"Islands of risk": Subgroups of adolescents at risk for HIV

Christopher D. Houck, Celia M. Lescano, Larry K. Brown, Marina Tolou-Shams, Jonathon Thompson, Ralph DiClemente, M. Isabel Fernandez, David Pugatch, William E. Schlenger, Barbara J. Silver

Research output: Contribution to journalArticlepeer-review


Objective: To use cluster analysis to determine profiles of adolescents at risk for HIV. Methods: Adolescents 15-21 years old (N = 1153) with a history of unprotected sex were assessed in five domains of risk (unprotected sex, alcohol/marijuana use, other drug use, mental health crises, and arrest/school dropout) as well as demographic, contextual, and behavioral variables. Results: Cluster analysis revealed separate three-cluster solutions for males and females. Among males, clusters were characterized by (a) mental health crises and unprotected sex, (b) alcohol/marijuana use and unprotected sex, and (c) lower risk. Among females, clusters were distinguished by (a) unprotected sex, (b) substance use and mental health crises, and (c) lower risk. Cluster membership was associated with secondary variables related to sexual risk. Conclusions: Even within populations of high-risk adolescents, subgroups exist for which specific risk factors co-occur, particularly unprotected sex, mental health crises, and substance use. These patterns suggest that effective HIV prevention interventions may need to target the association between mental health and/or substance abuse with sexual risk for some adolescents.

Original languageEnglish (US)
Pages (from-to)619-629
Number of pages11
JournalJournal of pediatric psychology
Issue number6
StatePublished - Jul 2006


  • Adolescents
  • HIV
  • Sexual risk

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology


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