Protective Factors Associated with Sexual Risk Behaviors and Drug Use Among African American Adolescent Girls in Child Welfare

Background and Purpose: Childhood maltreatment has been linked to poor health behaviors and health outcomes as evidenced by the Adverse Childhood Experiences Study (ACES).  Adolescents with histories of abuse and neglect are more likely to engage in alcohol and drug use, and risky sexual behaviors (James et al., 2009). Moreover, girls exhibit higher rates of health-risk behaviors than boys (Leslie et al., 2010). Few studies have examined protective factors in African American (AA) girls with histories of maltreatment, despite their over-representation in the child welfare system. Thus, the following questions were investigated: What are the frequencies of sexual risk behaviors and drug use among AA girls in child welfare? And, to what extent are protective factors (placement and school stability, school engagement, resiliency) significantly associated with sexual risk behaviors and drug use?  

Methods: The study utilized baseline data from 168 AA adolescent girls who were referred to a trauma-focused cognitive-behavioral intervention.  Participants were ages 12-18 (M=14.9, SD = 1.6), in an urban area. Independent variables were: school engagement (7 items; Goodenow, 1993), placement stability (number of lifetime types), school stability (number of schools attended, and number of mid-year school changes), and resiliency (14 items; Wagnild, 2011).  Dependent variables included: Consensual sexual intercourse (Ever; Yes/No); Ever had STDs (Yes/No); Sex without a condom at last time (Yes/No); Count of total risky sexual behaviors (Ever; sex while drinking or using drugs, traded sex for food or drugs, anal sex, oral sex, no condom at last sex); number of drugs ever used.  Data analyses included descriptive statistics, correlations, and logistic and negative binomial regressions controlling for age.   

Results:  Descriptive results indicated that 52% of the participants reported ever having consensual sexual intercourse, and 38% of girls engaged in one or more sexual risk behaviors.  Number of drugs used ranged from 0-7 with 52% of participants reporting having used one or more drugs. Regression analyses revealed that placement stability was a significant protective factor for reducing the odds of: ever having sex (OR=1.30, 95% CI 1.07-1.57), having had an STD (OR=1.47, 95% CI 1.15-1.88), sex without a condom at last time (OR=1.25, 95% CI 1.07-1.47), count of total risky sexual behaviors (IRR=1.35, 95% CI 1.22-1.49), and number of drugs ever used (IRR=1.22, 95% CI 1.13-1.32).  School engagement was significantly associated with reducing the number of drugs ever used (IRR=.96, 95% CI .91-.99).  School stability and resiliency were not associated with fewer sexual or drug use behaviors.

Conclusions and Implications: Placement stability and school engagement are recognized as important predictors of behavioral and educational outcomes for youths in child welfare. The contribution of this study is that it extends previous work to sexual risk behaviors for AA females controlling for other potential protective factors. Prior research suggests that positive parental bonds and monitoring are associated with decreased risk behaviors. Based on previous research and the current findings, future research may involve programs for youth to enhance positive relationships with adults and schools for reducing sexual risk behaviors and drug use in this population.