Sexual Health Risk Behaviors Among Adolescent Females in Juvenile Detention

Background/Purpose: Juvenile offenders are disproportionately more likely to report risky sexual behavior than non-offenders (Robins, Odgers, & Russell, 2010).  With adolescent girls comprising one-third of all cases in the juvenile justice system (Pasko, 2010), 60% of them have also reported having three or more sexual partners and about 25% reported not using a condom (Robins et al., 2010). Over half of these females tested positive for STDs and STIs (Robins et al., 2010). 

The juvenile’s age of first arrest is significantly related to participation in health risky sexual behavior (Leve & Chamberlain, 2004). Another determinant related to juvenile detention and health risk behavior is drug use (Dembo et al., 2009).   Despite these concerns, there is still limited assessment of the associated sexual risk behaviors among female juvenile detainees. The purpose of this research study was 1) to examine the prevalence of sexual risk behaviors among incarcerated female adolescents and 2) to determine the associations that exist among this sample.

Methods: Adolescent females in a long-term regional detention center were administered a health behaviors survey during a regular morning class period.  A cross-sectional study design was used for the sample of female detainees (N=104), aged 12 to 20 in grades 7 to 12.  The assessed health risk behaviors included substance use behaviors (smoking, alcohol consumption, use of marijuana, cocaine, methamphetamines, ecstasy, aerosols and steroids), sexual behaviors (number of sexual partners and condom use), gang involvement, weapon possession, physical fights, physical activity and eating habits. The research questions examined the relationship between sexual risk behaviors and the use of alcohol, drugs and condoms by respondents during their last sexual encounter prior to incarceration.   Logistic regression analysis was used to assess the association between sexual risk behaviors, substance use and condom use.

Results: The analyses revealed that 91% of adolescents had engaged in sexual intercourse.  Adolescent sexual risk taking was highly prevalent (46% non-condom use, 36% repeated alcohol use) among female detainees.  The median age for initial sexual encounters was thirteen while 32% reported their first sexual experience at age twelve or younger. For substance use, four out of the 12 risk behaviors, alcohol consumption prior to incarceration (1 month), number of sexual partner (lifetime), number of sexual partners prior to incarceration (3 months), and the age at first sexual intercourse, were included in the final model (R²=.796, F_(4,99) p<.001). For condom use, having at least one drink in the month prior to incarceration was statistically significant (R²=.328, F_(1,102) p<.001).

Conclusion: This study revealed the high prevalence of sexual risk taking behaviors among a sample of female adolescent detainees.  Given the significant relationship between sexual risk behaviors, substance use, and condom use, the juvenile justice system should consider these factors when developing programming and policies for female adolescents.  Additionally, services for at-risk adolescent females should include strategies for health promotion and continuity of care once released. Further research is also needed to examine what other factors may influence engagement in these behaviors.