Drug Use and HIV/STI Risk Trajectories in Court-Involved, Non-Incarcerated Youth

Investigator: Marina Tolou-Shams, PhD
Sponsor: NIH National Institute on Drug Abuse

Location(s): United States


A juvenile's first point of contact with the juvenile courts represents an opportune moment for assessment and intervention. This study will provide novel data on the longitudinal patterns and associated risk and protective factors of drug use, HIV/STI risk behavior, psychiatric symptoms and recidivism among first-time offending, non- incarcerated juvenile offenders. Data will inform the development of public health screening, prevention and treatment programs to be delivered at the earliest point in the juvenile offending trajectory.

Cross-sectional studies have identified that court-involved, non-incarcerated (CINI) juveniles exhibit similar substance use and HIV/STI risk behavior rates as those detained or incarcerated. Yet, among first-time offending, CINI juveniles, there is a gap in our knowledge about who might develop drug use problems, engage in HIV/STI risk behaviors, have psychiatric difficulties and/or recidivate and what risk and protective factors may be related to their outcomes. The objective of the proposed research is therefore to investigate 24 month trajectories of drug use, HIV/STI risk behavior, psychiatric symptoms, and recidivism from the point of first juvenile court contact among a cohort of 400 first-time offending, CINI juvenile offenders. Specifically, we seek to characterize the two-year developmental course and co-occurrence of drug use, HIV/STI risk, psychiatric symptoms and recidivism in this population and to identify the individual, family and extrafamilial- level risk and protective factors associaed with these outcomes. First-time offending juveniles, ages 13-17, and a caregiver (N= 40 dyads for Phase I pilot study; N=400 for Phase II survey study) will be recruited from the Rhode Island Family Court, Juvenile Intake Department to participate in computerized survey assessments. In Phase I (first eight months of Year 1), 40 juveniles and a caregiver will be randomly sampled to complete the computerized survey measure once (at baseline, i.e., time of first contact with the juvenile court) to allow for pilot testing of sampling methodology and to provide quantitative and qualitative feedback related to survey development, administration and implementation. In Phase II (last quarter of Year 1 through Year 4), 400 juvenile/caregiver dyads (N=800 total) will be recruited (using a systematic disproportionate stratified sampling approach) at baseline and then re-assessed at 4, 8, 12, 16, 20 and 24 months subsequent to the juvenile's first court contact. Biological specimens for juvenile drug use and sexually transmitted infections (STIs) will also be collected at each assessment. Baseline and follow-up data will be used to construct individual and latent class growth analyses to characterize longitudinal trajectories of CINI juvenile's drug use, HIV/STI risk behaviors, psychiatric symptoms, and recidivism.