Substance Use and HIV Among Justice-Involved Youth: Intersecting Risks

  • Marina Tolou-ShamsEmail author
  • Anna Harrison
  • Matthew E. Hirschtritt
  • Emily Dauria
  • Jill Barr-Walker
Behavioral Bio-Medical Interface (JL Brown and RJ DiClemente, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Behavioral-Bio-Medical Interface


Purpose of Review

This review discusses recent advances in research on the intersection of HIV prevention and substance use among youth involved with the justice system. We discuss current themes of recent findings and provide guidance for researchers, policymakers, and clinicians on the next steps in advancing work in this nascent area.

Recent Findings

Of the 46 studies that measured HIV risk and substance use among justice-involved youth, 56% were cross-sectional designs, 22% were intervention trials, and 22% were longitudinal designs. Cross-sectional studies suggested that substance use is highly associated with HIV risk behaviors. Longitudinal analyses underscored the importance of understanding contextual risk factors, such as trauma and violence. Intervention trials demonstrated improved scientific rigor of behavioral approaches.


Despite recent advances, research in this field remains limited. Future directions include longer follow-up periods, consideration of biomedical HIV-prevention interventions, and a focus on dissemination and implementation science of efficacious interventions.


Juvenile justice Youth HIV Substance use Prevention 



This work was supported by National Institute on Drug Abuse grants R01DA034538 and R01DA035231 (Dr. Tolou-Shams), T32DA007250 (Dr. Harrison), R25DA037190 (Dr. Dauria), and National Institute of Mental Health grant R25MH06048 (Dr. Hirschtritt). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, National Institute of Mental Health or National Institute of Health.

