Session: First Time Juvenile Offenders: Tailoring Approaches to Substance Use and HIV/STI Prevention (Society for Prevention Research 24th Annual Meeting)

Introduction: Recent estimates indicate 2.11 million youth under the age of 18 are arrested annually and that 31 million are under juvenile court jurisdiction. Seventy-one percent of these youth are referred to juvenile courts rather than adult criminal courts. Juvenile justice system involvement is associated with a variety of adverse public health outcomes, such as substance use, psychiatric symptoms, sexual risk behavior, and higher rates of sexually transmitted infections (STIs). The majority of such research, however, has focused on samples of detained or incarcerated juveniles; a high-risk juvenile offender subsample, but one that represents approximately only 20% of arrested youth. Courts are typically unconcerned about a juvenile until they have had several juvenile court contacts, by which point public health concerns and problem behaviors are more entrenched and much more challenging to intervene upon. Thus, elucidating the developmental course and associated risk and protective factors of drug use, HIV/STI risk behavior, psychiatric symptoms and recidivism among juveniles from the point of first juvenile court contact will critically inform the development and implementation of early public health screening, prevention and treatment interventions for juvenile offenders.  Juvenile courts are an innovative setting to identify ways to promote health equity among this underserved high-risk juvenile population.

Methods: Presentations focus on baseline data (first juvenile court contact) collected as part of a large-scale longitudinal epidemiological survey of drug use, HIV/STI risk behaviors, psychiatric symptoms, and legal involvement with 400 first-time offending, Court-Involved Non-Incarcerated (CINI) youth, aged 12-18 and their caregiver. Guided by Ecodevelopmental Theory, our study provides a framework to understand risk and protective factors for adolescent drug use and HIV/STI risk behavior, while accounting for the role of different contexts and developmental processes.

Results: Rates of substance use and HIV/STI risk behaviors are high.  Gender disparities appear to exist such that first-time offending girls with delinquent offenses are engaging in risk behaviors at rates higher than other subgroups of first-time offending CINI youth.  Similar to studies of more severe juvenile offenders, psychosocial maturity appears to be an important developmental consideration in tailoring interventions to reduce substance use and delinquent behaviors among CINI youth.  Additionally, intergenerational patterns of substance use and HIV/STI risk behaviors among caregivers and first-time CINI youth exist and caregivers’ own history of risk behaviors in combination with current parenting skills appears to serve both risk and protective roles in CINI juvenile substance use and sexual risk-taking.

Conclusions:  First-time offending, CINI youth represent a large, but neglected, subgroup of youth who exhibit similar high rates of health risk behaviors as detained youth. Our findings provide a first look at what is important to consider when developing tailored screening and intervention tools at first point of juvenile court contact, which is an opportune moment in time for early public health intervention.