270586 Understanding the larger context of risk to develop effective HIV/STI prevention interventions for youth on probation: The role of the family and the juvenile justice system

Tuesday, October 30, 2012 : 11:00 AM - 11:15 AM

Katherine Elkington, PhD , HIV Center for Clinical and Behavioral Studies, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY
Kimberly Belmonte, MA , The Graduate Center, City University of New York, New York, NY
Jessica Latack, MS , Department of Psychology, State University of New York at Stony Brook, Stony Brook, NY
Tracy Walsh, BA , Mailman School of Public Health, Columbia University, New York, NY
Gail Wasserman, PhD , Division of Child Psychiatry, NYSPI and Columbia University, new York, NY
Jennifer S. Hirsch, PhD , Department of Sociomedical Sciences, Columbia University, New York, NY
Claude Ann Mellins, PhD , HIV Center for Clinical and Behavioral Studies, NYSPI and Columbia University, New York, NY
Background: Youth in the juvenile justice system (JJS) are at considerable risk for HIV/STI yet there are few targeted interventions. Family-based HIV/STI prevention programs have been effective with other vulnerable populations, but we know little about the influence of family on HIV/STI risk in JJS youth. We explored family factors influencing sexual risk, as well as contextual factors within probation departments that influence delivery and sustainability of HIV/STI interventions.

Methods: In-depth qualitative interviews with 24 youth-caregiver dyads (58% female; 29% white; 29% Hispanic; age 15.3yrs) and 12 female probation officers (PO) (100% white; age 45.9yrs) from two juvenile probation departments explored how families influence sexual risk, and system- and staff-level factors that influence delivery of HIV/STI interventions. We conducted a thematic analysis of all interview texts.

Results: Caregiver-youth relationships were strained with limited communication, particularly about sex. Several caregivers lacked sufficient agency to address sexual risk and monitor youth activities. Probation involvement improved youth-caregiver relationships and monitoring. Many POs struggled to reconcile the department's role in reducing youth recidivism with the responsibility of providing HIV/STI programming. In the absence of department policy about youth sexuality, many POs felt inadequately trained to address sexual risk. Several POs co-led non-HIV related psychosocial groups.

Conclusion: Families of youth on probation had difficulty with communication and monitoring, which appeared to affect youth HIV/STI risk behaviors. Probation involvement improved youth-caregiver relationships, suggesting probation departments could provide a platform for delivery of sustainable family-based HIV/STI programs. However, departmental policies to address youth sexual risk are needed.

Learning Areas:
Planning of health education strategies, interventions, and programs
Public health or related organizational policy, standards, or other guidelines
Social and behavioral sciences

Learning Objectives:
1)Describe the influence of family factors (e.g. quality of relationships, parental monitoring, limit setting and involvement, and youth-caregiver communication) on sexual risk behavior in youth on probation. 2)Describe the probation system- and staff-level factors that may influence delivery of sustained HIV/STI prevention interventions 3) Discuss the development, delivery and sustainability of family-based HIV/STI interventions for youth on probation offered within the probation system.

Keywords: Adolescents, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved in HIV-related research for over 10 years. During this time, I have published several manuscripts and presented at various conferences on the risk and promotive factors that contribute to HIV/STI risk behaviors and other poor outcomes in vulnerable adolescent populations, including youth involved in the juvenile justice system. I have also written and presented work focused on developing HIV/STI prevention interventions for vulnerable populations of youth and adults.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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