Compliance with Ethics Guidelines

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


  1. 1.
    Centers for Disease Control and Prevention (CDC). Diagnoses of HIV infections in the United States and dependent areas, 2015. HIV Surveill Rep. 2015;27:1–114.Google Scholar
  2. 2.
    Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Hawkins JH, et al. Youth risk behavior surveillance — United States, 2015. Morb Mortal Wkly Rep. 2016;65:1–51.Google Scholar
  3. 3.
    Zanoni BC, Mayer KH. The adolescent and young adult HIV cascade of care in the United States: exaggerated health disparities. AIDS Patient Care STDs. 2014;28:128–35.CrossRefGoogle Scholar
  4. 4.
    Office of Juvenile Justice and Delinquency Prevention. Law enforcement and juvenile crime: juvenile arrests. In: OJJDP Statistical briefing book. 2018. Accessed 15 Jan 2019.
  5. 5.
    Office of Juvenile Justice and Delinquency Prevention. Easy access to the census of juveniles in residential placement: 1997-2015. 2015. Accessed 15 Jan 2019.
  6. 6.
    Dembo R, Faber J, Cristiano J, DiClemente RJ, Krupa JM, Terminello A, et al. Health risk behavior among justice involved male and female youth: exploratory, multi-group latent class analysis. Subst Use Misuse. 2017;52:1751–64.CrossRefGoogle Scholar
  7. 7.
    Sattler AL. Treating youths in the juvenile justice system. Pediatr Clin N Am. 2017;64:451–62.CrossRefGoogle Scholar
  8. 8.
    Belenko S, Dembo R, Rollie M, Childs K, Salvatore C. Detecting, preventing, and treating sexually transmitted diseases among adolescent arrestees: an unmet public health need. Am J Public Health. 2009;99:1032–41.CrossRefGoogle Scholar
  9. 9.
    Widom R, Hammett TM. HIV/AIDS and STDs in juvenile facilities. Natl Inst Justice Res Br. U.S. Department of Justice, Office of Justice Programs; 1996. Accessed 15 Jan 2019.
  10. 10.
    Teplin LA, Mericle AA, McClelland GM, Abram KM. HIV and AIDS risk behaviors in juvenile detainees: implications for public health policy. Am J Public Health. 2003;93:906–12.CrossRefGoogle Scholar
  11. 11.
    Abram K, Stokes M, Welty L, Aaby D, Teplin L. Disparities in HIV/AIDS risk behaviors after youth leave detention: a 14-year longitudinal study. Pediatrics. 2017;139:e20160360.CrossRefGoogle Scholar
  12. 12.
    Welty LJ, Harrison AJ, Abram KM, Olson ND, Aaby DA, McCoy KP, et al. Health disparities in drug-and alcohol-use disorders: a 12-year longitudinal study of youths after detention. Am J Public Health. 2016;106:e1–9.CrossRefGoogle Scholar
  13. 13.
    Centers for Disease Control and Prevention (CDC). HIV surveillance report [Internet]. 2014 [cited 2017 Jul 12]. Available from:
  14. 14.
    Hockenberry S, Wachter A, Sladky A. Juvenile residential facility census, 2014: selected findings. US Department of Justice, Office of Justice Programs, National report series juvenile residential facility census, 2014: Selected Findings 2016. Accessed 15 Jan 2019.
  15. 15.
    Iroh PA, Mayo H, Nijhawan AE. The HIV care cascade before, during, and after incarceration: a systematic review and data synthesis. Am J Public Health. 2015;105:e5–16.CrossRefGoogle Scholar
  16. 16.
    Gordon MS, Kinlock TW, Mckenzie M, Wilson ME, Rich JD. Rapid HIV testing for individuals on probation/parole: outcomes of an intervention trial. AIDS Behav. 2013;17:2022–30.CrossRefGoogle Scholar
  17. 17.
    Wilson HA, Hoge RD. The effect of youth diversion programs on recidivism: a meta-analytic review. Crim Justice Behav. 2013;40:497–518.CrossRefGoogle Scholar
  18. 18.
    Tolou-Shams M, Stewart A, Fasciano J, Brown L. A review of HIV prevention interventions for juvenile offenders. J Paediatr Psychol. 2010;35:250–61.CrossRefGoogle Scholar
  19. 19.
    Hong JS, Voisin DR, Crosby S. A review of STI/HIV interventions for delinquent and detained juveniles: an application of the social-ecological framework. J Child Fam Stud. 2015;24:2769–78.CrossRefGoogle Scholar
  20. 20.
    Austin J, Johnson KD, Weitzer R. Alternatives to the secure detention and confinement of juvenile offenders 2005;41. Available from: Accessed 15 Jan 2019.
  21. 21.
    Elkington KS, Peters Z, Choi CJ, Bucek A, Leu CS, Abrams EJ, et al. Predicting arrest in a sample of youth perinatally exposed to HIV: the intersection of HIV and key contextual factors. AIDS Behav. 2018;22(10):3234–43.Google Scholar
  22. 22.
    Gamarel KE, Brown L, Kahler CW, Fernandez MI, Bruce D, Nichols S. Prevalence and correlates of substance use among youth living with HIV in clinical settings. Drug Alcohol Depend. 2016;169:11–8.CrossRefGoogle Scholar
  23. 23.
