Substance Use Disorders and HIV/AIDS Risk Behaviors in Youth After Juvenile Detention: A 16-Year Longitudinal Study

Purpose: To examine the association between substance use disorders (SUDs) and HIV/AIDS risk behaviors in detained youth as they age.

Methods: Prospective longitudinal study of a stratified random sample of 1,829 youth aged 10 to 18 years at baseline, sampled between November 1995 and June 1998 from the Cook County Juvenile Temporary Detention Center, Chicago, Illinois, and reinterviewed up to 13 times (to median age 32); 17,766 interviews overall.

Results: Youth had greater odds of engaging in every risk behavior when they had an SUD compared with when they did not have an SUD. For example, SUD was associated with condomless vaginal sex with a high-risk partner (OR: 2.28, 95% CI: 1.84-2.82). SUD was also associated with multiple partners, although the strength varied by time and sex (e.g., 16 years after baseline, OR: 3.58, 95% CI: 2.46-5.23 females; OR: 2.07, 95% CI: 1.48-2.88 males). Types of SUD-alcohol, comorbid alcohol and marijuana, drugs other than marijuana-were also associated with HIV/AIDS risk behaviors.

Discussion: SUDs and HIV/AIDS risk behaviors are linked among youth in the juvenile justice system and as they age. There is a longstanding need for targeted and integrated HIV and SUD services, but this need remains unmet.