Sensitivity and specificity of the CRAFFT to identify heavy cannabis use: Evidence from a large statewide adolescent sample

Patterns of Polysubstance Use in Young Black and Latinx Sexual Minority Men and Transgender Women and Its Association with Sexual Partnership Factors: The PUSH Study

Background: Adult studies have demonstrated that polysubstance use increases HIV acquisition risk through increased sexual behaviors, however, few studies have examined polysubstance in young Black and Latinx sexual minority men (SMM) and transgender women (TW). Methods: We used cross-sectional data from 466 young Black and Latinx SMM and TW living in four high HIV-burden US cities enrolled in the PUSH Study, a status-neutral randomized control trial to increase HIV prevention and treatment adherence. We examined data for patterns of polysubstance use comparing age differences of use and explored associations between substance use and sexual partnership factors - inconsistent condom use, pressure to have condomless anal sex, and older partner, using bivariate and multivariate analyses. Results: Most participants described prior substance use with alcohol and cannabis being most common (76% each) and 23% described other illicit drug use, including stimulants, cocaine, hallucinogens, sedatives, opioids, and inhalants. Polysubstance use was common with nearly half (47%) of participants reporting alcohol and cannabis use, 20% reporting alcohol, cannabis, and one other illicit drug use, and 19% reporting alcohol or cannabis use plus one other illicit drug use. Polysubstance use was associated with greater adjusted odds of pressure to have condomless anal sex, older partner (>5 years older), and inconsistent condom use. Conclusions: Associations of polysubstance use with sexual practices and sexual partnerships that are known predictors of HIV acquisition or transmission among Black and Latinx SMM and TW underscore the need for combination interventions that include substance use treatment alongside antiretroviral-based and partner-based HIV prevention and treatment interventions.Trial Registration: ClinicalTrials.gov Identifier: NCT03194477.

Coming of age in recovery: The prevalence and correlates of substance use recovery status among adolescents and emerging adults

BACKGROUND AND AIMS

To date, no epidemiological survey has estimated the prevalence of adolescents identifying as being in recovery. This is necessary for planning and identifying the needs of youth with current and remitted substance use disorders. This study estimated the prevalence of recovery status in a large statewide epidemiological survey administered between January and March 2020.

PARTICIPANTS

Participants were high school students in 9th through 12th grades throughout Illinois.

MEASUREMENTS

Youth were asked if they were in recovery and if they had resolved problems with substances. Youth who reported recovery and problem resolving dual status (DS), recovery only (RO), and problem resolution only (PRO) were compared to propensity score matched control groups who reported neither status (neither/nor; NN). Outcomes included alcohol use, binge alcohol use, cannabis use, and prescription drug use in the past 30 days.

FINDINGS

Prevalence estimates were 884 (1.4%) for DS, 1546 (2.5%) for PRO, and 1,811 (2.9%) for RO. Relative to propensity matched control samples, all three groups had significantly lower odds of prescription drug use. The PRO group had lower odds of past month cannabis use. There were no significant differences for either alcohol outcome.

CONCLUSIONS

Prevalence estimates of youth in recovery are slightly lower than those of adults in recovery, and estimates should be replicated. Youth in recovery and those resolving problems have numerous behavioral health needs, and relative to matched controls, have even odds for past 30-day alcohol use. These findings compel us to further define recovery for adolescents and emerging adults to allow for improving treatments and epidemiological research.

Assessing the self-reported honesty threshold in adolescent epidemiological research: comparing supervised machine learning and inferential statistical techniques

BACKGROUND

Epidemiological surveys offer essential data on adolescent substance use. Nevertheless, the precision of these self-report-based surveys often faces mistrust from researchers and the public. We evaluate the efficacy of a direct method to assess data quality by asking adolescents if they were honest. The main goal of our study was to assess the accuracy of a self-report honesty item and designate an optimal threshold for it, allowing us to better account for its impact on point estimates.

METHODS

The participants were from the 2020 Illinois Youth Survey, a self-report school-based survey. We divided the primary dataset into subsets based on responses to an honesty item. Then, for each dataset, we examined two distinct data analysis methodologies: supervised machine learning, using the random forest algorithm, and a conventional inferential statistical method, logistic regression. We evaluated item thresholds from both analyses, investigating probable relationships with reported fake drug use, social desirability biases, and missingness in the datasets.

RESULTS

The study results corroborate the appropriateness and reliability of the honesty item and its corresponding threshold. These contain the agreeing honesty thresholds determined in both data analyses, the identified association between reported fake drug use and lower honesty scores, increased missingness and lower honesty, and the determined link between the social desirability bias and honesty threshold.

CONCLUSIONS

Confirming the honesty threshold via missing data analysis also strengthens these collective findings, emphasizing our methodology's and findings' robustness. Researchers are encouraged to use self-report honesty items in epidemiological research. This will permit the modeling of accurate point estimates by addressing questionable reporting.