HIV Risk-Related Attitudes and Behaviors of Incarcerated Adolescents: Implications for Public School Students

Introduction According to the Centers for Disease Control and Prevention (CDC), 872 new cases of HIV infection had been reported in adolescents ages 13 through 19 years by midyear of 1992 (Child Health USA '92, p. 35). The number of adolescent AIDS cases doubled to 1,768 cases by June 1994 (CDC, 1994). Sexual intercourse is the exposure factor in 44% of cases of AIDS in adolescents: in 23% of cases, males reported having sex with other males; in 18% of cases, males engaged in heterosexual activity with a person who is HIV-infected or in a high-risk group; and 3% of cases were males reporting sexual activity and intravenous drug use (IDU) behaviors (Boyer & Ellen, 1994). New cases of AIDS also increased among young adults between 1992 and 1994 at about the same rate as adolescents. As of mid-June 1992, 8,911 cases of AIDS had been reported in young adults ages 20 to 24. By June 1994, the CDC reported 15,204 fresh cases of young adults being infected with HIV (CDC, 1994). Because of the long latency period, most of these cases in young adults are the result of exposure during adolescence. In this age group, sexual intercourse was the reported exposure factor for 81% of white non-Hispanics, 74% of African-American non-Hispanics and 60% of Hispanic young adults (Child Health USA '92, p. 36). These findings highlight the critical importance of sexual practices in decreasing risk of HIV infection and AIDS for adolescents and young adults. In a study of young homosexual males in the San Francisco area, Stall, McKusick, Wiley, Coates and Ostrow (1986) found that both alcohol and drug use were associated with the probability of engaging in risky sexual behaviors As noted by DiClemente (1991), studies have shown that incarcerated youths are more likely than adolescents from a normal population to engage in high risk sexual behaviors. In DiClemente's own sample, 34.6% reported rarely or never using condoms, similar to the 37%-38% found by Rotheram-Borus, Meyer-Bahlburg, Koopman, et al. (1992). Rotheram-Borus and colleagues (Rotheram-Borus, Becker, Koopman, & Kaplan, 1991; Rotheram-Borus et al., 1992) have conducted several studies on HIV/AIDS risk behavior among runaway and delinquent adolescent males and females and have found that only 14% of males and 18% of females reported consistent condom use, whereas 38% of males and 39% of females rarely or never used a condom (Rotheram-Borus et al., 1992). In this study, we examine the reported sexual practices and alcohol and other drug use behaviors, that may constitute risk behaviors, and knowledge and attitudes about HIV/AIDS among a sample of 847 sexually active incarcerated adolescents. Method Participants. Participants in the study are 847 sexually active adolescents (716 males and 131 females), a subsample(1) of 1,008 youths who were individually interviewed for a NIDA-funded project between January 1992 to July 1995 at the Virginia residential juvenile correctional facilities. Thirty-nine percent (n=328) of the sample are Caucasian, 55 % (n=466) are African American, and 6% (n=52) report belonging to other ethnic/racial groups. The average age of the sample is 15.8 years (s=1.24), with ages ranging from 12 to 19 years. Most of the participants in this study have a history of prior criminal offenses, alcohol and/ or other drug abuse, academic problems, and/ or family interpersonal problems. At the time of admission, participants had been charged with criminal offenses and sentenced for varying lengths of stay within the state's juvenile correctional system. Recruitment for this ongoing study was sequential from the date of admission. Informed consent for participation in a single-session structured interview was obtained from the adolescent and his/her parent or guardian. Instruments. The Demographic and Descriptive Inventory (DADI) (Compas, Howell, & Phares, 1989) is a 69-item questionnaire that inquires into family background, frequency of use of alcohol and/or other drugs, consequences of alcohol and other drug use, and involvement in other problem behaviors, including high risk sexual behaviors. …