40 per hundred for 26- to 34-year-old
adults; and 5.66 per hundred for 35- to 70-year-old adults. The ages cited are the age of the person
at the time of HIV infection. It should be noted that annual AIDS incidence rates are not uniformly
distributed over time following infection. Thus, for example, rates are close to zero during the first
two years following infection, and they rise during the next four to six years. It should also be noted
that incubation periods may vary across transmission categories for adolescents. Indeed, some teens
may progress from infection to disease more quickly than others. According to case reports, teens who
acquired HIV infection through drug use or sexual behavior have progressed more rapidly than adults
from infection to AIDS (K. Hein, Adolescent AIDS Program, Montefiore Medical Center, Bronx,
N.Y., personal communication, 1989). Other data indicate that the median survival period is shorter
for patients less than 20 years of age (9.0 months) than for patients between the ages of 20 and 29 years
(13.0 months) or 30 to 39 years (13.2 months) (Lemp et al., 1990).
6It should be realized, of course, that bode the cumulative risk of infection and the rate of risky behav-
iors can be expected to increase with age during adolescence (see the evidence presented below).
OCR for page 150
150 ~ AIDS: THE SECOND DECADE
20. Those persons who are diagnosed with AIDS during their teens will
be drawn mainly from the group of persons whose incubation periods
were markedly shorter than the median and who were infected during
their early teens.
Seroprevalence data for probability samples of individuals drawn
from well-defined populations of epidemiological interest would provide
a more reliable basis for inferring the prevalence of infection among
teenagers. Unfortunately, with few exceptions, seroprevalence surveys
conducted in this country have relied on samples of convenience, and
most have not included teenagers. The largest samples that provide
information on adolescents are derived from the routine HIV screening
of applicants for military service and the Job Corps. These data cannot
be generalized with knowable margins of error to other populations, but
they can provide some insight into segments of the teenage population in
which the infection may be established.
HIV prevalence estimates derived from blinded testing of newborns
for HIV antibody (i.e., CDC's neonatal surveillance activity, which is
described in Chapter 1) provide a reliable indicator of the prevalence of
infection among women delivering children. (Infants, whether infected
or not, carry the maternal antibodies to HIV at birth if the mother
is infected with the virus.) Analysis of these data by the age of the
mother could provide important information about HIV infection among
teenage women who bear children. Unfortunately, tabulations of HIV
seroprevalence by mother's age are not presently available for most
states. hndeed, the committee notes that, in some states, data on the age
of the mother are not being collected.
To provide better information about HIV infection and AIDS among
adolescents, the committee recommends that the Centers for Disease
Control make available to the research community AIDS-related data
that permit separate consideration of teenagers and other age groups.
Specifically, the committee recommends that:
ˇ data on AIDS cases be made available in a form that
permits tabulation by specific ages or by narrow age
groups (these data should be as complete as possible
without threatening inadvertent disclosure of the iden-
tity of any individual case);7
every state that participates in the neonatal surveillance
.
7 The Committee on National Statistics at the National Research Council and the Social Science Re-
search Council have jointly convened a panel to study the broad issues of confidentiality and data
access in research. Their report will be available in approximately two years.
OCR for page 151
AI:DS AND ADOLESCENTS ~ 151
activity include the age of the mother coded in years or
by narrow age group; and
ˇ CDC provide data from its family of surveys by specific
ages or in narrow age groups, as well as by race, gender,
and ethnicity.
The Scope of the Problem
AIDS Cases. As noted above, the small percentage of AIDS cases
diagnosed in the adolescent population does not imply that AIDS and
HTV are not a problem for teenagers. Indeed, as Verrnund and colleagues
(1989) argue, a substantial fraction of the AIDS cases diagnosed among
persons in their twenties reflect infections contracted during the teenage
years. As of December 31, 1989, approximately 24,000 cases of AIDS
had been reported among teenagers and young adults (ages 13-29~. Table
3-1 shows the distribution of reported AIDS cases by age at diagnosis,
using the broad age categories into which CDC has coded the data
released to the public. It can be seen that roughly one case in five is
diagnosed among persons under the age of 30. The proportion of cases
actually diagnosed among teenagers, however, is small.
Figure 3-1 displays the case counts by age at diagnosis for persons
diagnosed with AIDS between the ages of 13 and 29. Allowing, as noted
earlier, for an incubation period that is rarely less than two years and
a mean incubation period that may be eight years or longer, one would
expect that nearly all of the AIDS cases diagnosed among persons in
their very early twenties would reflect HIV infections contracted during
adolescence.9 The overall impact of AIDS on teenagers and young adults
is reflected in the fact that AIDS was the tenth leading cause of death
among 15- to 24-year-olds as early as 1984; it had risen to the seventh
leading cause of death for this age group in 1986 and the sixth in 1987
(Kilboume, Buehler, and Rogers, 1990~.
The CDC's family of surveys collects data on HIV infection from several subpopulations, including
clients attending drug treatment, STD, tuberculosis, and prenatal clinics, patients at general hospitals,
and newborn infants. With the exception of the survey of infants, all of the other surveys rely on
samples of convenience. Data collected through this program are intended to provide information
on the prevalence and incidence of infection in selected populations, to provide early warning of the
emergence of infection in new populations, and to target intervention programs and other resources.
9
It may seem intuitively appealing to argue that at least one-half of the 4,268 cases diagnosed at age
28 reflect infections contracted during the teens. This argument is not, however, logically required.
Because there is a non-zero probability of an AIDS diagnosis being recorded in each year from roughly
two years after HIV infection, it would be theoretically possible (with a suitably large number of HIV
infections among persons in their early twenties) to observe 4,000 cases of AIDS among 28-year-olds,
none of which had been contracted by teenagers.
OCR for page 152
152 ~ AIDS: THE SECOND DECADE
TABLE 3-1 Distribution of AIDS Cases Reported Through December 31, 1989, by
Age at Diagnosis
Diagnosis No. of
(years) Cases Percentage
< 1 785 0.7
1-12 1,210 1.0
13-19 461 0.4
2~24 5,090 4.3
25-29 18,966 16.1
3~39 54,334 46.1
40~9 24,951 21.2
50t 11,984 10.2
Total 117,781 1OO.Oa
Percentages may not sum to 100.0 because of rounding.
SOURCE: Special tabulation provided by the Statistics and Data Processing Branch of
the AIDS Program, Centers for Disease Control.
6,000
5,000
4,000
oh
111
an
C ~ 3.000
Oh
2,000
1 ,000
4,996
2,714
1 ,979
34 38 67 90 188 ~1
863
~ 289
3,194
3,794
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
AGE AT DIAGNOSIS
FIGURE 3-1 Number of AIDS cases reported among 15- to 30-year-olds through December 31,
1989, by single years of age at diagnosis. SOURCE: Special tabulation provided by the Statistics
and Data Processing Branch of the AIDS Program, Centers for Disease Control.
