Girls in the juvenile justice system have been found to have high rates of co-occurring delinquency, drug abuse, and trauma. Girls with this triple-threat risk constellation are at high risk for engaging in risky sexual behavior and for contractin sexually transmitted infections (STIs), including HIV. Because HIV is associated with serious health-related problems, identifying interventions that effectively prevent and treat HIV risk behaviors has been at the forefront of recent research and clinical practice. Although effective interventions exist for the treatment of HIV risk behaviors in boys in the juvenile justice system, to our knowledge, no effective programs have been identified for girls with the triple-threat constellation of behaviors in the juvenile justice system. The proposed study aims to fill this gap by adapting and testing an intervention to reduce HIV/STI risk behavior among girls with the triple-threat risk constellation. The proposed study is a resubmission of a competing continuation (renewal) of the ProTeens study, which focuses on testing a family-centered intervention for treating HIV risk, drug use, and delinquency in boys ("Preventing Drug Abuse and HIV/AIDS in Delinquent Youths: An Integrated Intervention";R01DA025857);adaptations will be made to address the treatment needs of delinquent girls. The girls and their parent(s) will be randomly assigned to either a family- centered triple-threat intervention condition (INT;n = 100) or to an active comparison condition (n = 100) consisting of group therapy and case management (GCM). The INT condition will consist of individually administered HIV preventive intervention for adolescent girls involved in the juvenile justice system that integrally addresses delinquency, drug abuse, and trauma exposure, along with group-based training and support for parents. The girl and parent components will run concurrently for three months. The GCM condition will consist of group therapy and case management for girls provided as usual by the juvenile justice department. Given the well-documented detrimental social, health, and mental health outcomes associated with HIV/STI risk behaviors, and the lack of effective gender-based preventive interventions for girls in the juvenile justice system, the proposed intervention protocol has the potential of a high public health impact yielding positive implications for patients, clinicians, researchers, and policy makers.
Risky sexual behavior is associated with a host of negative outcomes, most notably the risk for contracting sexually transmitted infections (STIs), including HIV. HIV is of particular concern for adolescents and young adults, who have been found to account for half of the new infections in the United States;despite overall declines in the number of new HIV infections nationwide, no decline has been found among adolescents. Although rates of HIV risk behavior among the normative adolescent population is of concern, adolescent girls in the juvenile justice system who have very high rates of co-occurring delinquency, drug abuse, and trauma exposure, are at particularly high risk for engaging in HIV risk behavior. The Institute of Medicine and the CDC have emphasized the importance of using evidence-based interventions for treating HIV risk behaviors;however, few effective treatment programs exist. To our knowledge, no effective programs have been identified for girls with co-occurring problems in the juvenile justice system. Thus, an effective intervention protocol that addresses HIV/STI risk among juvenile justice girls has the potential for high public health impact yielding positive implications for patients, clinicians, researchers, and policy makers.