Article Text
Abstract
Background Criminal justice involvement (CJI) may influence a former offender's sexually transmitted infection (STI) risk by, for example, disrupting sexual networks thereby increasing sex partnership exchange or increasing links to high-risk networks and thus STI-infected sex partners. If CJI increases STI risk, juvenile CJI may be a particularly important determinant of subsequent STI, because experiences and behaviours during the adolescent period have been shown to influence risk trajectories into adulthood and because adolescent CJI that continues into adulthood would result in greater CJI exposure. No study, to our knowledge, has measured associations between juvenile CJI and adult STI risk.
Methods We used Wave III (2001–2002—young adulthood) of the National Longitudinal Study of Adolescent Health (N=14 322) to estimate cross-sectional associations between reported history of juvenile justice involvement and adult biologically-confirmed infection with chlamydia, gonorrhoea, or trichomoniasis.
Results In analyses adjusting for age, race, gender, socio-economic factors, drug use, delinquency, and depression/suicidality, indicators of 1 juvenile arrest and 2–5 juvenile arrests were not associated with adult STI. Those who had been arrested 6 or more times as a juvenile had 8 times the odds of adult STI as those with no juvenile arrest history (adjusted OR—8.58, 95% CI 2.94 to 25.1). History of juvenile conviction and serving a sentence of juvenile detention or probation also was associated with STI (adjusted OR 2.07, 95% CI 1.16 to 3.70). Persistent offenders, defined by report of both juvenile and adult arrest, had elevated odds of STI compared to those who were never arrested (adjusted OR 1.72, 95% CI 1.06 to 2.80), while those who reported history of arrest either as a juvenile or as an adult but not during both time periods did not have elevated STI risk see Abstract P1-S2.33 Table 1.
Conclusions Adolescents who have very high repeat contact with the criminal justice system, who are convicted as juveniles, who remain offenders into adulthood and priority populations for STI treatment and prevention. Though the potential for residual confounding especially due to unmeasured mood and personality characteristics is a limitation, the strong, independent associations between juvenile CJI indicators and adult STI suggest that for some, the disruptive effect of juvenile CJI may contribute to trajectory to results in adulthood STI.