    Gamarel KE, Nelson KM, Brown L, Fernandez MI, Nichols S. The usefulness of the CRAFFT in screening for problematic drug and alcohol use among youth living with HIV. AIDS Behav. 2017;21:1868–77.CrossRefGoogle Scholar
  24. 24.
    Khan MR, Rosen DL, Epperson MW, Goldweber A, Hemberg JL, Richardson J, et al. Adolescent criminal justice involvement and adulthood sexually transmitted infection in a nationally representative US sample. J Urban Heal. 2013;90:717–28.Google Scholar
  25. 25.
    Winkelman TNA, Frank JW, Binswanger IA, Pinals DA. Health conditions and racial differences among justice-involved adolescents, 2009 to 2014. Acad Pediatr. 2017;17:723–31.CrossRefGoogle Scholar
  26. 26.
    Voisin DR, Kim D, Takahashi L, Morotta P, Bocanegra K. Involvement in the juvenile justice system for African American adolescents: examining associations with behavioral health problems. J Soc Serv Res. 2017;43:129–40.CrossRefGoogle Scholar
  27. 27.
    Ricks JM, Crosby RA, Terrell I. Elevated sexual risk behaviors among postincarcerated young African American males in the South. Am J Mens Health. 2015;9:132–8.Google Scholar
  28. 28.
    Bryan AD, Magnan RE, Gillman AS, Yeater EA, Feldstein Ewing SW, Kong AS, et al. Effect of including alcohol and cannabis content in a sexual risk-reduction intervention on the incidence of sexually transmitted infections in adolescents: a cluster randomized clinical trial. JAMA Pediatr. 2018;172(4):e175621.Google Scholar
  29. 29.
    Dembo R, Schmeidler J, Wareham J, Briones-Robinson R, Winters KC, Ungaro R. Impact of brief intervention services on drug-using truant youths’ self-reported delinquency and arrest charges: a longitudinal study. J Child Adolesc Subst Abuse. 2016;25:458–79.CrossRefGoogle Scholar
  30. 30.
    DiClemente RJ, Davis TL, Swartzendruber A, Fasula AM, Boyce L, Gelaude D, et al. Efficacy of an HIV/STI sexual risk-reduction intervention for African American adolescent girls in juvenile detention centers: a randomized controlled trial. Women Health. 2014;54:726–49.CrossRefGoogle Scholar
  31. 31.
    Donenberg GR, Emerson E, Mackesy-Amiti ME, Udell W. HIV-risk reduction with juvenile offenders on probation. J Child Fam Stud. 2015;24:1672–84.CrossRefGoogle Scholar
  32. 32.
    Donenberg G, Emerson E, Kendall AD. HIV-risk reduction intervention for juvenile offenders on probation: The PHAT Life Group Randomized Controlled Trial. Health Psychol. 2018;37(4): 364–374.Google Scholar
  33. 33.
    Letourneau EJ, McCart MR, Asuzu K, Mauro PM, Sheidow AJ. Caregiver involvement in sexual risk reduction with substance using juvenile delinquents: overview and preliminary outcomes of a randomized trial. Adolesc Psychiatry. 2013;3:342–51.Google Scholar
  34. 34.
    Perrino T, Pantin H, Huang S, Brincks A, Brown CH, Prado G. Reducing the risk of internalizing symptoms among high-risk Hispanic youth through a family intervention: a randomized controlled trial. Fam Process. 2016;55:91–106.Google Scholar
  35. 35.
    Rowe CL, Alberga L, Dakof GA, Henderson CE, Ungaro R, Liddle HA. Family-based HIV and sexually transmitted infection risk reduction for drug-involved young offenders: 42-month outcomes. Fam Process. 2016;55:305–20.Google Scholar
  36. 36.
    Tolou-Shams M, Dauria E, Conrad SM, Kemp K, Johnson S, Brown LK. Outcomes of a family-based HIV prevention intervention for substance using juvenile offenders. J Subst Abus Treat. 2017;77:115–25.CrossRefGoogle Scholar
  37. 37.
    Letourneau EJ, McCart MR, Sheidow AJ, Mauro PM. First evaluation of a contingency management intervention addressing adolescent substance use and sexual risk behaviors: risk reduction therapy for adolescents. J Subst Abus Treat. 2017;72:56–65.CrossRefGoogle Scholar
  38. 38.
    Allen ST, Ruiz MS, O’Rourke A. Differences in the prevalence of risk behaviors between heterosexual and lesbian, gay, bisexual, and questioning (LGBQ) female adolescents in the juvenile justice system. J Gay Lesbian Soc Serv. 2016;28:171–5.CrossRefGoogle Scholar
  39. 39.
    Magnan RE, Callahan TJ, Ladd BO, Claus ED, Hutchison KE, Bryan AD. Evaluating an integrative theoretical framework for HIV sexual risk among juvenile justice involved adolescents. J AIDS Clin Res. 2013;4:217.CrossRefGoogle Scholar
  40. 40.
    McMahon RC, Stanforth ET, Devieux JG, Jean-Gilles M. HIV risk behavior and internalizing/externalizing psychopathology among adolescents in court-ordered treatment. Am J Drug Alcohol Abus. 2016;42:187–95.CrossRefGoogle Scholar
  41. 41.
    Rich SL, Robertson AA, Wilson JK. Having the talk: individual, family, and partner factors on unprotected sex among female adolescent offenders. Deviant Behav. 2014;35:311–22.CrossRefGoogle Scholar
