EVOLUTION OF RISK BEHAVIORS OVER 2 YEARS AMONG A COHORT OF URBAN AFRICAN-AMERICAN ADOLESCENTS

Objective: To examine the evolution of risk behaviors over 2 years amo ng a community-based cohort of low-income African American preadolesce nts and young adolescents enrolled in a randomized trial of an acquire d immunodeficiency syndrome risk reduction intervention. Design: Longi tudinal, community-based cohort. Setting: Nine recreation centers serv ing 3 public housing developments. Subjects: Three hundred eighty-thre e African American youths aged 9 through 15 years at baseline. Interve ntions: Frequency distributions, X-2 analyses, and regression analyses regarding 10 risk behaviors were conducted. To assess whether a speci fic risk behavior or its protective (nonrisk) behavioral analogue, com posing a risk-nonrisk behavioral complex leg, was sexually active and was sexually abstinent or used drugs and refrained from drugs),was sta ble over time, kappa values were determined for the 10 risk-nonrisk be havioral complexes. Main Outcome Measures: instrument assessing risk b ehaviors administered at baseline and every 6 months aurally and visua lly via talking computer. Results: The prevalence of sexual intercours e, cigarette smoking, alcohol consumption, and drug use increased nota bly over time. Drug use increased from a 6-month cumulative prevalence of 7% at baseline to 27% at the 24-month follow-up (P<.001). Cumulati vely over the 2-year study interval, 81% of youths had engaged in figh ting, 58% had engaged in sexual intercourse, and from 33% to 40% had: engaged in truancy, knife or bat carrying or both, alcohol consumption , drug use, and cigarette smoking. All of the risk-nonrisk behavioral complexes except weapon carrying were stable during the semiannual ass essment intervals. Fighting (kappa= 0.22, P<.01),sexual intercourse (k appa=0.33, P<.001), alcohol consumption (kappa=0.21, P<.001), and unpr otected sexual intercourse (kappa=0.34, P<.05) mere stable for 2 years . Six risk-nonrisk behavioral complexes were stable for the 2-year int erval among youths aged 13 through 15 years at baseline, while only 2 risk-nonrisk behavioral complexes were stable among younger youths. Th e intervention seemed to affect the stability of 4 risk behaviors: tru ancy, drug use, unprotected sexual intercourse, and, possibly, lightin g. For unprotected sexual intercourse, this intervention effect seemed to be due to stabilization of nonparticipation in risky behavior. Int ervention youths were less likely to adopt a risk behavior tie, engage in it for greater than or equal to-2 risk assessment periods) than co ntrol youths, but they were not less likely to experiment with a risk behavior. Conclusions: There is evidence that although the prevalence of risk behaviors does change with a,ae, most risk-nonrisk behavioral complexes seem to be relatively stable over time and stability may inc rease with time. Risk reduction interventions seem to decrease risk ad option, stabilize nonrisk behaviors, and possibly destabilize risk beh avior.