OCR for page 153
AIDS AND ADOLESCENTS | 153
HIV Seroprevalence. Since October 1985, the Department of De-
fense has tested applicantsl° for military service for evidence of HIV in-
fection; in January 1986 the armed forces began screening all active-duty
personnel. The crude prevalence rate for 17- to 19-year-old applicants
screened between October 15, 1985 and March 31, 1989 was 0.34 per
1,000 (Burke et al., 1990~. HIV prevalence rates among military appli-
cantsli from October 1985 to March 1986 increased directly and linearly
with age from 0.25 per thousand among 18-year-olds to 4.9 per thou-
sand among 27-year-olds (Burke et al., 1987:132~.12 Among active-duty
personnel during the period October 1985 to July 1989, prevalence rates
were found to have a similar distribution by age. The observed rates were
lowest among soldiers less than 20 years old (0.5 per thousand), peaked
at 3.4 per thousand among 30- to 34-year-olds, and gradually declined
among older military personnel (Kelley et al., 1990~.
Figures 3-2a and 3-2b plot these age-specific prevalence rates for
military applicants and active-duty personnel. The plots demonstrate that
roughly parallel age trends are found for the two groups. Data tabulated
separately for applicants from the New York-New Jersey metropolitan
area suggest a similar trend. The prevalence of HIV among applicants
from the New York-New Jersey metropolitan area is several times higher
than the rate among applicants from the rest of the nation (see Figure
3-2c). In this case, prevalence rates among military applicants 30 years of
age and older are somewhat higher than those of applicants aged 26-30.
The other large group of young people who are routinely screened
for HIV are persons applying to participate in the Job Corps. The Job
Corps is a federal program that provides training and employment for so-
cioeconomically and educationally disadvantaged youths. Of the 69,233
applicants between the ages of 16 and 21 years who were screened be-
tween October 1987 and November 198S, 3.9 per thousand were infected
(St. Louis et al., 1989~. This rate is much higher than the prevalence
10Among military applicants who had been screened between October 1985 and March 1986, 86 per-
cent were male and 76 percent were white; 46 percent were less than 20 years old, and only 5 percent
reported education beyond a high school diploma (Burke et al., 1987)
11The observed age-specific prevalence estimates largely reflect the rates among older males (434
seropositive among a total of 263,572 men). Overall, HIV prevalence was lower among women, and
fewer were tested (26 seropositive among 42,489 women). However, among 17- and 18-year-olds, the
prevalence rates for males and females were approximately equal (Burke et al., 1987). Other analyses
of military data find prevalence rates among teenage females to be comparable to those among teenage
males (Horton, Alexander, and Brundage, 1989; Kelley et al., 1990).
12The authors concluded that HIV prevalence increased linearly with age between 18 and 27 years
(Burke et al., 1987:132). Estimated prevalence among males over the age of 27 was lower, however,
than the prevalence rates observed among male applicants between 25 and 27 years old.
OCR for page 154
154 ~ AIDS: THE SECOND DECADE
6 r
a' 4
Q
-
LLJ
He 3
LL
> 2
UJ
cr
ILL
>
I 1
o
~ Males
-
/\
\/
_,~
Females /
`1/ , , , 1
1 7 1 8 1 9 20 21 22 23 24
AGE
25 26 27 28 29 > 30
FIGURE 3-2A Prevalence of HIV (rate per 1,000 persons), by age, among male and female
applicants for military service [N = 306,061] (October 1985 through March 1986). SOURCE:
Burke et al., 1987.
3
Q
-
LLJ
Cal
A
LL
G 1
>
I
o
17-19 20-24 25-29
4
30-34 35-39 40 ~
AGE
FIGURE 3-2B Prevalence of HIV (rate per 1,000 persons), by age, among active duty military
personnel [N = 1,752,191] (January 1987 through April 1988). SOURCE: Peterson et al., 1988.
OCR for page 155
AIDS AND ADOLESCENTS ~ 155
Males
-
a' 2.0
a)
Q
LLJ
A
LL
~ 1.0
0,0
Females
1 1
< 20 21-25
AGE GROUP
26-30 > 30
FIGURE 3-2C Prevalence of HIV (percent), by age, among male and female applicants for
military service from New York-New Jersey metropolitan area [N = 44,139] (October 1985
through June 1987). SOURCE: Brundage et al., 1988.
rates found among the youngest groups of applicants for military ser-
vice, which may reflect differences in the populations represented in
applications to these two organizations.
HIV Seroprevalence in Childbearing Women. Anonymous anti-
body testing of newborn infants provides information on the prevalence
of HIV infection among childbearing women (because infants circulate
maternal antibody during the first months of life). As noted earlier, data
are not available for every state, and some states do not provide infor-
mation on the age of the mother. Data have been published for New
York City and the rest of New York State (Novick et al., 1989a). Among
babies born in New York State between November 1987 and November
198S, the seroprevalence rate was 1.6 per thousand outside New York
City and 12.5 per thousand for births in New York City. Figure 3-3 plots
the age-specific rates of infection found in New York City. Although
these data show an age trend similar to that found in other studies, the
rates of infection even among teenage mothers are substantial.~3 A1-
most 10 per thousand or ~ percent of black teenagers who delivered
children in New York City during this period were infected with HIV.
Reanalyses of ZIP Code-specific areas with high rates of drug use (determined by comparing rates
of drug-related hospital discharges) found rates as high as 40 per thousand or 4 percent in some ZIP
Codes areas of New York City (Novick et al., 1989a).
OCR for page 156
156 ~ AIDS: THE SECOND DECADE
35
o
o
o
~ 30
a'
Q
AL 25
a:
by
ILL
o
CC
lo
Oh
20
15
10
o
_
, _
White
Black
Hispanic
32.2
_
1~ N~f
20.3
17
14.7
< 20 20-29 30-39 40 +
AGE OF MOTHER
FIGURE 3-3 HIV seroprevalence rates (per 1,000 persons) among New York City women giving
birth between November SO, 1987, and November 30, 1988. Of 12S,120 New York City women
tested, race/ethnicity was unknown for 2,461, and age was unknown for 2,334. SOURCE:
Novick et al., 1989a:Table 4.
The prevalence of HIV infection among Hispanic teenage mothers was
almost as high. In considering Figure 3-3, the committee would note
that it is only the contrast with rates of almost 30 per thousand found
among 30- to 39-year-old black mothers that make the observed teenage
prevalence rates appear relatively low.
