Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, New York.
Social Science Research Center, Mississippi State University, Starkville, Mississippi.
AIDS Patient Care STDS. 2020 Feb;34(2):72-80. doi: 10.1089/apc.2019.0157.
Justice-involved youth (JIY) are at considerable risk for human immunodeficiency virus (HIV), but are disconnected from treatment and prevention. Juvenile justice agencies providing community supervision (CS) are well positioned to provide HIV prevention, testing, and prompt referral to treatment for JIY. However, we lack an understanding of juvenile CS agency responses to HIV/sexually transmitted infection (STI) needs among JIY. We conducted a nationwide systematic assessment of how juvenile CS agencies identify, refer, and move youth through the HIV care cascade using a nationally representative sample of 195 juvenile CS agencies across 20 states. Two-thirds of CS agencies did not offer any HIV-/STI-related services, and 82% reported no collaboration with health agencies. Screening or referral for HIV risk behaviors was reported by 32% of the CS agencies and 12% for any intervention or prevention for HIV/STI risk behaviors. Between 21% and 30% of agencies were unaware of the location of local HIV/STI services. HIV/STI prevention training was not a priority for directors and was ranked second to last out of 16 training topics. Agencies where staff expressed need for HIV risk training and where specific court programming was available were more likely to provide or refer for HIV/STI screening and/or testing. Agencies were more likely to provide or refer for services if they provided pre-trial/pre-adjudication supervision, parole, or court programming. Considering the low provision of HIV/STI-related services and limited collaboration between health and justice agencies, interventions that promote cross-system collaboration designed to minimize barriers and facilitate identification, referral, and linkage to HIV services for JIY are necessary.
涉及司法程序的青少年（JIY）感染人类免疫缺陷病毒（HIV）的风险相当高，但他们与治疗和预防措施相脱节。提供社区监管（CS）的青少年司法机构非常适合为 JIY 提供 HIV 预防、检测，并及时转介他们接受治疗。然而，我们对青少年 CS 机构如何应对 JIY 中的 HIV/性传播感染（STI）需求知之甚少。我们对 20 个州的 195 个青少年 CS 机构进行了全国性的系统评估，了解这些机构如何识别、转介和推动青少年接受 HIV 护理流程。三分之二的 CS 机构没有提供任何 HIV/性传播感染相关的服务，82%的机构报告与卫生机构没有合作。只有 32%的 CS 机构报告对 HIV 风险行为进行了筛查或转介，而 12%的机构报告对 HIV/性传播感染风险行为采取了任何干预或预防措施。21%至 30%的机构不知道当地 HIV/性传播感染服务的位置。HIV/性传播感染预防培训不是主任的优先事项，在 16 个培训主题中排名倒数第二。表示需要 HIV 风险培训且有特定法庭项目的机构更有可能提供或转介进行 HIV/性传播感染筛查和/或检测。如果机构提供审前/审前监管、假释或法庭项目，则更有可能提供或转介服务。考虑到 HIV/性传播感染相关服务的提供程度较低，以及卫生和司法机构之间的合作有限，需要采取促进跨系统合作的干预措施，以尽量减少障碍，并为 JIY 识别、转介和获得 HIV 服务提供便利。
