P2-S1.15 Criminal justice involvement in adolescence and sexually transmitted infection in adulthood in USA
Authors: Khan M , Rosen D , Epperson M , Berger A , Smyrk K 
Published: July 2011

Background

Criminal justice involvement (CJI) may influence a former offender's sexually transmitted infection (STI) risk by, for example, disrupting sexual networks thereby increasing sex partnership exchange or increasing links to high-risk networks and thus STI-infected sex partners. If CJI increases STI risk, juvenile CJI may be a particularly important determinant of subsequent STI, because experiences and behaviours during the adolescent period have been shown to influence risk trajectories into adulthood and because adolescent CJI that continues into adulthood would result in greater CJI exposure. No study, to our knowledge, has measured associations between juvenile CJI and adult STI risk.

Methods

We used Wave III (2001–2002: young adulthood) of the National Longitudinal Study of Adolescent Health (N=14 322) to estimate cross-sectional associations between reported history of juvenile justice involvement and adult biologically-confirmed infection with chlamydia, gonorrhoea, or trichomoniasis.

Results

In analyses adjusting for age, race, gender, socio-economic factors, drug use, delinquency, and depression/suicidality, indicators of 1 juvenile arrest and 2–5 juvenile arrests were not associated with adult STI. Those who had been arrested 6 or more times as a juvenile had 8 times the odds of adult STI as those with no juvenile arrest history (adjusted OR 8.58, 95% CI 2.94 to 25.1). History of juvenile conviction and serving a sentence of juvenile detention or probation also was associated with STI (adjusted OR: 2.07, 95% CI 1.16 to 3.70). Persistent offenders, defined by report of both juvenile and adult arrest, had elevated odds of STI compared to those who were never arrested (adjusted OR: 1.72, 95% CI 1.06 to 2.80), while those who reported history of arrest either as a juvenile or as an adult but not during both time periods did not have elevated STI risk.

Conclusions

Adolescents who have very high repeat contact with the criminal justice system, who are convicted as juveniles, or who remain offenders into adulthood are priority populations for STI treatment and prevention. Though the potential for residual confounding especially due to unmeasured mood and personality characteristics is a limitation, the independent associations between juvenile CJI indicators and adult STI suggest that for some, the disruptive effect of juvenile CJI may contribute to a trajectory that results in adulthood STI see Abstract P2-S1.15 Table 1.

Abstract P2-S1.15 Table 1

ORs and 95% CIs for the association between juvenile justice involvement and adult biologically-confirmed sexually transmitted infection (Assessed at Wave III)*, among young adults aged 18–28 years in the USA†

Adult biologically-confirmed sexually transmitted infectionJuvenile criminal justice involvementUnadjusted OR (95% CI)Adjusted OR (95% CI)‡Number of times arrested as a minor 0 timesReferentReferent 1 time1.23 (0.73 to 2.07)1.24 (0.73 to 2.11) 2–5 times1.30 (0.59 to 2.84)1.17 (0.49 to 2.78) 6+ times7.58 (3.00 to 19.17)8.58 (2.94 to 25.1)Ever convicted or plead guilty in a juvenile court NoReferentReferent Yes2.14 (1.26 to 3.63)2.07 (1.16 to 3.70)Persistent Offending Never arrested as a juvenile or an adultReferentReferent Arrested as a juvenile, not as an adult1.19 (0.64 to 2.22)1.35 (0.71 to 2.56) Arrested as an adult, not as a juvenile1.11 (0.78 to 1.56)1.22 (0.82 to 1.81) Arrested both as a juvenile and an adult1.98 (1.26 to 3.10)1.72 (1.06 to 2.80)Timing of First Arrest Never arrested as a juvenile or an adultReferentReferent Arrested for the first time as a minor1.58 (1.09 to 2.29)1.53 (1.02 to 2.29) Arrested for the first time as an adult1.10 (0.78 to 1.55)1.21 (0.81 to 1.79)

*Overall, 6.1% of the analytic sample was confirmed to have a positive test result withChlamydia trachomatis,Neisseria gonorrhoeae,orTrichomonas vaginalis.

†Use of survey commands to account for stratification, clustering, and unequal selection probabilities yielded nationally representative estimates of white and black young adults.

‡Adjusted for age; gender; race/ethnicity; age at first sex; high school education status of mother/primary caretaker; high school education status of respondent; poverty level measured at Wave III, defined as difficulty affording housing/utilities in past year; adolescent history of getting drunk or marijuana, cocaine, or injection drug use; high levels of delinquency in adolescence, defined as a score of 7 on a 7 point delinquency scale; and indicators of hopelessness in adolescence, including respondent report that he/she would be killed by the age of 21 year and report that he/she would get HIV/AIDS.