HIV Seroprevalence in Other Studies. The seroprevaTence rates
provided above on women bearing children in New York City are but-
tressed by emerging data from serosurveys of nonprobability samples
of hospital patients. Ernst and colleagues (1989), for example, recently
reported that, among patients aged 15 to 24 at the Bronx Lebanon Hos-
pital, 36 per thousand or 3.6 percent of males and 25 per thousand or
2.5 percent of females were infected with HIV. Table 3-2 summarizes se-
lected results of this and other small-scale seroprevalence studies among
teenagers and young adults. Although the observed prevalence of HIV
infection varies from population to population and from study to study,
one finding is clear: the AIDS virus is substantially seeded in some
segments of the adolescent population. Moreover, although the variation
in estimates argues for more comprehensive and standardized monitoring
of the spread of infection in this population, the lesson for prevention is
nonetheless apparent. HIV infection is already spreading in the teenage
OCR for page 157
AIDS AND ADOLESCENTS ~ 157
population, and in some locales and population subgroups, the spread has
been substantial.
Variation of AIDS and HIV Prevalence by Gender. Just as more
AIDS cases are seen among adult males than among adult females, so
too are there more cases of AIDS among teenage boys than among
teenage girIs.~4 Of all AIDS cases reported as of December 31, 1989,
males outnumbered females by a 9:1 ratio.is As the first row of Table 3-3
shows, however, the ratio of male to female cases is much lower among
teenagers than among adults in the United States. Thus, it can be seen that
the male-to-female ratio, which is roughly 1:1 among cases diagnosed in
infants (younger than 1 year), increases to 4:1 among teenagers, to 6:1
among 20- to 24-year-olds, and ultimately to 16:1 for cases diagnosed
among persons in their forties.
In addition to variations by age, the ratio of male-to-female cases of
AIDS and HIV infection varies substantially among populations. Eleven
percent of AIDS cases among teenagers have been diagnosed in the New
York metropolitan areas and the male-to-female ratio for those cases is
approximately 2:1 (Table 3-31. The size of this ratio indicates that girls
in the New York area are supporting a greater burden of disease than
girls nationally.'7 HIV infection rates calculated for military applicants
As of July 1, 1986, there were more than 35 million individuals in this country between the ages of
10 and 19 years, constituting approximately 14.6 percent of the total population. The ratio of males lo
females is essentially 1:1 (1.044:1) (U.S. Bureau of the Census, 1987:17).
15As of December 31, 1989, females of all ages accounted for 11,524 cases of AIDS out of a total of
117,781 reported cases.
16As of December 31, 1989, a total of 461 AIDS cases had been reported among 13- to 19-year-
olds; 50 of these cases were from the New York Primary Metropolitan Statistical Area. In 1983, the
Office of Management and Budget changed the classification system used to define metropolitan areas
in federal statistical reports. The basic tern' for such areas, formerly known as Standard Metropolitan
Statistical Areas or SMSAs, was changed to Metropolitan Statistical Areas or MSAs. The basic concept
of a metropolitan area, however, remained that of an area with a large population nucleus and the
adjacent communities, e.g., suburbs, that have a high degree of economic and social integration with
that nucleus. Within metropolitan complexes of one million or more population, separate Primary
Statistical Areas (PMSA) may be designated under the new classification system. Any metropolitan
area containing one or more PMSAs was, in turn, designated a Consolidated Metropolitan Statistical
Area (CMSA). The New York PMSA, for example, includes the five counties that comprise the City of
New York, plus the suburban counties of Westchester, Rockland, and Putnam. Adjacent areas include
other PMSAs, e.g., the Nassau-Suffolk (Long Island) PMSA. The New York PMSA and the Nassau-
Suffolk PMSA are 2 of the 12 PMSAs that constitute the Consolidated Metropolitan Statistical Area
that bears the awkward name: "New York-Northern New Jersey-Long Island, NY-NJ-CT CMSA."
(U.S. Bureau of the Census, 1985, Appendix 2).
17The higher proportion of cases among females of all ages in New York reflects the greater relative
proportion of cases attributable to IV drug use and heterosexual transmission in the Northeast than
other areas. (See for example, Figure 1-1 in Chapter 1.)
OCR for page 242
242 ~ AIDS: THE SECOND DECADE
Howard, J., Taylor, J. A., Ganikos, M. L., Holder, H. D., Godwin, D. F., and Taylor, E.
D. (1988) An overview of prevention research: Issues, answers, and new agendas.
Public Health Reports 103:674 683.
Hudson, R. A., Petty, B. A., Freeman, A. C., Haley, C. E., and Krepcho, M. A.
(1989) Adolescent runaways' behavioral risk factors, knowledge about AIDS and
attitudes about condom usage. Presented at the Fifth International Conference on
AIDS, Montreal, June ~9.
Hummel, R., Rodriguez, G., Brandon, D., and Wells, D. (1989) Outreach model for
HIV positive adolescents and adolescents currently at high risk for HIV infection.
Presented at the Fifth International Conference on AIDS, Montreal, June =9.
Inazu, J. K., and Fox, G. L. (1980) Maternal influence on the sexual behavior of
teenage daughters. Journal of Family Issues 1:81-102.
Institute of Medicine (IOM). (1988) [1omelessness, Health, and Human Needs. Wash-
ington, D.C.: National Academy Press.
Institute of Medicine/National Academy of Sciences (IOM/NAS). (1986) Confronting
AIDS: New Directions in Public Health, Health Care, and Research. Washington,
D.C.: National Academy Press.
Institute of Medicine/National Academy of Sciences (IOM/NAS). (1988) Confronting
AIDS: Update 1988. Washington, D.C.: National Academy Press.
Jackson, J., and Neshin, S. (1986) New Jersey community health project: Impact of
using ex-addict education to disseminate infonnation on AIDS to intravenous drug
users. Presented at the Second International Conference on AIDS, Paris, June
25-26.
Jackson, J., and Rotl~iewicz, L. (1987) A coupon program: AIDS education and drug
treatment. Presented at the Third International Conference on AIDS, Washington,
D.C., June 1-5.
Jaffe, L. R., Seehaus, NJ., Wagner, C., and Leadbeater, B. J. (1988) Anal intercourse
and knowledge of acquired immunodeficiency syndrome among minonty-group
female adolescents. Journal of Pediatrics 112:1005-1007.
Jessor, R., Chase, J. A., and Donovan, J. E. (1980) Psychosocial correlates of marijuana
use and problem drinking in a national sample of adolescents~merican Journal
of Public Health 70:6~613.
Jessor, R., Costa, F., Jessor, S. L., and Donovan, J. E. (1983) Time of first intercourse:
A prospective study. Journal of Personality and Social Psychology 44:608~26.
