Pathways to Drug and Sexual Risk Behaviors among Detained Adolescents.

This study recruited 559 youths from detention centers (mean age was 15.4 years; 50.1% of detainees were girls) to investigate pathways that link witnessing community violence in the 12 months before detainment to drug and sexual risk behaviors in the two months preceding detainment. Through the use of audio-computer-assisted technology, data were collected on demographics, family factors, peer influences, religiosity, witnessing community violence, and drug and sexual risk behaviors. When controlling for demographics and family variables, the authors found positive associations between witnessing community violence and drug and sexual risk behaviors. Witnessing community violence was directly linked to sexual risk behaviors and indirectly associated with these risk behaviors and substance use through gang membership and perceived risky peer norms. Findings suggest that interventions targeting change in peer affiliations and perceived norms may be an effective strategy for reducing risky drug and sexual behaviors among detained youths. KEY WORDS: community violence; detained youths; drug use; gangs; HIV risks; peer norms ********** In the United States, considerable numbers of youths are involved in the juvenile justice system. Each year, approximately 2.5 million youths are arrested (Snyder, 2003), and an additional 1.8 million cases are referred to juvenile courts (Puzzanchera, Stahl, Finnegan, Tierney, & Snyder, 2003). Furthermore, an average of 109,000 youths (age 18 and younger) are incarcerated daily (Snyder, 2003). Incarceration rates, however, are not consistent across all adolescent populations. For example, the number of juvenile female detainees is increasing at a much faster rate than that of males (Sickmaund, Sladky, & Kang, 2003). In addition, African American and Hispanic youths, representing 20% of the adolescent population (U.S. Census Bureau, 2000), account for approximately 60% of juvenile detainees (Sickmaund et al., 2003). Many detained (or previously detained) youths come from disadvantaged backgrounds. For instance, many of these youths live in impoverished communities that may place them at increased risk of exposure to negative influences and other dangers, such as community violence (Canterbury et al., 1995; Chung & Steinberg, 2006). In this study, community violence exposure refers to witnessing violence between individuals who are unrelated and who may or may not know each other, which generally takes place outside the home (WHO, 2002). In some communities, because of high violence, low neighborhood cohesion, and elevated social disorganization, gang activity may be prevalent (Brody et al., 2001; Rankin & Quane, 2002). Unfortunately, acceptance into a group such as a gang depends on adhering to group norms that may sanction not only delinquent behaviors, but also health risk behaviors (Molidor, 1996). Therefore, it is not unexpected that youths held in detention represent a highly vulnerable population for engaging in illicit drug use and risky sexual behaviors (Crosby, DiClemente, Staples-Horne, 2003; Teplin, Mericle, McClelland, & Abram, 2002). Detained youths report higher rates of marijuana, amphetamines, and crack use compared with reports from other adolescent groups (Eng & Butler, 1997). In addition, recent evidence from the Centers for Disease Control and Prevention (2002) indicated that rates of gonorrhea among adolescent detainees were almost seven and 10 times greater among these boys and girls, respectively, when compared with adolescents from the general population. Furthermore, surveillance surveys have shown consistently that detained adolescents have higher rates of chlamydia and gonorrhea infection than do other adolescent groups (Canterbury et al., 1995; Pack, DiClemente, Hook, & Oh, 2000). Unfortunately, the pathways to such behaviors are not sufficiently understood. A growing body of literature documents significant associations between community violence exposure and drug and sexual risk behaviors. …