Beyond One-Size-Fits-All: Sexual Risk Profiles of African American Girls in Juvenile Detention

Background and Purpose:  Faced with persistent structural and social inequalities, African American adolescent girls are at disproportionate risk for acquiring HIV and sexually transmitted infections (STIs) (Abram et al., 2017). STIs are especially prevalent among African American girls involved with the juvenile justice system, a population that experiences a high level of psychosocial need and trauma relative to their peers from the general population. However, there are limited studies that have examined important within-group differences among this population with regards to risky sexual behaviors. Such a focus is critical to illuminating factors that promote resiliency among juvenile justice-involved African American girls.

This study uses latent class analysis (LCA) to explore differing sexual risk profiles among a sample of African American girls in juvenile detention. We hypothesize that there is meaningful variation in sexual risk profiles of detained African American adolescent girls, which correlates with contextual family and individual factors.

Methods:  Data were derived from detained African American girls (N=188) between the ages of 13 and 17 years with at least one experience of vaginal intercourse. Sexual behaviors were assessed prior to confinement. Five indicators of sexual risk were included in the LCA model: early sexual debut, unprotected sex, use of substances during sex, high numbers of sex partners, and high risk sex (i.e., sex trading or sex with someone recently released from incarceration). Contextual measures assessed were the broken windows index (i.e., a proxy for neighborhood disadvantage), deviant peer profiles, neighborhood crime, and peer bullying. Family factors were parental/caregiver support, discipline, and communication. Individual measures were abuse, trauma, mental health, substance use, perceived life chances, and self-esteem. All measures were compared across classes in relation to sexual risk behaviors.

Results:  Three distinct classes of sexual risk behaviors emerged: “Lowest Risk” (LR, 43.3%) with low endorsement of sexual risk items, “High Sex Partners” (HSP, 45.2%) with a high number of sexual partners and elevated levels of unprotected sex, and “Highest Risk” on all other indicators (HR, 11.3%). Groups differed significantly across most major variables. These groups did not reflect a mere low-, medium-, and high-risk relationship to sexual health, as evidenced in comparisons across other domains. For example, though the HSP class resembled the LR class in terms of mental health, they were more similar to the HR class on contextual and family risk. Sexual health outcomes also differed significantly by class, with high rates of pregnancies (18.1%, 24.9%, and 57.0%) and STIs (13.9%, 41.4%, and 67.8%) reported in the three respective classes.

Conclusions and Implications:  Findings demonstrated that there is significant diversity among detained African American girls, with a substantial proportion that report low risk sexual behaviors contrary to frequent portrayals in the extant literature when important within-group differences are not adequately examined. On the other hand, the high rates of STIs and pregnancies confirm this population’s vulnerability. Identifying discrete sexual risk profiles among detained African American adolescent girls may inform tailored HIV/AIDS and STI screening, prevention and intervention measures, as well as programs designed to promote their sexual wellness.