Letourneau Elizabeth J, McCart Michael R, Asuzu Kammarauche, Mauro Pia M, Sheidow Ashli J
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.
Adolesc Psychiatry (Hilversum). 2013;3(4):342-351. doi: 10.2174/22106766113036660002.
Substance using juvenile offenders have some of the highest rates for engaging in risky sexual behaviors compared to other adolescent subgroups.
An overview of the literature on sexual risk behaviors among these youth is provided, including the empirical support for including caregivers/parents as critical partners in sexual risk reduction efforts with this population. In particular, there is (a) evidence that family factors contribute to adolescent sexual risk, (b) emerging support for caregiver focused interventions that target adolescent sexual risk, and (c) established support for caregiver focused interventions that target other complex adolescent behavior problems. In addition, this paper presents preliminary results from a randomized controlled trial evaluating a family-based intervention for substance using juvenile delinquents that combines contingency management (CM) for adolescent substance use with a novel sexual risk reduction (SRR) protocol. Results through six months post-baseline (corresponding with the end of treatment) are presented for intervention fidelity and outcomes including number of intercourse acts (Sex Acts), use of condoms or abstinence (Safe Sex), and obtaining HIV testing (Testing).
In comparison to youth focused group substance abuse treatment, the CM-SRR intervention was associated with significantly greater therapist use of SRR techniques and greater caregiver involvement in treatment sessions (supporting treatment fidelity) and significantly lower increases in Sex Acts (supporting treatment efficacy). There were also higher odds for Safe Sex and for Testing, although these results failed to reach statistical significance. Findings add to the growing literature supporting the feasibility and efficacy of caregiver focused interventions targeting sexual risk behaviors among high-risk adolescent populations.
与其他青少年亚群体相比，有物质使用问题的青少年罪犯从事危险性行为的比例极高。
本文概述了有关这些青少年性风险行为的文献，包括关于将照顾者/父母纳入针对该人群降低性风险努力的关键合作伙伴的实证支持。具体而言，有以下几点：(a) 证据表明家庭因素会导致青少年性风险；(b) 针对青少年性风险的以照顾者为重点的干预措施得到了越来越多的支持；(c) 针对青少年其他复杂行为问题的以照顾者为重点的干预措施已得到既定支持。此外，本文还展示了一项随机对照试验的初步结果，该试验评估了一种针对有物质使用问题的青少年罪犯的家庭干预措施，该措施将针对青少年物质使用的应急管理 (CM) 与一种新的性风险降低 (SRR) 方案相结合。呈现了基线后六个月（对应治疗结束）的干预保真度和结果，包括性交行为次数（性行为）、使用避孕套或禁欲（安全性行为）以及进行艾滋病毒检测（检测）。
与以青少年为重点的团体药物滥用治疗相比，CM-SRR 干预与治疗师对 SRR 技术的显著更多使用以及照顾者在治疗环节中的更多参与相关（支持治疗保真度），并且性行为的增加显著更低（支持治疗效果）。安全性行为和检测的几率也更高，尽管这些结果未达到统计学显著性。研究结果进一步丰富了越来越多的文献，支持针对高风险青少年人群的性风险行为以照顾者为重点的干预措施的可行性和有效性。
