Preventing HIV/STI Risk Behavior in Girls with Delinquency, Drug Abuse & Trauma

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PROJECT SUMMARY/ABSTRACT The co-existence of conduct problems, drug abuse, and HIV risk behaviors is widely accepted, and numerous studies have highlighted the co-occurrence of these problems for youths involved in the juvenile justice system. Detrimental social, health, and mental health outcomes for youths with this triple threat of co-occurring problems are well-documented. Such youths are at high risk for a cascading host of additional problems as they age including AIDS, severe and persistent physical and mental health problems, incarceration, and early death. Although specific targets for prevention and intervention for youths with the triple-threat constellation have been identified, no evidence-based models have been developed to integrally address this constellation with adolescent juvenile justice populations. Program models are needed that treat this constellation in a coordinated fashion across juvenile justice and mental health systems. A lack of research on the development and implementation of integrated, multi-system treatment interventions targeting youths with the triple-threat constellation has led to a gap in the research base and in effective comprehensive services for high-risk youths. The proposed study builds on preliminary findings from a Mentored Career Development Award (K23 MH070684) and aims to test an integrated, family-centered preventive intervention for adolescent boys and girls with conduct problems who are at high risk for experiencing problems with chronic delinquency, drug abuse, and contracting HIV/AIDS, and their parents in partnership with the local juvenile justice authority where the intervention will be delivered. The proposed sample (N=160) includes youths ages 14-18 who have at least one criminal referral, documented drug use, are living in the community (e.g., biological/adoptive parent, relative or foster care) and have been placed on supervised probation or a formal accountability contract by the juvenile justice system in Lane County, OR. Youths and their parent(s) will be randomly assigned to an integrated conduct problem, drug use, and HIV/AIDS risk intervention (ICDH; n=80) or to a services-as-usual (SAU; n=80) control condition. Analyses will examine group differences in proximal and longer-term outcomes based on group assignment (intervention or control), the effects of potential mediating variables on the association between group assignment and proximal and longer-term outcomes, and general developmental modeling and theory-building questions specific to high-risk adolescents.