Predictors of substance use in African American and Mexican American high risk adolescent women

Aims: Evaluate depressive symptoms and substance use among Mexican (MA) and African (AA)-American adolescent women and identify factors associated with substance use to inform development of community-based interventions for high risk adolescents. Methods: AA (n=94, 16.8%) and MA (n=465, 83.2%) women (14-18 years) with histories of sexually transmitted infection (STI) or violence and high risk sexual behavior were recruited from metropolitan public-health clinics. Participants completed semi-structured interviews including assessments for violence, sexual risk behavior, personal, family, peer, and partner substance use, depressive symptoms, and psychological stressors. Results: Most participants (82%) reported elevated depressive symptoms (Centers for Epidemiologic Studies Depression Scale >/= 16). MA adolescents were more likely than AA adolescents to report high levels of psychological stressors (t=-2.38, p=.018), cigarette (74% vs. 52%, p<.001), alcohol (79% vs. 60%, p<.001), and other drug use (87% vs. 67%, p<.001). No differences in depressive symptoms, physical, sexual or emotional violence, or partner substance use were identified by ethnicity. Controlling for theoretically guided variables (i.e., ethnicity, history of violence or STI, sex partners, life stressors, pregnancy), multinomial logistic regression analysis indicated ethnicity, numbers of sexual partner and depressive symptoms were predictors of substance use (X2(6, N=554) = 53.22, p <.001). Participants with substance using partner were more than two times as likely to use substances themselves. Conclusions: High levels of depressive symptoms and substance use mandates a focus on early intervention and prevention strategies among MA adolescent women who are particularly vulnerable; the role of partner substance use is a potential target for intervention.