HIV/STI Risk Behaviors In Delinquent Youth: A Community Health Problem

Results of a recent study of 800 juvenile detainees aged 10-18 finds that young people involved
in the juvenile justice system are at great risk for HIV and sexually transmitted infections (STIs),
and this risk increases dramatically as they age. Because the majority of incarcerated youth
return to their communities, HIV/STI risk behaviors among this population represent a public
health concern for both the individual and the community.


Background: Few comprehensive studies examine HIV/STI risk behaviors in delinquent youth.
Because youth are generally detained for short periods of time (2 weeks on average), their
behaviors place persons in the community at increased risk. Therefore, HIV/STI risk behaviors in
delinquent youth are not just a problem for the juvenile justice system, but are also a community
public health problem.


Study Design: Scientists from Northwestern University School of Medicine interviewed 800
juvenile detainees aged 10 to 18 years. The research team examined behaviors associated with an
increased risk for HIV/STI, including sex and injection risk behaviors. Approximately 3 years later,
724 participants were reinterviewed (irrespective of where they lived - community, correctional
facility, or residential placement facility) to assess changes in HIV/STI risk behaviors.


What They Found: More than 60 percent of the juvenile detainees had engaged in at least 10 risk
behaviors at the baseline interview, and nearly two-thirds continued to engage in at least 10 risk
behaviors at follow-up. Of particular concern is the fact that at follow-up, 44 percent of males and
62 percent of females had had recent unprotected sex. The scientists also observed that among
juvenile detainees living in the community, HIV/STI risk behaviors were more prevalent at follow-up
than at baseline, whereas HIV/STI risk behaviors were less prevalent among detainees who were
incarcerated at follow-up. Although the researchers found few racial and ethnic differences in risk
behaviors, several differences were noted between male and female participants. Males had higher
prevalence rates of HIV/STI risk behaviors and they were more likely to continue risky behaviors
and develop new ones, compared to females. For females, injection risk behaviors were more
prevalent, and they were also more likely to develop and continue engaging in injection risk
behaviors.


Comments From The Authors: Our findings show that youth involved in the juvenile justice
system continue to be at great risk for HIV/STIs as they age. We need to develop interventions
tailored to fit specific patterns of risk and transmission. Because of the disproportionate numbers
of African Americans who cycle through correctional facilities, the pediatrics community must
focus on implementing culturally appropriate interventions for African-American youth and young
adults.


What's Next: In addition to the improving coordination between agencies, future research should examine the role of
incarceration in HIV/STI risk behaviors.


Publication: Dr. Linda Teplin and her colleagues published this study in the May 2007 issue of Pediatrics.


The National Institute on Drug Abuse (NIDA) is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and other topics are available in English and Spanish.


These fact sheets and further information on NIDA research and other activities can be found on the NIDA home page at drugabuse.