Substance use and HIV risks are important to study in Hispanic adolescents because of their rapidly growing numbers and because of their heightened vulnerability to substance use and HIV contraction (Prado, Schwartz, et al., 2006
; Szapocznik, Prado, Burlew, Williams, & Santisteban, 2007
). Our study was designed to subgroup Hispanics adolescents based on their intrapersonal and ecodevelopmental risk profiles and to compare rates of substance use, sexual behavior, and STD rates across subgroups.
Several noteworthy findings emerged from our study. First, as hypothesized, four distinct risk subgroups of Hispanic adolescents emerged in our sample. As expected the level of ecodevelopmental risk was not always highly correlated with the level of intrapersonal risk. For example, some moderate intrapersonal risk for substance use adolescents reported low to moderate ecodevelopmental risk, whereas others reported high ecodevelopmental risk. This finding suggests that Hispanic adolescents can be uniquely identified based on their ecodevelopmental and intrapersonal risk processes. Future research needs to examine what cutoffs of ecodevelopmental risk place adolescents in the “high” versus “low” ecodevelopmental risk subgroup. However, the classes that emerged were somewhat different from those that were hypothesized. For example, it was hypothesized that intrapersonal risks for substance use and sexual behavior would be positively highly correlated. However, the results of the latent class analyses reveal that adolescents reporting moderate levels of intrapersonal risk for substance use reported high levels of intrapersonal risk for sexual behavior.
The findings from our study also highlight the differences that exist among Hispanic adolescent subgroups in our sample. Like other populations, Hispanics are a heterogeneous subgroup, and hence, there are differences in substance use and sexual behavior within Hispanics. The results suggest that there are differences in substance use and sexual behavior by ecodevelopmental and intrapersonal risk profiles. The findings from this study suggest that substance use is mostly driven by ecodevelopmental risks and not intrapersonal risk for substance use. Thus, the findings suggest that adolescents with high ecodevelopmental risk should be targeted for substance abuse prevention. It should be noted, however, that most of the adolescents in this sample were 13 years of age, and substance use rates would be expected to increase as youth enter mid- and late adolescence. It is not clear whether intrapersonal risks for substance use begin to influence drug use as Hispanic adolescents progress through adolescence and into young adulthood.
Although future research is warranted with larger and more representative samples, substance abuse preventive interventions for Hispanic adolescents may need to target ecodevelopmental risk factors such as parent–adolescent communication. A limited number of ecodevelopmental substance abuse interventions with demonstrated efficacy for Hispanic adolescents (e.g., Prado et al., in press
) have begun to emerge in the literature (see Szapocznik et al., 2007
, for a review). On the other hand, the number of substance use intrapersonal interventions demonstrating efficacy for Hispanic adolescents ismore limited (Szapocznik et al., 2007
). Is this purely a coincidence or a reflection that ecodevelopmental interventions may be more efficacious than intrapersonal interventions in preventing Hispanic adolescent substance use? Future studies should first replicate these findings with other samples, and if replicated, future research should then examine the relative efficacy of ecodevelopmental and intrapersonal interventions for different Hispanic adolescent risk subgroups.
The findings emerging for sex initiation, unsafe sex, and STD outcomes also have important implications. The findings indicate that most adolescents reporting lifetime and past 90-day sexual behavior, and all adolescents reporting unsafe sex and STDs were those reporting high intrapersonal sex risk. The adolescents in this high intrapersonal sex risk class also reported low to moderate levels of ecodevelopmental risk, thus suggesting that (at least in our sample) ecodevelopmental risk variables have less influence on sexual behavior than intrapersonal risks for sexual behavior. It should be noted, however, that most of the adolescents in this sample were 13 years of age and that relatively few of them had engaged in any type of sexual behavior. It is not clear whether ecodevelopmental risks will have an influence on sexual behavior as Hispanic adolescents progress through adolescence and into young adulthood. Our findings, however, suggest that adolescents with high intrapersonal risk for sexual behavior may be more likely to initiate sex early, have unprotected sex, and be more likely to contract a sexually transmitted infection and thus should be targeted for sexual risk reduction intervention. After replication of these findings, future research should examine if interventions that target intrapersonal risk factors for sexual behavior (e.g., Villarruel, Jemmott, & Jemmott, 2006
) are most efficacious in preventing unsafe sex among Hispanic adolescents.
Our findings must be considered in light of several limitations. First, Miami-Dade County is a Hispanic enclave and may not be generalizable to other parts of the country. Second, although cluster analytic data-driven approaches “have the potential to make major contributions to applied health psychology research” (Clatworthy, Buick, Hankins, Weinman, & Horne, 2005
, p. 330), our findings should be replicated using population-based samples to provide increased confidence in the generalizability of the findings. Third, the present cross-sectional design has helped us to explore the relationship between risk subgroup and substance use and sexual behavior. However, longitudinal studies will be required to make directional inferences. Fourth, only self-report data were used. Research has shown that adolescents may underreport sensitive behaviors such as substance use and unsafe sex (Tourangeau, Rips, & Rasinski, 2000
). Fifth, because of the moderate sample size, we were unable to estimate a five- or six-class model. Such a model may possibly better describe the heterogeneity across risk subgroups. Finally, only family data were collected to assess ecodevelopmental risk. Because family, peer, and school microsystems all exert influences on adolescent risk-taking behavior, we recommend that future studies include measures of peer and school, as well as family, processes.