Disparities in HIV/AIDS Risk Behaviors After Youth Leave Detention: A 14-Year Longitudinal Study
State of the art in the subject
Detained youth initiate HIV/AIDS risk behaviors at younger ages and report more risk behaviors – including use of alcohol and non-injecting drugs – than those in the general population. Yet, we know little about the prevalence and patterns of risk behaviors after youth leave detention and age into adulthood.
Added value of the study to the subject
Although rates decrease over time, sex risk behaviors remain prevalent among detained youth as they age, especially among racial/ethnic minority males. The pediatric community must address how disproportionate confinement of racial/ethnic minority youth contributes to HIV/AIDS health disparities.
To examine changes in the prevalence of 15 HIV/AIDS sex and drug risk behaviors in delinquent youth during the 14 years after they leave detention, focusing on sex and racial/ethnic differences.
The Northwestern Juvenile Project, a prospective longitudinal study of 1829 youth randomly sampled from detention in Chicago, Illinois, recruited between 1995 and 1998 and reinterviewed up to 11 times. Independent interviewers assessed HIV/AIDS risk behaviors using the National Institutes on Drug Abuse Risk Behavior Assessment.
Fourteen years after detention (median age, 30 years), one-quarter of males and one-tenth of females had >1 sexual partner in the past 3 months. One-tenth of participants reported recent unprotected vaginal sex with a high-risk partner. There were many sex and racial/ethnic differences.
For example, African American males had 4.67 times the odds of having >1 partner than African American females (95% confidence interval [CI], 3.22–6.76). Over time, compared with non-Hispanic white males, African American males had 2.56 times the odds (95% CI, 1.97–3.33) and Hispanic males had 1.63 times the odds (95% CI, 1.24–2.12) of having multiple partners, even after adjusting for incarceration and age. Non-Hispanic white females were more likely to have multiple partners than racial/ethnic minority females.
Although rates decrease over time, prevalence of sex risk behaviors are much higher than the general population. Among males, racial/ethnic minorities were at particular risk.
The challenge for pediatric health is to address how disproportionate confinement of racial/ethnic minority youth contributes to disparities in the HIV/AIDS epidemic.