Risk factors of repeated infectious disease incidence among substance-dependent girls and boys court-referred to treatment

Abstract

Background: A small portion of Americans account for a disproportionate amount of the incidences of sexually transmitted infection observed over a short period of time. Studies with adults have begun to characterize this population, yet there is very little data on adolescent sexually transmitted infection repeaters (STIR). This study explores characteristics associated with STIR among 102 girls and 93 boys (aged 14–18) court-referred for residential treatment. Methods: Background characteristics, substance use disorders, risky and interpersonal behaviors, and history of sexually transmitted infections were collected at intake using valid and reliable instruments. A negative binomial logistic regression was performed to determine the background, risky behaviors, and social patterns associated with adolescent STIR. Results: Approximately two out of three adolescents (62%) did not use contraception the last time they had sex, and 15% had at least one sexually transmitted infection recorded in their medical chart. Sexually transmitted infection repeaters entered treatment with higher rates of cocaine abuse (13%) than youth without multiple infections (3%, p < 0.05). History of sexual abuse, having sex with a person who said no, higher exhibitionism, and social estrangement increased the odds of adolescent STIR. Main effects of exhibitionism and social estrangement on increased odds of STIR were more pronounced for sexually abused adolescents. Conclusions: The findings suggest a need for incorporating HIV education during residential treatment to improve health outcomes and intervention strategies that further connectedness for youth and victims of sexual abuse.

• Adolescents
• infection
• risky sex
• sexual abuse history
• STD
• substance use disorders

Acknowledgements

The authors wish to thank New Directions treatment staff and participants in this study.

Funding

This research was supported in part by grants awarded to Dr. Pagano from the National Institute on Alcohol Abuse and Alcoholism (NIAAA, K01 AA015137) and the John Templeton Foundation (#13591). The NIAAA and the John Templeton Foundation had no further role in study design, in the data collection and analysis, writing of the report, or decision to submit the paper for publication.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.