Jessor, S. L., and Jessor R. (1975) Transition from virginity to nonvirginity: A
social-psychological study over time. Developmental Psychology 11:473~84.
Job, R. F. S. (1988) Effective and ineffective use of fear in health promotion campaigns.
American Journal of Public Health 78:163-167.
Johnston, L. D., Bachman, J. G., and O'Malley, P. M. (1984) Monitoring the Future:
Questionnaire Responses from the Nation's High School Seniors, 1983. Ann Arbor,
Mich.: Institute for Social Research.
Johnston, L. D., Bachman, J. G., and O'Malley, P. M. (1989) Results of the 1988
National High School Senior Survey (press release). University of Michigan, Ann
Arbor, Mich., Februaly 28.
Johnston, L. D., O'Malley, P. M., and Bachman, J. G. (1988) Illicit Drug Use, Smoking,
and Drinking by America's High School Students, College Students, and Young
Adults 1975-1987. Rockville, Md.: National Institute on Drug Abuse
OCR for page 243
AIDS AND ADOLESCENTS ~ 243
Jones, E. F., Forrest, J., Goldman, N., Henshaw, S. K., Lincoln, R., et al. (1985)
Teenage pregnancy in developed countries: Determinants and policy implications.
Family Planning Perspectives 17:53~3.
Kahn, J. R., Kalsbeck, W. D., and Hofferth, S. L. (1988) National estimates of
teenage sexual activity: Evaluating the comparability of three national surveys.
Demography 25:189-204.
Kahn, J. R., Rindfuss, R. R., and Guilkey, D. K. (in press) Adolescent contraceptive
method choices. Demography.
Kandel, D. B. (1975) Stages in adolescent involvement in drug use. Science 190:912-
914.
Kandel, D. B. (1978) Similarity in real-life adolescent friendship pairs. Journal of
Personality and Social Psychology 36:30~312.
Kandel, D. B. (1980) Drug and drinking behavior among youth. In I. Coleman, A.
Inkeles, and N. Smelser, eds., Annual Review of Sociology 6:235-285.
Kandel, D. B. (1984) Marijuana users in young adulthood. Archives of General
Psychiatry 41:20~209.
Kandel, D. B. (1985) On processes of peer influences in adolescent drug use: A
developmental perspective. In B. Stimmel, ea., Alcohol and Substance Abuse in
Adolescence. New York: Haworth Press.
Kandel, D. B., and Davies, M. (In press) Cocaine use in a national sample of U.S.
youth (NLSY): Epidemiology, predictors and ethnic pattems. In C. Schade and
S. Scholer, eds., The Epidemiology of Cocaine Use and Abuse, National Institute
on Drug Abuse Research Monograph. Rockville, Md.: National Institute on Drug
Abuse.
Kandel, D. B., and Logan, J. A. (1984) Patterns of drug use from adolescence to young
adulthood: I. Periods of risk for initiation, continued use, and discontinuation.
American Journal of Public Health 74 660466.
Kandel, D. B., Kessler, R. C., and Margulies, R. Z. (1978) Antecedents of adolescent
initiation into stages of Snug use: A developmental analysis. Journal of Youth
and Adolescence 7:13~0.
Kandel, D. B., Murphy, D., and Kams, D. (1985) Cocaine use in young adulthood:
Patterns of use and psychosocial correlates. In N. J. Kozel, and E. H. Adams,
eds., Cocaine Use in America: Epidemiologic and Clinical Perspectives. National
Institute on Drug Abuse Research Monograph 61. Rockville, Md.: National
Institute on Drug Abuse.
Keating, D. P. (1980) Thinking processes in adolescence. In J. Adelson, ea., Handbook
of Adolescent Psychology. New York: John Wiley and Sons.
Kegeles, S., Greenblatt, R., Catania, J., Cardenas, C., Gottlieb, J., and Coates, T. (1989)
AIDS risk behavior among sexually active Hispanic and Caucasian adolescent
females. Presented at the Fifth International Conference on AIDS, Montreal, June
09.
Kegeles, S. M., Adler, N. E., and Irwin, Jr., C. E. (1988) Sexually active adolescents
and condoms: Changes over one year in knowledge, attitudes and use. American
Journal of Public Health 78:460~61.
Kelley, P. W., Miller, R. N., Pomerantz, R., Wann, F., Brundage, J. F., and Buck, D. S.
(1990) Human immunodeficiency virus seropositivity among members of the active
duty U.S. Army 1985-1989. American Journal of Public Health 80:405~10.
OCR for page 244
244 ~ AIDS: THE SECOND DECADE
Kilbourne, B. W., Buehler, J. W., and Rogers, M. F. (1990) AIDS as a cause of death
in children, adolescents, and young adults. American Journal of Public Health
80:499-500.
Kilbourne, B. W., Rogers, M. F., and Bush, T. J. (1989) The relative importance of
AIDS as a cause of death in pediatric and young adult populations in the U.S.
198~1987. Presented at the Fifth International Conference on AIDS, Montreal,
June =9.
Kiselica, M. S. (1988) Helping an aggressive adolescent through the "Before, during
and after program." The School Counselor 35:299-306.
Kleinman, P. H., Goldsmith, D. S., Friedman, S. R., Mauge, C. E., Hopkins, W., and
Des Jarlans, D. C. (In press.) Knowledge about and behaviors affecting the spread
of AIDS. International Journal of the Addictions.
Kolbe, L., Jones, J., Nelson, G., Daily, L., Duncan, C., et al. (1988) School health
education to prevent the spread of AIDS: Overview of a national program. Hygie
7: 1(~13.
Kreipe, R. E., and Strauss, J. (1989) Adolescent medical disorders, behavior, and
development. In G. R. Adams, R. Montemayor, and T. P. Gullotta, eds., The
Biology of Adolescent Behavior and Development. Newbury Park, Calif.: Sage
Publications.
Lamke, L. K., Lujan, B. M., and Showalter, J. M. (1988) The case for modifying
adolescents' cognitive self-statements. Adolescence 92:967-974.
Lashley, K. S., and Watson, J. B. (1922) A Psychological Study of Motion Pictures in Re-
lation to Venereal Disease Campaigns. Washington, D.C.: U.S. Interdepartmental
Social Hygiene Board.
Lawrence, F. C., Tasker, G. E., Daly, C. T., Orhiel, A. L., and Wozniak, P. H. (1986)
Adolescent's time spent viewing television. Adolescence 21:431~36.
Lemp, G. F., Payne, S. F., Neal, D., Temelso, T., and Rutherford, G. W. (1990) Survival
trends for patients with AIDS. Journal of the American Medical Association
263:402~06.
