Many adolescents entering substance abuse treatment have coexisting mental health problems and are criminally involved. Examination of the complexities of substance use, mental health, and criminal justice involvement along with changes in these issues following treatment is needed. This study includes 941 males and 266 females enrolled in seven drug treatment programs located in geographically diverse areas of the United States. Comparisons between males and females at treatment entry and three, six, 12 and 30 months later were examined with regard to substance use, mental health, and criminal justice involvement. Results indicate that females showed significantly greater severity in substance use, problems associated with use, and mental health related variables at intake while males had significantly more days on probation/parole. With respect to change over time, the rate of change in mental health and days on probation/parole differed between the sexes. Results indicate that while rate of change is different for males and females on most variables, there was positive change following treatment for both groups with regard to substance use, mental health, and probation/parole status. The high severity levels of females at intake calls for gender-specific outreach and identification along with gender-specific treatments.

Addressing transmission risk behaviors is an important secondary HIV prevention strategy. In addition to treatment for opioid dependence, addressing other substance use, social issues, particularly housing, and mental health may have important implications for reducing HIV transmission in HIV-infected opioid-dependent patients.

Most criminally involved drug-using females are mothers and are a disenfranchised population; although, little data are available on the differences between female drug users with children and female drug users without children in their care with regard to income, stability, resources, and other economic and contextual variables. Given the lack of information on criminally involved drug-using women, this study examines differences between drug-using women with children and drug-using women without children in their care with regard to basic demographics, mobility, resources, drug use, and legal problems or involvement. Participants selected for this examination included 154 criminally involved female drug users who had given birth to at least one child and were selected from a larger sample of 214 women who were randomly assigned to participate in a legal session. Descriptive and inferential statistics were used to examine the differences and similarities of the two groups. An ethnic-racial disparity was evident when examining the differences of characteristics of women who have children in their care versus those who do not. Overall, data from this study suggest that both groups of women are on the edge in terms of poverty, addiction, and rearrest. These results indicate that proactive measures that address this high-risk group are required.

This paper describes HIV sex and drug risk behavior and behavior change of injection drug and crack cocaine using women enrolled in a national multi-site Cooperative Agreement program. Baseline data on the 1,403 women who were randomly assigned to a two session intervention that was standardized across sites indicate that sex and drug risk behavior for becoming infected with HIV was considerable. Six-month post intervention follow-up data for the same sample of women show that significant reductions in sex and drug risk behavior were observed for the entire sample of women for the risk variables under study. Significant reductions were also demonstrated for various sub-groups of women enrolled in the study on most of the sex and drug risk variables. Given these findings, it appears that the standard intervention was effective in assisting drug using women reduce their behaviors that put them at risk of becoming infected with HIV. Further research in needed on the development and evaluation of HIV interventions that target specific risk behaviors and various HIV risk behavior profiles of women.