Incarcerated adolescents report greater sexual risk than do nonincarcerated peers. High-risk sexual behavior is associated with substance use. To determine how much sexual risk is combined with substance use, 167 incarcerated adolescents reported on their sexual risk behavior in the year before incarceration that involved alcohol or marijuana. For each risk behavior, marijuana use was more likely than was alcohol use. Marijuana use was more common for higher risk behaviors than for lower risk behaviors. Periods of incarceration provide opportunities for intervening on HIV-relevant risk behaviors among adolescents. The context of substance use within high-risk sexual situations ought to be a focus of interventions for incarcerated adolescents.
Keywordsadolescents; sexual risk; substance use; incarcerated populations; correctional health Adolescents who are involved in the juvenile justice system are at a higher risk of sexually transmitted diseases (including HIV/AIDS) and unplanned pregnancies than are their nondelinquent peers. Various studies of incarcerated adolescents have found that they report initiating sexual intercourse at early ages (American Academy of Pediatrics' Committee on Adolescence, 2001;Peres et al., 2002), high numbers of lifetime and recent sexual partners (Bryan & Stallings, 2002;Magura, Kang, & Shapiro, 1994), inconsistent use of condoms (Nagamune & Bellis, 2002;Rickman et al., 1994), and experimentation with anal intercourse (Gillmore, Morrison, Lowery, & Baker, 1994;Magura et al., 1994). In addition, teens who are incarcerated are more likely to report exchanging sex for drugs or money, or to meet other needs (Wood & Shoroye, 1993), and having sex while under the influence of alcohol or drugs (Magura et al., 1994;Morris, Baker, Valentine, & Pennisi, 1998;Otto-Salaj, Gore-Felton, McGarvey, & Canterbury, 2002) than are nonincarcerated adolescents.Many, if not most, incarcerated adolescents have experience using substances (primarily alcohol and noninjection drugs). Out of approximately 2.4 million juvenile arrests each year, more than 203,000 are for offenses related to substance use (Snyder, 2002 with substance use and intoxication among adolescent detainees (Devieux et al., 2002;Gary et al., 2000;Harwell, Trino, Rudy, Yorkman, & Gollub, 1999;Kingree, Braithwaite, & Woodring, 2002). Castrucci and Martin (2002) found a strong association between regular substance use and sexual risk (including multiple sex partners, inconsistent condom use, and trading sex for money or drugs) among their sample of incarcerated adolescents.The cross-sectional observational study reported here sought to evaluate the co-occurrence of sexual risk behavior and alcohol and marijuana use among a sample of incarcerated adolescents. Specifically, we were interested in ascertaining the following:1. The proportion of sexual behaviors that involved the use of alcohol or the use of marijuana. The behaviors under study were sexual intercourse in the past 12 months (a) with someone who was known very well and (b)...