Lesnick, H., and Pace, B. (1990) Knowledge of AIDS risk factors in South Bronx
minority college students. Journal of Acquired Immune Deficiency Syndromes
3:173-176.
Lewis, C. E., and Lewis, M. A. (1984) Peer pressure and risk-taking behaviors in
children. American Journal of Public Health 74:58() 584.
Longini, Jr., I. M., Clark, W. S., Horsburgh, C. R., Lemp, G. F., Byers, R. H., et al.
(1989) Statistical analysis of the stages of HIV infection using a Markov model.
Presented at the Fifth Intemational Conference on AIDS, Montreal, June =9.
Lui, K., Darrow, W. W. and Rutherford, G. W. (1988) A model-based estimate of the
mean incubation penod for AIDS in homosexual men. Science 240:1333-1335.
Mantell, J. E., and Schinke, S. P. (In press) The crisis of AIDS for adolescents: The
need for preventive risk-reduction interventions. In A. R. Roberts, ea., Crisis
Intervention Handbook. New York: Springer.
Marks, A., Malizio, J., Hoch, J., Brody, R., and Fisher, M. (1983) Assessment of health
needs and willingness to utilize health care resources of adolescents in a suburban
population. Journal of Pediatrics 102:456~60.
Marlatt, G. A. (1982) Relapse prevention: A self-control program for the treatment of
addictive behaviors. In R. B. Stuart, ea., Adherence, Compliance and Generaliza-
tion in Behavioral A1edicine. New York: Brunner/Mazel.
OCR for page 245
AIDS AND ADOLESCENTS
245
Martin, A. D., and Hetrick, E. S. (1987) Designing an AIDS risk reduction program
for gay teenagers: Problems and proposed solutions. In D. G. Ostrow, ea.,
Biobehavioral Control of AIDS. New York: Irvington Publishers, Inc.
Mason, J. O., Noble, G. R., Lindsey, B. K., Kolbe, L. J., Van Ness, P., et al.
(1988) Current CDC efforts to prevent and control human immunodeficiency virus
infection and AIDS in the United States through information and education. Public
Health Reports 103:255-260.
Mata, A. G., and Jorquez, J. S. (1988) Mexican-A:nencan intravenous drug users' and
needle-sharing practices: Implications for AIDS prevention. In R. J. Battjes, and R.
W. Pickens, eds., Needle Sharing Among Intravenous Drug Abusers: National and
International Perspectives. National Institute on Drug Abuse Research Monograph
80. Washington, D.C.: U.S. Government Printing Office.
Mays, V. M., and Cochran, S. D. (1987) Acquired immunodeficiency syndrome and
black Americans: Special psychosocial issues. Public Health Reports 102:22=
231.
McCaul, K. D., and Glasgow, R. E. (1985) Preventing adolescent smoking: What have
we learned about treatment construct validity? Health Psychology 4:361-387.
McKusick, L., Coates, T. J., and Babcock, K. (1988) Knowledge and attitudes about
AIDS and sexual behavior in California high school students. Presented at the
Fourth International Conference on AIDS, Stockholm, June 12-16.
Mensch, B. S., and Kandel, D. B. (1988a) Dropping out of high school and drug
inv olv ement. Soc to logy of Education 6 1: 95 - 11 3 .
Mensch, B. S., and Kandel, D. B. (1988b) Underreporting of substance use in a
national longitudinal youth cohort: Individual and interviewer effects. Public
Opinion Quarterly 52:10~124.
Meyer-Bahlburg, H. F. L. (1980) Sexuality in early adolescence. In B. B. Wolman,
and J. Money, eds., Handbook of Human Sexuality. Englewood Cliffs, N.J.:
Prentice-Hall.
Miller, P. Y., and Simon, W. (1974) Adolescent sexual behavior: Context and change.
Social Problems 22:58-76.
Mitchell, F., and Brindis, C. (1987) Adolescent pregnancy: Ihe responsibilities of
policy makers. Health Services Research 22:399~37.
Moore, D., and Schultz, N. (1983) Loneliness at adolescence: Correlates, attnbutions,
and coping. Journal of Youth and Adolescence 12:187-196.
Moore, K. A., Nord, C. W., and Peterson, J. L. (1989) Nonvoluntary sexual activity
among adolescents. Family Planning Perspectives 21:11~114.
Moore, K. A., Wenk, D., Hofferth, S. L., and Hayes, C. D., eds. (1987) Statistical
appendix: Trends in adolescent sexual and fertility behavior. In S. L. Hofferth,
and C. D. Hayes, eds., Risking the Future. Vol. 2, Working Papers and Statistical
Appendixes. Washington, D.C.: National Academy Press.
Morris, R., Huscroft, S., Roseman, J., Re, O., Baker, C. J., and Iwakoshi, K. A. (1989)
Demographic and high-risk behavior study of incarcerated adolescents. Presented
at the Fifth International Conference on AIDS, Montreal, June =9.
Morisky, D. E., DeMuth, N. M., Field-Fass, M., Green, L. W., and Levine, D. M
(1985) Evaluation of family health education to build social support for long-term
control of high blood pressure. Health Education Quarterly 12:35-50.
Mosher, W. D., and Bachrach, C. A. (1987) First premarital contraceptive use: United
States, 196~82. Studies in Family Planning 18:83-95.
OCR for page 246
246 ~ AIDS: THE SECOND DECADE
Mott, F. L., and Haunn, R. J. (1988) Linkages between sexual activity and alcohol and
drug use among American adolescents. Family Planning Perspectives 20:128-136.
Murray, D. M., and Petty, C. L. (1985) The prevention of adolescent drug abuse:
Implications of etiological, developmental, behavioral, and environmental models.
In C. L. Jones, and R. J. Battjes, eds., Etiology of Drug Abuse: Implications for
Prevention. National Institute on Drug Abuse Research Monograph 56. Rockville,
Md.: U.S. Department of Health and Human Services.
Nahmias, A., Corey, L., Lee, F., Clumeck, N., Cannon, R., and Holmberg, S. (1989)
Genital herpes as a possible risk factor for HIV transmission. Presented at the
Fifth International Conference on AIDS, Montreal, June =9.
National Institute on Drug Abuse (NIDA). (1988) National Household Survey on Drug
Abuse: Main Findings 1985. Rockville, Md.: National Institute on Drug Abuse.
Newcomb, M. D., and gentler, P. M. (1988) Consequences of Adolescent Drug Use:
Impact on the Lives of Young Adults. Newbu~ Park, Calif.: Sage.
Newcomb, M. D., and gentler, P. M. (1989) Substance use and abuse among children
and teenagers. American Psychologist 44:242-248.
Newcomer S. F., and Udry, J. R. (1983) Adolescent sexual behavior and popularity.
Adolescence 18:515-522.
