Gardner Sheena K, Elkington Katherine S, Knight Danica K, Huang Sofia, DiClemente Ralph J, Spaulding Anne C, Oser Carrie B, Robertson Angela A, Baird-Thomas Connie
Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS, 39759, USA.
Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University, 1051 Riverside Drive, #15, New York, NY, 10032, USA.
Health Justice. 2019 Sep 4;7(1):15. doi: 10.1186/s40352-019-0096-7.
While involvement in the legal system offers an opportunity to educate, screen, and treat high-risk youth, research shows that staff attitudes toward these practices can serve as barriers to implementation. The current study investigates the degree to which JJ staff endorse HIV prevention, testing, and treatment linkage practices with youth under community supervision and examines differences between individuals who supervise youth (e.g., juvenile probation officer) and those working in non-supervisory roles (e.g., case manager, assessment specialist).
Juvenile justice staff consenting to participation in JJ-TRIALS completed an initial staff survey (N = 501). Survey items measured perceived importance of HIV/STI prevention (4 items); perceived importance of HIV/STI testing (7 items); and perceived importance of HIV/STI treatment linkage (8 items).
Confirmatory Factor Analysis (CFA) was computed (SAS CALIS procedure) for each of the three domains. Findings suggest that while staff recognize that youth are at risk for HIV/STIs and require provision of HIV/STI prevention and treatment linkage, attitudes concerning the importance of procuring or providing testing services for youth is substantially lower. Furthermore, analytic models comparing staff with and without supervision responsibilities (computed using SAS PROC MIXED) indicated that attitudes differed by site and staff responsible for supervision rated HIV treatment linkage practices as less important compared to non-supervising staff.
Establishing partnerships with health agencies equipped with resources and skillsets to provide HIV/STI testing and related services may be an effective model to promote greater awareness and use of best practices among JJ staff and more effectively address the unmet needs of this high-risk population of youth.
虽然参与法律系统为教育、筛查和治疗高危青少年提供了机会，但研究表明，工作人员对这些做法的态度可能成为实施的障碍。当前的研究调查了少年司法工作人员认可在社区监管下对青少年进行艾滋病毒预防、检测和治疗联系做法的程度，并检验了监管青少年的人员（如少年缓刑监督官）与担任非监管角色的人员（如个案经理、评估专家）之间的差异。
同意参与JJ - TRIALS的少年司法工作人员完成了一份初始工作人员调查问卷（N = 501）。调查项目衡量了对艾滋病毒/性传播感染预防的感知重要性（4项）；对艾滋病毒/性传播感染检测的感知重要性（7项）；以及对艾滋病毒/性传播感染治疗联系的感知重要性（8项）。
对这三个领域分别进行了验证性因素分析（CFA）（使用SAS CALIS程序）。研究结果表明，虽然工作人员认识到青少年有感染艾滋病毒/性传播感染的风险，需要提供艾滋病毒/性传播感染预防和治疗联系，但对于为青少年获取或提供检测服务的重要性的态度要低得多。此外，比较有和没有监督责任的工作人员的分析模型（使用SAS PROC MIXED计算）表明，态度因工作地点而异，负责监督的工作人员认为艾滋病毒治疗联系做法不如非监督工作人员重要。
与具备提供艾滋病毒/性传播感染检测及相关服务资源和技能的卫生机构建立伙伴关系，可能是一种有效的模式，可提高少年司法工作人员对最佳做法的认识并促进其使用，更有效地满足这一高危青少年群体未得到满足的需求。
