Associations and Pathways between Substance Involvement and Risky Sexual Behavior over the Life Course of Urban African Americans

TL;DRAbstract

African Americans are disproportionately affected by HIV/AIDS and other sexually transmitted infections (STIs) relative to other racial/ethnic groups. Substance involvement has been linked to risky sexual behavior, an important risk factor for HIV/STI transmission, relatively early in the life course; yet such associations have not been found consistently among African Americans. Understanding of how substance involvement relates to risky sexual behavior among men and women over time and into midlife remains limited. The goal of this study was to examine the associations and pathways between substance involvement and risky sexual behavior over the life course in a community-based urban African American cohort (n=1242) followed prospectively from age 6 to 42 years. Using a combination of structural equation modeling and mediation testing, the study examined (1) prospective associations (from adolescence through adulthood) and within-life stage associations (in adolescence, young adultho

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