A Longitudinal Study of the Prevalence, Development, and Persistence of HIV/Sexually Transmitted Infection Risk Behaviors in Delinquent Youth: Implications for Health Care in the Community

Abstract

Objective-. To examine the prevalence, development, and persistence of sex and drug behaviors that place delinquent youth at risk for human immunodeficiency virus and other sexually transmitted infections (HIV/STI).Methods-At the baseline interview, HIV/STI drug and sex risk behaviors were assessed in a stratified random sample of 800 juvenile detainees, aged 10 to 18 years. Participants were reinterviewed approximately 3 years later (mean [SD] follow-up, 3.2 [0.3] years; median follow-up, 3.1 years). The final sample in these analyses (n = 724) includes 316 females and 408 males, 393 African Americans, 198 Hispanics, 131 non-Hispanic whites, and 2 participants who self-identified as "other."Results-Nearly three quarters of youth engaged in one or more unprotected sexual risk behaviors at follow-up. Over 60% had engaged in 10 or more risk behaviors at their baseline interview, and nearly two thirds of them persisted in 10 or more risk behaviors at follow-up. Among youth living in the community, many behaviors were more prevalent at follow-up than at baseline. Among incarcerated youth, the opposite pattern prevailed. Development and persistence of HIV/STI risk behaviors differed by gender, race/ethnicity, and age, even after adjusting for incarceration status. Compared with females, males had higher prevalence rates of many HIV/STI risk behaviors and were more likely to persist in some behaviors and develop new ones. Yet, injection risk behaviors were more prevalent among females than males and were also more likely to develop and persist. Compared with persons younger than 18, persons 18 and older had higher prevalence rates of many HIV/STI risk behaviors at follow-up. Overall, there were few racial and ethnic differences in patterns of HIV/STI risk behaviors; most involved the initiation and persistence of substance use among nonHispanic whites and Hispanics.Conclusions-Because detained youth have a median stay of only 2 weeks, HIV/STI risk behaviors in delinquent youth are a community public health problem, not just a problem for the juvenile justice system. Improving the coordination among systems that provide HIV/STI interventions to youth -primary care, education, mental health, and juvenile justice -can reduce the prevalence of risk behaviors and substantially reduce the spread of HIV/STI in young people.Corresponding Author: Linda A. Teplin, PhD, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 710 N. Lakeshore Drive, Suite 900, Chicago, IL 60611. . psycholegal@northwestern.edu. NIH Public Access Author ManuscriptPediatrics. Author manuscript; available in PMC 2010 January 29. Published in final edited form as:Pediatrics. 10-14Minorities are also overrepresented in the juvenile justice system, where HIV/STI risk behaviors are prevalent. 15-20 Detained youth report more risk behaviors and initiate them at younger ages than do youth in the community.21 Detained youth are likely to be at continued risk for HIV infection as they age. Adults in p...

HIV Risk Behaviors: Risky Sexual Activities and Needle Use Among Adolescents in Substance Abuse Treatment

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Methamphetamine Use and High-Risk Sexual Behaviors among Incarcerated Female Adolescents with a Diagnosed STD

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“…The association between delinquency and STI/sexual risk behavior is dependent on the population studied. For instance, youth involved in juvenile justice have been found to engage in increased sexual risk behavior and to be at particular risk for STI/HIV [14][15][16][17]. STI rates are also quite high among youth who are detained or incarcerated [18][19][20].…”