Juvenile detainees push envelope on HIV/AIDS risk behaviors

May 28, 2003

Nearly all juvenile jail detainees -- even those as young as 10 years -- engage in dangerous HIV and AIDS risk behaviors, a finding that poses serious public health problems and presents additional challenges to the juvenile justice system, Northwestern researchers report.

Results from a study by Linda A. Teplin and colleagues from the Psycholegal Studies Program at Northwestern University, published in the June issue of the American Journal of Public Health, show that rates of HIV risk behaviors reported by juvenile detainees aged from 10 to 18 are much higher than those in the general population. Fully 95 percent of the more than 800 youths examined at a juvenile temporary detention center in Chicago, who ranged in age from 10 to 18 years, engaged in three or more sexual and drug risk behaviors and 65 percent in 10 or more risk behaviors.

Teplin is Owen L. Coon Professor of Psychiatry and Behavioral Sciences and director of the Psycholegal Studies Program at the Feinberg School of Medicine at Northwestern University. Her co-authors on the study were Amy A. Mericle, Gary M. McClelland, research assistant professor of psychiatry and behavioral sciences and Karen M. Abram, assistant professor, psychiatry and behavioral sciences.

The study found that significantly more boys than girls engaged in sexual risk behaviors, such as having multiple partners and sex with high-risk partners. Among the males, even in the 10-to-13 age group , more than half to two thirds had vaginal sex and used alcohol or marijuana. However, boys in this age group had lower rates of the most risky behaviors, such as multiple sex partners, vaginal sex with high-risk partners and unprotected sex while drunk or high.

More than half of the girls aged 10 to 13 were sexually active; over 40 percent of this group had engaged in vaginal sex; and more than two thirds of the girls had used marijuana.

Many risk behaviors were more prevalent among older girls. Almost all the girls 16 and older -- 95 percent - were sexually active; more than half had had recent unprotected vaginal sex; over 90 percent had used alcohol or marijuana; and more than half had been tattooed.

Overall, over 40 percent of both boys and girls had been tattooed.

Even if study participants tended to exaggerate or underreport certain behaviors, Teplin and colleagues believe that the study findings underscore the need for interventions aimed at detained juveniles, especially when viewed in the context of previous reports suggesting that detained youth are at great risk for developing HIV as they age.

Because many detainees are truant, they may miss school-based interventions, Teplin said. Detention-based interventions could improve HIV and AIDS knowledge, attitudes and behavioral skills.

"HIV/AIDS risk behaviors aren't just a problem for the juvenile justice system," Teplin said.

"Many kids at great risk for HIV - kids who use drugs, who trade sex for money or drugs and runaways - will be arrested at some point and cycle through detention centers. Moreover, most detained kids return to their communities within two weeks. Reducing HIV and AIDS risk behaviors in kids in the juvenile justice system could reduce the spread of infection in the community," she said.

The researchers also recommended early interventions to help the youngest detainees avert the most serious risk factors, as well as programs that target specific patterns of risk based on gender, race/ethnicity and age.

Study participants were randomly selected 1,800 juveniles, age 10 to 18, who were arrested and detained between 1996 and 1998 at a juvenile temporary detention center in Chicago. During structured interviews, each of the 340 female and 460 male participants provided extensive data on personal behaviors that increase the risk of HIV infection. The sample included 145 non-Hispanic whites, 430 blacks, 223 Hispanics and two youths who identified themselves as other.

The unprecedented volume and scope of the data collected made it possible to examine age-related differences in HIV and AIDS risk behaviors among juvenile detainees for the first time and to investigate more sexual and drug risk behaviors than had been previously studied.
This study was supported by grants from the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, the Office of Juvenile Justice and Delinquency Prevention, the Robert Wood Johnson Foundation, the William T. Grant Foundation and a consortium of other agencies.

KEYWORDS: juvenile detainees, HIV, AIDS, risk behaviors.

Northwestern University

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