Newmeyer, J. A. (1988) Why bleach? Development of a strategy to combat HIV
contagion among San Francisco intravenous drug users. In R. J. Battjes, and R.
W. Pickens, eds., Needle Sharing Among Intravenous Drug Abusers: National and
International Perspectives. NIDA Research Monograph 80. Washington, D.C.:
U.S. Government Printing Office.
New York State Department of Health. (1989) AIDS in New York State through 1988.
Albany, N.Y.: New York State Department of Health.
Novello, A. C. (1988) Secretary's Work Group on Pediatric HIV Infection and Disease.
Washington, D.C.: Department of Health and Human Services.
Novick, L. F., Beans, D., Stricof, R., Stevens, R., Pass, K., and Wethers, J. (1989a)
HIV seroprevalence in newborns in New York State. Journal of the American
Medical Association 261:1745-1750.
Novick, L. F., Glebatis, D., Stricof, R., and Berns, D. (1989b) HIV infection in
adolescent childbearing women. Presented at the Fifth International Conference
on AIDS, Montreal, June 1~.
O'Donnell, J. A. (1985) InteIpreting progression from one drug to another. In L. N.
Robins, ea., Studying Drug Abuse. New Brunswick, N.J.: Rutgers University
Press.
O'Donnell, J. A., and Clayton, R. R. (1982) The stepping-stone hypothesis: MaIijuana,
heroin, and causality. Chemical Dependencies 4:229-241.
Office of Technology Assessment (OTA). (1988) How Effective is AIDS Education?
Washington, D.C.: Office of Technology Assessment.
Osgood, D. W., Johnston, L. D., O'Malley, P. M., and Bachman, J. G. (1988)
The generality of deviance in late adolescence and early adulthood. American
Sociological Review 53:81-93.
Paget, K. D. (1988) Adolescent pregnancy: Implications for prevention strategies in
educational settings. School Psychology Review 17:57~580.
OCR for page 247
AIDS AND ADOLESCENTS ~ 247
Parcel, G. S., Nader, P. R., and Meyer, M. P. (1977) Adolescent health concerns,
problems and patterns of obligation in a triethnic urban population. Pediatrics
66:157-164.
Pearl, D., Bouthilet, L., and Lazar, J., eds. (1982) Television and Behavior: Ten Years
of Scientif c Progress and Implications for the Eighties. Vol. 1: Summary Reports.
Rockville, Md.: U.S. Department of Health and Human Services.
Pentz, M. A., Cormack, C., Flay, B., Hansen, W. B., and Johnson, C. A. (1986)
Balancing program and research integrity in community drug abuse prevention:
Project STAR approach. Journal of School Health 56:389-393.
Pentz, M.A., Dwyer, J. H., MacKinnon, 1:). P., Flay, B. R., Hansen, W. B., et al.
(1989a) A mu' ticommunity trial for primary prevention of adolescent drug abuse.
Journal of the American Medical Association 261:3259-3266.
Pentz, M. A., MacKinnon, D. P., Flay, B. R., Hansen, W. B., Johnson, C. A., and
Dwyer, J. H. (1989b) Primary prevention of chronic diseases in adolescence:
Effects of the Midwestern prevention project on tobacco use. American Journal
of Epidemiology 130:713-724.
Perlman, J. A., Kelaghan, J., Wolf, P. H., Baldwin, W., Coulson, A., and Novello,
A. (1990) HIV risk difference between condom users and nonusers among U.S.
heterosexual women. Journal of Acquired Immune Deficiency Syndromes 3:155-
165.
Perry, C. L., Klepp, K. I., and Schultz, J. M. (1988) Primary prevention of cardiovascular
disease: Community-wide strategies for use. Journal of Consulting and Clinical
Psychology 56:358-364.
Peterson, M. R., Mumm, A. H., Mathis, R., Kelley, P. W., White S. L., et al. (1988)
Prevalence of HIV antibody in U.S. active-duty military personnel, April 1988.
Morbidity and Mortality Weekly Report 37:461~63.
Polich, J. M., Ellickson, P. L., Reuter, P., and Kahan, J. P. (1984) Strategies For
Controlling Adolescent Drug Use. Santa Monica, Calif.: The Rand Corporation.
Polit, D. F., and Kahn, J. R. (1986) Early subsequent pregnancy among economically
disadvantaged teenage mothers. American Journal of Public Health 76:167-171.
Pratt, W. F., Mosher, W. D., Bachrach, C. A., and Horn, M. C. (1984) Understanding
U.S. fertility: Findings from the National Survey of Family Growth, Cycle III.
Population Bulletin 39:3~1.
Price, J. H., Desmond, S., and Kukulka, G. (1985) High school students' perceptions
and misperceptions of AIDS. Journal of School Health 55:107-109.
Quinn, J. (1988) Natural allies: Youth organizations as partners in AIDS education. In
M. Quackenbush, M. Nelson, and K. Clark, eds., The AIDS Challenge: Prevention
Education for Young People. Santa Cruz, Calif.: Network Publications.
Quinn, T. C., Glasser, D., Cannon, R. O., Matuszak, D. L., Dunning, R. W., et al.
(1988) Human immunodeficiency v~rus infection among patients attending clinics
for sexually transmitted diseases. New England Journal of Medicine 318:197-203.
Radius, S. M., Dielman, T. E., Becker, M. H., Rosenstock, I., and Horvath, W. J.
(1980) Health beliefs of the school-aged child and their relationship to risk-taking
behaviors. International Journal of Health Education 23:3-11.
Remafedi, G. (1988) Preventing the sexual transmission of AIDS during adolescence.
Journal of Adolescent Health Care 9:139-143.
OCR for page 248
248 ~ AIDS: THE SECOND DECADE
Reuben, N., Hein, K., Drucker, E., Bauman, L., and Lauby, J. (1988) Relationship
of high-risk behaviors to AIDS knowledge in adolescent high school students.
Presented at the Annual Research Meeting of the Society for Adolescent Medicine,
New York City, March.
Rizvi, M. H. (1983) An empirical investigation of some item nonresponse adjustment
procedures. In W. G. Madow, H. Nisselson, and I. Olkin, eds., Incomplete Data
in Sample Surveys, Vol. 1, Report and Case Studies (Report of the National
Research Council Panel on Incomplete Data). New York: Academic Press.
Roberts, E. S., Kline, D., and Gagnon, I. (1981) Family Life and Sexual Learning of
Children. Vol. 1. Cambridge, Mass.: Population Education, Inc.
Robins, L. N., and Wish, E. (1977) Childhood deviance as a developmental process: A
study of 223 urban black men from birth to 18. Social Forces 56:448~73.
