A Longitudinal Study of Truant Youths' Involvement in Sexual Risk Behavior

Challenges to conducting adolescent HIV prevention services research with court-involved youth

Multiple assessment studies demonstrate that juvenile offenders are at increased risk for contracting HIV and other STIs relative to their non-offending counterparts. Such data are used to support the implementation of adolescent HIV prevention interventions within the juvenile justice system. Despite the compelling data related to high rates of unprotected sexual activity, pregnancy, STIs, substance use and psychiatric symptoms, there are very few empirically supported HIV prevention interventions for this adolescent subgroup. Using our experience conducting HIV prevention research studies with court-involved, non-incarcerated (CINI) youth we identify salient and unique challenges to consider when conducting HIV prevention intervention research with this population. Obstacles to consider include lack of "buy-in" and engagement from justice staff and families about the need for youth sexual health promotion and HIV prevention services and logistical barriers (time, transportation, space) related to conducting intervention research with a community-based sample of justice-involved youth. We consider these various challenges and provide recommendations for researchers on how to overcome barriers to continue to develop evidence-based HIV prevention services for communities of youth in need.

Health Risk Behavior Among Justice Involved Male and Female Youth: Exploratory, Multi-Group Latent Class Analysis

BACKGROUND

Youth involved in the juvenile justice system experience a disproportionate prevalence of serious mental health issues, substance abuse, and are at an increased risk of engaging in risky sexual practices. Gender differences exist, with girls at a markedly greater risk of acquiring a sexually transmitted disease.

OBJECTIVES

The present study seeks to determine if there are subgroups of male and female youth who differ in their health risk behavior. If so, do any male or female subgroups at different levels of health risk differ in regard to their sociodemographic and psychological factors, and finally, what are intervention/service delivery implications of these differences.

METHODS

Youth were participants in an innovative health service at a centralized intake facility located in a large southeastern U.S. city. Latent class analysis and multinomial logistic regression is utilized to examine the heterogeneity of health risk behaviors across gender groups in a sample of 777 newly arrested youth.

RESULTS

Results indicate a three class solution provided the optimal fit with the data for each gender group: a Lower Health Risk group, a Higher Health Risk group, and a Highest Health Risk group. Multinomial logistic regression analysis identified significant sociodemographic and depression effects among both male and female youth. Conclusions/Importance: Youth characterized by risky sexually behavior, elevated depression, and drug involvement should be the focus of integrated intervention services. This study documents the critical need for front end, juvenile justice intake facilities to provide behavioral and public health screening, with treatment follow-up, on newly arrested youth.

A Multigroup, Longitudinal Study of Truant Youths, Marijuana Use, Depression, and STD-Associated Sexual Risk Behavior

Truant youth are likely to engage in a number of problem behaviors, including sexual risky behaviors. Previous research involving non-truant youth has found sexual risk behaviors to be related to marijuana use and depression, with differential effects for male and female youth. Using data collected in a NIDA funded, prospective intervention project, results are reported of a male-female, multi-group, longitudinal analysis of the relationships among truant youth baseline sexual risk behavior, marijuana use, and depression, and their sexual risk behavior over four follow-up time points. Results indicated support for the longitudinal model, with female truants having higher depression scores, and showing stronger relationships between baseline depression and future engagement in sexual risk behavior, than male truants. Findings suggest that incorporating strategies to reduce depression and marijuana use may decrease youth sexual risk behavior.

Sexual Risk Behavior among Male and Female Truant Youths: Exploratory, Multi-Group Latent Class Analysis

Little is known of sexual risk behaviors among truant youths across gender. This study utilized latent class analysis to examined heterogeneity of sexual risk behaviors across gender among a sample of 300 truant adolescents. Results revealed two latent subgroups within gender: low vs. high sexual risk behaviors. There were gender differences in baseline covariates of sexual risk behaviors, with male truants in higher risk group experiencing ADHD (attention deficit hyperactivity disorder) problems, and female truants in higher risk group experienced marijuana use and depression symptoms. African-American race was a significant covariate for high sexual risk behaviors for both genders. Service and practice implications of sexual risk issues of truant youth are discussed.