Treating risky HIV behaviors in incarcerated adolescents

Background: Juvenile justice involved youth are twice as likely to use alcohol and 3.5 times more likely to use marijuana compared to adolescents not previously arrested. Substance use plays a prominent role in sex engagement for incarcerated adolescents. Relaxation training (RT) combined with psycho-education around substance use and consequences (SET) reduces risky sexual behavior. This study examines the role of depression in treatment of substance abusing incarcerated teens on HIV risk 3 and 6 months after release. Methods: In a two group design, incarcerated teens (N=106) were randomized to either 2 sessions of individual motivational interviewing (MI) plus10 sessions of group cognitive behavior therapy (CBT) or individual RT plus group SET. Participants were 88% male, mean= 17.1 years old, 33% white, 36% Black, 11% Hispanic, 6% Asian, 3% American Indian, and 25% and 58% met diagnostic criteria for alcohol and marijuana use disorders, respectively. Sexual risk was assessed by asking how many times (past 3 months) participants had sex with someone they did not know well. Depression was assessed with the California Epidemiologic Studies - Depression Scale. Repeated measures ANCOVA was used. Results: There was a significant treatment group by depression interaction for number of times had sex with someone not known well. Simple effects tests revealed that sex risk did not differ between groups when depression was low. When depression was high, sex risk was lower after RT/SET compared to MI/CBT. Conclusions: RT/SET may be a viable approach to reduce risky sexual behaviors, particularly with adolescents with high depression.