Health risk factors among detained adolescent females
Introduction
Contemporary threats to the health of adolescent females are primarily the consequence of risk behaviors and related outcomes such as teenage pregnancy and sexually transmitted diseases (STDs).1, 2 Witnessing violence and residing in neighborhoods characterized by violent behavior also places adolescent females at risk.3 Moreover, selected mental health issues (e.g., suicidality, impulsivity, sexual adventurism) may be common among adolescent females.4, 5
Evidence suggests that adjudicated adolescent females sentenced to detention may be an especially high-risk population, bearing a disproportionate burden of medical and emotional disorders.6, 7, 8, 9, 10 Although providing medical and psychological services during the detention period is clearly important,8 the period is also a potentially valuable opportunity to initiate behavioral interventions designed to reduce risk, thereby averting subsequent morbidity.10 In sharp contrast to studies of detained adolescent males, few studies have specifically investigated health risk among detained females.6, 9, 10, 11, 12
This exploratory study identified health risk factors among a sample of detained adolescent females using behavioral and biological indicators (i.e., STDs). Health risk factors pertaining to pregnancy, sexual risk, violence, selected mental health issues, and substance abuse were identified. In addition, because of evidence suggesting racial disparities in health status among women,13 the study examined whether the identified health risk factors differed as a function of nonminority versus minority status. The study also investigated the strength of association between composite measures of risk in four distinct areas: sex-related risk behaviors, violence-related risk factors, selected mental health issues, and substance abuse behavior. Finally, significant correlates of testing positive for at least one of three assessed STDs were identified.
Section snippets
Study sample
Georgia detention facilities house adolescents convicted of offenses ranging from truancy to homicide as well as adolescents who have been temporarily placed in detention before sentencing. Eight detention facilities located in Georgia formed the basis for a cross-sectional survey of adolescents. Research assistants visited each of the eight detention facilities on a weekly basis. At each visit, all newly detained adolescents (i.e., those who had not been detained during the previous visit)
Characteristics of sample
Average age was 15.3 years (standard deviation [SD]=0.96). Nearly 42% identified as white and non-Hispanic, with 36.5% identifying as African American and non-Hispanic, 8.6% as white and Hispanic, 6.1% as African American and Hispanic, and the remainder identifying as other races/ethnicities. Nearly 70% (69.4%) indicated that they had served at least one previous detention sentence. Participants had been in detention for a mean of 36.4 days (SD=67.6), with the median stay of 14.5 days.
Health risk factors
Table 1
Conclusions
This exploratory research provides documentation suggesting that health risk behaviors are found in high proportions among detained adolescent females. This may be true regardless of nonminority versus minority status. Because the detention period is an ideal opportunity to provide health care and health education to this population, preventive medicine programs inside detention walls are clearly warranted. Evidence suggests that these programs should be broad in scope, and that the depth of
References (35)
Adolescents at risk
(1990)Adolescents at Risk Conference: overview
J Adolesc Health
(1991)- et al.
The effects of family and community violence on children
Annu Rev Psychol
(2000) - et al.
Health risk takers and prevention
Suicide risk among adolescents
- et al.
Health risk behavioral survey from 39 juvenile correctional facilities in the United States
J Adolesc Health
(1995) Health status of detained and incarcerated youth
JAMA
(1990)Health care for incarcerated youth: position paper of the Society for Adolescent Medicine
J Adolesc Health
(2000)- et al.
Medical status of adolescents at time of admission to a juvenile detention center
J Adolesc Health
(1998) - et al.
Health issues of juvenile offenders
HIV and AIDS risk behaviors in juvenile detainees: implications for public health policy
Am J Public Health
Prevalence of HIV-related risk behaviors and STDs among incarcerated adolescents
J Adolesc Health
American women and health disparities
J Am Med Womens Assoc
Adolescent sexual behavior, drug use, and violence: Increased reporting with computer survey technology
Science
Application of computer-assisted interviews to sexual behavior research
Am J Epidemiol
Alternative methods in the investigation of adolescents' sexual life
J Adolesc Health
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2023, Evaluation and Program PlanningPredictors of sexual and reproductive health among girls involved in the juvenile legal system: The influence of resources, race, and ethnicity
2022, Children and Youth Services ReviewCitation Excerpt :As a result, SRH risk compounds for system-involved girls of color, who carry the highest burden of outcomes associated with risky sex such as STI/HIV contraction and unintended pregnancy (UIP), despite engaging in fewer sexual risk behaviors compared to system-involved White girls and boys (Barnert et al., 2016; Biswas & Vaughn, 2011; Crosby et al., 2004; Tam et al., 2019; Voisin, Hong, & King, 2012; Logan-Greene et al., 2021). Cross-sectionally, studies find that anywhere between 20 and 50% of detained Black and Latinx girls contract STIs (Crosby et al. 2004; Fasula et al. 2018; Johnston et al. 2015). Further, unintended pregnancy (UIP) rates range from 25 to 29% (Acoca et al. 2004; Gray et al. 2016) among detained girls of color, which is more than twice the rate of UIP among adolescents in the general population (Cavazos-Rehg et al. 2010; Gray et al. 2016).
The health of adolescents in detention: a global scoping review
2020, The Lancet Public HealthCitation Excerpt :Overall, the prevalence of suicidal behaviour was markedly higher among detained adolescents than among adolescents in the general population.51–56 In detained adolescents, the prevalence of suicidal ideation ranged from 12·7% to 59·0% over the lifetime,57–60 2·9–30·6% during the past month,25,28,61–64 2·2–80·0% during the past 6 months,47,65,66 and 15·4–58·1% during the past year67 (appendix p 9);68 and the lifetime prevalence of suicide attempts ranged from 4·0% to 29·4% for males (mean 16·8% [SD 7·1]; median 17·3% [IQR 12·2–20·9])15,40,41,54,59,61,62 and from 20·8% to 51·1% for females (37·3% [10·6]; 39·8% [25·4–43·0]).40,41,59,65 For both sexes combined, the prevalence of suicide attempts was 1·9–6·6% during the past month and 13·3–35·0% during the past year (appendix p 10).11,28,29,41,45,57–64,66,67,69–81
Justice involvement and girls’ sexual health: Directions for policy and practice
2019, Children and Youth Services ReviewTreating Youths in the Juvenile Justice System
2017, Pediatric Clinics of North AmericaCitation Excerpt :In comparison, only 48% of high school girls in a population-based survey reported having had sexual experience and only 13% reported having 4 or more lifetime sexual partners.32,33 An earlier study of detained girls reported that the average number of lifetime sex partners was 8.8.34 Rates of STIs (20%–42%) discovered during health evaluations in JJ facilities, are much higher than those in community samples.31,34