Rolf, J., Nanda, J., Thompson, L., Mamon, J., Chandra, A., et al. (1989) Issues in
AIDS prevention among juvenile offenders. In J. O. Woodruff, D. Doherty, and J.
G. Athey, eds., Troubled Adolescents and HIV Infection. Washington, D.C.: Child
and Adolescent Service System Program (CASSP), Georgetown University Child
Development Center.
Rolf, J., Nanda, J., Baldwin, J., Chandra, A., and Thompson, L. (In press) Substance
abuse and HIV/AIDS risk among delinquents: A prevention challenge. Inter-
national Journal of Addictions, Silver Anniversary Issue on Prevention (Special
Issue No. 3~.
Rosenbaum, E., and Kandel, D. B. (In press) Early onset of adolescent sexual behavior
and drug involvement. Journal of Marriage and the Family.
Rosenberg, M. (1965) Society and the Adolescent Self Image. Princeton, N.J.: Princeton
University Press.
Rotheram-Borus, M. J., Selfndge, C., Koopman, C., Haignere, C., Meyer-Bahlburg,
H., and Ehrhardt, A. (1989) The relationship of knowledge and attitudes toward
AIDS to safe sex practices among runaway and gay adolescents. Presented at the
Fifth International Conference on AIDS, Montreal, June 09.
Rothman, J., and David, T. (1985) Status offenders in Los Angeles County: Focus on
runaway and homeless youth. Los Angeles: School of Social Welfare, University
of California at Los Angeles.
Santrock, J. W. (1981) Adolescence: An Introduction. Dubuque, Iowa: William C.
Brown.
Schinke, S. P. (1984) Preventing teenage pregnancy. In M. Hersen, R. M. Eisler, and
P. M. Miller, eds., Progress in Behavior Modification. San Prancisco: Academic
Press.
Severson, H. H. (1984) Adolescent social drug use: School prevention program. School
Psychology Review 13:15~161.
Shaffer, D., and Caton, D. (1984) Runaway and homeless youth in New York City: A
report to the Ittleson Foundation. New York: The Ittleson Foundation.
Sharp, E., Cowan, D., Goldenbaum, M., Brundage, J., and McNeil, J. (1989) Epidemi-
ology of HIV infection among young adults in the U.S.: Regional variations and
trends. Presented at the Fifth International Conference on AIDS, Montreal, June
=9.
OCR for page 249
AIDS AND ADOLESCENTS ~ 249
Siegel, D., Lazarus, N., Durbin, M., Krasnovsky, F., Chesney, M., and Kakimoto, D.
(1989) AIDS prevention in junior high school students in an AIDS epicenter:
Results of a baseline survey. Presented at the Fifth International Conference on
AIDS, Montreal, June =9.
Single, E., Kandel, D. B., and Johnson, B. D. (1975) The reliability and validity of
drug use responses in a large-scale longitudinal swvey. Journal of Drug Issues
5:426~43.
Smith, E. A., and Udder, J. R. (1985) Coital and non-coital sexual behaviors of white
and black adolescents. American Journal of Public Health 75:120~1203.
Sobol, J. (1987) Health concerns of young adolescents. Adolescence 22:739-750.
Sonenstein, F. L., Fleck, J. H., and Ku, L. C. (1989a) At risk of AIDS: Behaviors,
knowledge and attitudes among a national sample of adolescent males. Presented
at the Annual Meeting of the Population Association of America, Baltimore, Md.,
March 31.
Sonenstein, F. L., Pleck, J. H., and Ku, L. C. (1989b) Sexual activity, condom use
and AIDS awareness among adolescent males. Family Planning Perspectives
21:152-158.
Sorenson, R. C. (1973) Adolescent Sexuality in Contemporary America. New York:
World Publishing Co.
Spencer, B. D. (1989) On the accuracy of current estimates of the numbers of intravenous
drug users. In C. F. Turner, H. G. Miller, and L. E. Moses, eds., AIDS, Sexual
Behavior, and Intravenous Drug Use. Washington, D.C.: National Academy Press.
St. Louis, M. E., Hayman, C. R., Miller, C., Anderson, J. E., Peterson, L. R., and
Dondero, T. J. (1989) HIV infection in disadvantaged adolescents in the U.S.:
Findings from the Job Corps screening program. Presented at the Fifth International
Conference on AIDS, Montreal, June =9.
Stall, R., McKusick, L., Wiley, J., Coates, T. J., and Ostrow, D. G. (1986) Alcohol and
drug use during sexual activity and compliance with safe sex guidelines for AIDS:
The AIDS Behavioral Research Project. Health Education Quarterly 13:359-371.
Stark, E. (1986) Young, innocent, and pregnant. Psychology Today 20:28-30,32-35.
Sternleib, J. J., and Muncan, L. (1972) A survey of health problems, practices and
needs of youth. Pediatrics 49:177-186.
Stimson, G. V. (1988) Injecting Equipment Exchange Schemes: Final Report. London:
Monitoring Research Group, Sociology Department, Goldsmith's College.
Stimson, G. V. (1989) Syringe exchange programmer for injecting drug users. AIDS
5:253-261.
Strecher, V. J., DeVellis, B. M., Becker, M. H., and Rosenstock, I. M. (1986) The role
of self-efficacy in achieving health behavior change. Health Education Quarterly
13:73-91.
Strunin, L., and Hingson, R. (1987) Acquired immunodeficiency syndrome and adoles-
cents: Knowledge, beliefs, attitudes and behavior. Pediatrics 79:825-828.
Sutton, S. R. (1982) Fear-arousing communications: A critical examination of theory
and research. In J. R. Eiser, ea., Social Psychology and Behavioral Medicine.
New York: John Wiley and Sons.
OCR for page 250
250 ~ AIDS: THE SECOND DECADE
Telzak, E. E., Chiasson, M. A., Stoneburner, R. L., Rivera, J., Jaffee, H. W., and
Schultz, S. (1989) A prospective cohort study of HIV-1 seroconversion in patients
with genital ulcer disease in New York City. Presented at the Fifth International
Conference on AIDS, Montreal, June k9.
Temoshok, L., Moulton, J. M., Elmer, R. M., Sweet, D. M., Baxter, M., and Shalwitz,
J. (1989) Youth in detention at high risk for HIV: Knowledge, attitudes and
behaviors regarding condom use. Presented at the Fifth International Conference
on AIDS, Montreal, June =9.
Tolsma, D. D. (1988) Activities of the Centers for Disease Control in AIDS education.
Journal of School Health 58: 133-136.
Trussell, J. (1988) Teenage pregnancy in the United States. Family Planning Perspec-
tives 20:262-272.
