Alcohol/drug exposure, HIV-related sexual risk among urban American Indian and Alaska Native Youth: evidence from a national survey

J Sch Health. 2011 Nov;81(11):671-9. doi: 10.1111/j.1746-1561.2011.00643.x.


Background: Migration of the native populations from reservations to the urban areas has resulted in mixed ethnicities of American Indian/Alaskan Native (AIAN) children. Minority youth require special attention and services in urban schools as they disproportionately experience poverty, low educational attainment, unemployment, and single-parent status.

Methods: We used 2005 and 2007 Youth Risk Behavior Survey data to examine alcohol/drug use patterns and their association with sexual risk taking among AIAN only (single-racial) and biracial youth in combination with White, African American, or Hispanic ethnicities (N = 1178).

Results: Overall, one half of the students were sexually active, with significantly higher rates among males; AIAN-Black students initiated sex earlier than the other groups. Condom nonuse is higher among AIAN-Whites (>50%) compared to one third of AIAN-Hispanics and one fourth of AIAN-Blacks. Nearly 10% of all students, except AIAN-Blacks, reported lifetime use of heroin/meth. Sexual behavior was significantly associated with episodic drinking. Students with Hispanic background have twice the odds of being sexually active compared to AIANs.

Conclusions: Our findings underscore growing health care needs and targeted prevention initiatives for mixed racial underserved native youth. Urban school settings have potential to deliver services and offer alcohol/drug prevention programs to address the needs of mixed racial native urban youth. Using the School Based Health Clinic model has been successful; we need to reform prevention approaches to accommodate needs of multiracial urban native youth.

MeSH terms

  • Adolescent
  • Age Factors
  • Alcoholism / ethnology
  • Condoms / statistics & numerical data
  • Female
  • HIV Infections / ethnology*
  • Health Surveys
  • Humans
  • Indians, North American / statistics & numerical data*
  • Inuits / psychology*
  • Male
  • Risk-Taking
  • Sex Factors
  • Sexual Behavior / statistics & numerical data*
  • Socioeconomic Factors
  • Substance-Related Disorders / ethnology*
  • Urban Population / statistics & numerical data*