title: Family-Based HIV and Sexually Transmitted Infection Risk Reduction for Drug-Involved Young Offenders: 42-Month Outcomes.
abstract: This study tested a family-based human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention approach integrated within an empirically supported treatment for drug-involved young offenders, Multidimensional Family Therapy (MDFT). A randomized, controlled, two-site community-based trial was conducted with 154 youth and their parents. Drug-involved adolescents were recruited in detention, randomly assigned to either MDFT or Enhanced Services as Usual (ESAU), and assessed at intake, 3, 6, 9, 18, 24, 36, and 42-month follow-ups. Youth in both conditions received structured HIV/STI prevention in detention and those in MDFT also received family-based HIV/STI prevention as part of ongoing treatment following detention release. Youth in both conditions and sites significantly reduced rates of unprotected sex acts and STI incidence from intake to 9 months. They remained below baseline levels of STI incidence (10%) over the 42-month follow-up period. At Site A, adolescents who were sexually active at intake and received MDFT showed greater reduction in overall frequency of sexual acts and number of unprotected sexual acts than youth in ESAU between intake and 9-month follow-ups. These intervention differences were evident through the 42-month follow-up. Intervention effects were not found for STI incidence or unprotected sex acts at Site B. Intensive group-based and family intervention in detention and following release may reduce sexual risk among substance-involved young offenders, and a family-based approach may enhance effects among those at highest risk. Site differences in intervention effects, study limitations, clinical implications, and future research directions are discussed.
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Rowe
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Linda
authors.initials: L
authors.lastname: Alberga
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Gayle A
authors.initials: GA
authors.lastname: Dakof
authors.affiliation: Department of Psychology, Sam Houston State University, Huntsville, TX.
authors.forename: Craig E
authors.initials: CE
authors.lastname: Henderson
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Rocio
authors.initials: R
authors.lastname: Ungaro
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Liddle
mesh_terms: D000293:Adolescent; D057237:Criminals / Q000523:psychology*; D005196:Family Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D008297:Male; D040242:Risk Reduction Behavior; D012725:Sexual Behavior / Q000523:psychology; D012749:Sexually Transmitted Diseases / Q000517:prevention & control* / Q000523:psychology; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D047568:Unsafe Sex / Q000523:psychology
keywords: Adolescents; Detention; Familias; Families; HIV; Human Immunodeficiency Virus; ITS; Intervention; Juvenile Justice; STI; Sexually Transmitted Infection; VIH; adolescentes; intervención; justicia juvenil; 家庭; 少年司法; 干预; 青少年