Turner, C. F., Miller, H. G., and Barker, L. (1989) AIDS research and the behavioral
and social sciences. In R. Kulstad, ea., AIDS, 1988 Washington, D.C.: American
Association for the Advancement of Science.
Turner, C. F., Miller, H. G., arid Moses, L. E., eds. (1989) AIDS, Sexual Behavior, and
Intravenous Drug Use. Washington, D.C.: National Academy Press.
Udry, J. R., and Billy, J. O. G. (1987) Initiation of coitus in early adolescence. American
Sociological Review 52:841-855.
U.S. Bureau of the Census. (1985) Statistical Abstract of the United States: 1985.
105th ed. Washington, D.C.: U.S. Government Printing Office.
U.S. Bureau of the Census. (1987) Statistical Abstract of the United States: 1988.
108th ed. Washington, D.C.: U.S. Government Printing Office.
Valdiserri, R. O. (1989) Preventing AIDS: The Design of Effective Programs. New
Brunswick, N.J.: Rutgers University Press.
van den Hoek, I. A. R., Coutinho, R. A., van Haastrecht, H. J. A., van Zadelhoff, A.
W., and Goudsmit, J. (1988) Prevalence and risk factors of HIV infection among
drug users and drug-using prostitutes in Amsterdam. AIDS 2:55~0.
van den Hock, J. A. R., van Haastrecht, H. J. A., and Coutinho, R. A. (1990) Risk
reduction among intravenous drug users in Amsterdam under the influence of
AIDS. American Journal of Public Health 79:1355-1357.
Vermund, S. H., Hein, K., Gayle, H. D., Caky, J. M., Thomas, P. A., and Drucker,
E. (1989) Acquired irnmunodeficiency syndrome among adolescents. American
Journal of Diseases in Children 143:122~1225.
Vemon, M. E. L., Green, J. A., and Frothingham, T. E. (1983) Teenage pregnancy: A
prospective study of self-esteem and other sociodemographic factors. Pediatrics
72:632~35.
Vincent, M. L., Clearie, A. F., and Schluchter, M. D. (1987) Reducing adolescent preg-
nancy through school and community-based education. Journal of the American
Medical Association 257:3382-3386.
Vlahov, D., Anthony, J. C., Celentano, D. D., Solomon, L., Choudhury, N., and
Mandell, W. (1989) Trends of risk reduction among initiates into intravenous
drug use 1982-1987. Presented at the Fifth International Conference on AIDS,
Montreal, June =9.
VoeLker, R. (1989) No uniform policy among states on HIV/AIDS education. American
Medical News September 15:3.
OCR for page 251
AIDS AND ADOLESCENTS ~ 251
Walker, D. K., Cross, A. W., Heyman, P. W., Ruch-Ross, H., Benson, P., and Tuthill,
J. W. G. (1982) Comparisons between inner-city and private school adolescents'
perception of health problems. Journal of Adolescent Health Care 3:82-90.
Watters, J. K., (1987) Preventing human immunodeficiency virus contagion among
intravenous drug users: The impact of street-based education on risk behavior.
Presented at the Third International Conference on AIDS, Washington, D.C., June
1-5.
Wetzel, J. R. (1987)American Youth: A Statistical Snapshot. Washington, D.C.: The
William T. Grant Foundation.
Wiebel, W. W. (1988) Combining ethnographic and epidemiologic methods in targeted
AIDS interventions: The Chicago model. In R. J. Battjes, and R. W. Pickens,
eds., Needle Sharing Among Intravenous Drug Abusers: National and Interna-
tional Perspectives. National Institute on Drug Abuse Research Monograph 80.
Washington, D.C.: U.S. Government Printing Office.
Wigersma, L., and Oud, R. (1987) Safety and acceptability of condoms for use by
homosexual men as a prophylactic against transmission of HIV during anogenital
sexual intercourse. British Medical Journal 295:94.
Yamaguchi, K.? and Kandel, D. B. (1984a) Patterns of drug use from adolescence
to young adulthood: II. Sequences of progression. American Journal of Public
Health 74:668-672
Yamaguchi, K., and Kandel, D. B. (1984b) Patterns of drug use from adolescence
to young adulthood: III. Predictors of progression. American Journal of Public
Health 74:673~81.
Yates, G., MacKenzie, R., Pennbndge, J., and Cohen, E. ( 1988) A risk profile
comparison of runaway and non-runaway youth. American Journal of Public
Health 78:82~821.
Zabin, L. S., and Clark, S. D. (1983) Institutional factors affecting teenagers' choice
and reasons for delay in attending a family planning clinic. Family Planning
Perspectives 15:25-29.
Zabin, L. S., Kantner, J. F., and Zelnik, M. (1979) The risk of adolescent pregnancy in
the first months of intercourse. Family Planning Perspectives 11:215-222.
Zabin, L. S., Hardy, J. B., Smith, E. A., and Hirsch, M. B. (1986) Substance use and
its relation to sexual activity among inner-city adolescents. Journal of Adolescent
Health Care 7:32~331.
Zelnik, M. (1983) Sexual activity among adolescents: Perspective of a decade. In E. R.
McAnarney, ea., Premature Adolescent Pregnancy and Parenthood. New York:
Grune and Stratton.
Zelnik, M., and Kantner, J. F. (1977) Sexual and contraceptive experience of young
unmamed women in the United States, 1976 and 1971. Family Planning Per-
spectives 9:55-71.
Zelaik, M., and Kantner, J. (1979) Reasons for nonuse of contraception by sexually
active women aged 15-19. Family Planning Perspectives 11:289-296.
Zelnik, M., and Kantner, J. (1980) Sexual activity, contraceptive use and pregnancy
among metropolitan-area teenagers: 1971-1979. Family Planning Perspectives
12:23~237.
Zelnik, M., and Shah, F. K. (1983) First intercourse among young Americans. Family
Planning Perspectives 15:64 70.
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252 ~ AIDS: THE SECOND DECADE
Zelnik, M., Kanmer, J. F., and Ford, K. (1981) Sex and Pregnancy in Adolescence.
Beverly Hills, Calif.: Sage Publications.
Zenilman, J. (1988) Sexually transmitted diseases in homosexual adolescents. Journal
of Adolescent Health Care 9:129-138.
Zewdie, D., Abdurahman, M., Ayhunie, S., Adal, G., Tadesse, M., and Yemane, B. T.
(1989) High prevalence of V-1 antibodies in STD patients with genital ulcers.
Presented at the Fifth International Conference on AIDS, Montreal, June =9.
Ziffer, J., Ziffer, A., Bywater, M., and Bywater, L. (1989) Knowledge of HIV
transmissions and adolescent sexual behavior. Presented at the Fifth International
Conference on AIDS, Montreal, June =9.
Representative terms from entire chapter:
aids prevention
