Romero Erin Gregory, Teplin Linda A, McClelland Gary M, Abram Karen M, Welty Leah J, Washburn Jason J
Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 710 N Lakeshore Dr, Chicago, IL 60611, USA.
Pediatrics. 2007 May;119(5):e1126-41. doi: 10.1542/peds.2006-0128.
Our goal was to examine the prevalence, development, and persistence of drug and sex risk behaviors that place delinquent youth at risk for HIV and other sexually transmitted infections.
At the baseline interview, HIV/sexually transmitted infection 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. The final sample in these analyses (n = 724) included 316 females and 408 males; there were 393 African American participants, 198 Hispanic participants, 131 non-Hispanic white participants, and 2 participants who self-identified their race as "other."
More than 60% of youth had engaged in > or = 10 risk behaviors at their baseline interview, and nearly two thirds of them persisted in > or = 10 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. Compared with females, males had higher prevalence rates of many HIV/sexually transmitted infection 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. Overall, there were few racial and ethnic differences in patterns of HIV/sexually transmitted infection risk behaviors; most involved the initiation and persistence of substance use among non-Hispanic whites and Hispanics.
Because detained youth have a median stay of only 2 weeks, HIV/sexually transmitted infection 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/sexually transmitted infection 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/sexually transmitted infection in young people.
我们的目标是调查那些使违法青少年面临感染艾滋病毒及其他性传播感染风险的毒品和性风险行为的流行情况、发展过程及持续情况。
在基线访谈中，对800名年龄在10至18岁的青少年被拘留者进行分层随机抽样，评估其艾滋病毒/性传播感染毒品和性风险行为。大约3年后对参与者进行再次访谈。这些分析中的最终样本（n = 724）包括316名女性和408名男性；有393名非裔美国参与者、198名西班牙裔参与者、131名非西班牙裔白人参与者以及2名自我认定种族为“其他”的参与者。
超过60%的青少年在基线访谈时曾有过≥10种风险行为，其中近三分之二的人在随访时仍有≥10种风险行为。在社区中的青少年里，许多行为在随访时比在基线时更为普遍。在被监禁的青少年中，情况则相反。与女性相比，男性在许多艾滋病毒/性传播感染风险行为上的患病率更高，并且更有可能持续某些行为并出现新的行为。然而，注射风险行为在女性中比在男性中更为普遍，并且也更有可能发展和持续。总体而言，在艾滋病毒/性传播感染风险行为模式上几乎没有种族和民族差异；大多数差异涉及非西班牙裔白人和西班牙裔中物质使用行为的开始和持续情况。
由于被拘留青少年的平均拘留时间仅为2周，违法青少年中的艾滋病毒/性传播感染风险行为是一个社区公共卫生问题，而不仅仅是青少年司法系统的问题。改善为青少年提供艾滋病毒/性传播感染干预措施的各系统（初级保健、教育、心理健康和青少年司法）之间的协调，可降低风险行为的流行率，并大幅减少艾滋病毒/性传播感染在年轻人中的传播。
