DOLESCENTS ARE ACKNOWLedged as a population at increased risk of human immunodeficiency virus (HIV) infection. 1-5 Among adolescents, African American girls are a subgroup at particularly high risk of HIV infection. A seroepidemiologic study of Job Corps applicants reported that HIV prevalence among African American adolescent girls was significantly higher than among their white or Hispanic female peers (4.9 vs 0.7 and 0.6 per 1000, respectively) and exceeds that of white, Hispanic, and African American male adolescents (0.8, 1.5, and 3.2 per 1000, respectively). African American adolescent girls in the South had the highest prevalence (6.4 per 1000) relative to adolescents from other geographic regions. 6 Recent meta-analyses and reviews indicate that theoretically derived and empirically based HIV interventions can Author Affiliations are listed at the end of this article.

The findings demonstrate a consistent pattern of health risk behaviors and adverse biological outcomes associated with less perceived parental monitoring. Additional research needs to focus on developing theoretical models that help explain the influence of familial environment on adolescent health and develop and evaluate interventions to promote the health of adolescents.

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To evaluate the efficacy of an intervention to reduce incident sexually transmitted disease (STD) and enhance STD/human immunodeficiency virus (HIV)preventive behaviors and psychosocial mediators. Design: A randomized controlled trial of an HIV prevention program.

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Research should cross manifold levels of causation so that programs will be more effective at promoting adolescents' adoption and maintenance of STD/HIV preventive behaviors.

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Objectives We determined the factors associated with hepatitis C (HCV) infection among rural Appalachian drug users. Methods This study included 394 injection drug users (IDUs) participating in a study of social networks and infectious disease risk in Appalachian Kentucky. Trained staff conducted HCV, HIV, and herpes simplex-2 virus (HSV-2) testing, and an interviewer-administered questionnaire measured self-reported risk behaviors and sociometric network characteristics. Results The prevalence of HCV infection was 54.6% among rural IDUs. Lifetime factors independently associated with HCV infection included HSV-2, injecting for 5 or more years, posttraumatic stress disorder, injection of cocaine, and injection of prescription opioids. Recent (past-6-month) correlates of HCV infection included sharing of syringes (adjusted odds ratio = 2.24; 95% confidence interval = 1.32, 3.82) and greater levels of eigenvector centrality in the drug network. Conclusions One factor emerged that was potentially unique to rural IDUs: the association between injection of prescription opioids and HCV infection. Therefore, preventing transition to injection, especially among prescription opioid users, may curb transmission, as will increased access to opioid maintenance treatment, novel treatments for cocaine dependence, and syringe exchange.