  42. 42.
    Richardson J, Robillard A. The least of these: chronic exposure to violence and HIV risk behaviors among African American male violent youth offenders detained in an adult jail. J Black Psychol. 2013;39:28–62.CrossRefGoogle Scholar
  43. 43.
    Schmiege SJ, Bryan AD. Heterogeneity in the relationship of substance use to risky sexual behavior among justice-involved youth: a regression mixture modeling approach. AIDS Behav. 2016;20:821–32.CrossRefGoogle Scholar
  44. 44.
    Stephens T, Holliday RC, Jarboe J. Self-reported ecstasy (MDMA) use and past occurrence of sexually transmitted infections (STIs) in a cohort juvenile detainees in the USA. J Community Health. 2015;40:308–13.CrossRefGoogle Scholar
  45. 45.
    Stephens T, Holliday RC, Hopkins S, Rose S, Braithwaite R, Smith S. Correlates of African American female adolescent offenders 3, 4-methylenedioxymethamphetamine (MDMA or “ecstasy”) use and sexually transmitted infection morbidity. J Hum Behav Soc Environ. 2016;26:194–201.CrossRefGoogle Scholar
  46. 46.
    Udell WA, Hotton AL, Emerson E, Donenberg GR. Does parental monitoring moderate the impact of community violence exposure on probation youth’s substance use and sexual risk behavior? J Child Fam Stud. 2017;26:2556–63.CrossRefGoogle Scholar
  47. 47.
    Voisin DR, King KM, Diclemente RJ, Carry M. Correlates of gang involvement and health-related factors among African American females with a detention history. Child Youth Serv Rev. 2014;44:120–6.CrossRefGoogle Scholar
  48. 48.
    Wilson HW, Berent E, Donenberg GR, Emerson EM, Rodriguez EM, Sandesara A. Trauma history and PTSD symptoms in juvenile offenders on probation. Vict Offenders. 2013;8:465–77.CrossRefGoogle Scholar
  49. 49.
    Steinberg JK, Grella CE, Boudov MR, Kerndt PR, Kadrnka CM. Methamphetamine use and high-risk sexual behaviors among incarcerated female adolescents with a diagnosed STD. J Urban Health. 2011;88:352–64.CrossRefGoogle Scholar
  50. 50.
    Tolou-Shams M, Conrad S, Louis A, Shuford SH, Brown LK. HIV testing among non-incarcerated substance-abusing juvenile offenders. Int J Adolesc Med Heal. 2015;27:467–9.Google Scholar
  51. 51.
    Pagano ME, Maietti CM, Levine AD. Risk factors of repeated infectious disease incidence among substance-dependent girls and boys court-referred to treatment. Am J Drug Alcohol Abuse. 2015;41:230–6.CrossRefGoogle Scholar
  52. 52.
    Chinchila MA, Koson DS. Psychopathic traits moderate relationships between parental warmth and adolescent antisocial and other high-risk behaviors. Crim Justice Behav. 2016;43:722–38.CrossRefGoogle Scholar
  53. 53.
    Gillman AS, Yeater EA, Feldstein Ewing SW, Kong AS, Bryan AD. Risky sex in high-risk adolescents: associations with alcohol use, marijuana use, and co-occurring use. AIDS Behav. 2018;22(4):1352–62.Google Scholar
  54. 54.
    Sarver DE, McCart MR, Sheidow AJ, Letourneau EJ. ADHD and risky sexual behavior in adolescents: conduct problems and substance use as mediators of risk. J Child Psychol Psychiatry. 2014;55:1345–53.CrossRefGoogle Scholar
  55. 55.
    Gray SC, Holmes K, Bradford DR. Factors associated with pregnancy among incarcerated African American adolescent girls. J Urban Health. 2016;93:709–18.CrossRefGoogle Scholar
  56. 56.
    Callahan TJ, Montanaro E, Magnan RE, Bryan AD. Project MARS: design of a multi-behavior intervention trial for justice-involved youth. Transl Behav Med. 2013;3:122–30.Google Scholar
  57. 57.
    Clements-Nolle K, Larson S, Buttar A, Dermid-Gray L. Childhood maltreatment and unprotected sex among female juvenile offenders: evidence of mediation by substance abuse and psychological distress. Womens Health Issues. 2017;27:188–95.CrossRefGoogle Scholar
  58. 58.
    Conrad SM, Queenan R, Brown LK, Tolou-Shams M. Psychiatric symptoms, substance use, trauma, and sexual risk: a brief report of gender differences in marijuana-using juvenile offenders. J Child Adolesc Subst Abuse. 2017;26:433–6.CrossRefGoogle Scholar
  59. 59.
    Hatcher SS, King DM, Evans SZ, Summers LM. An assessment of sexual health risk behaviors among female youth in juvenile detention. Child Youth Serv. 2017;38:302–17.CrossRefGoogle Scholar
  60. 60.
    King KM, Voisin DR, DiClemente RJ. Gang norms and risky sex among adolescents with a history of detention. J Soc Serv Res. 2013;39:545–51.CrossRefGoogle Scholar
  61. 61.
    King DM, Hatcher SS, Blakey JM, Mbizo J. Health-risk behaviors and dating violence victimization: an examination of the associated risk behaviors among detained female youth. Soc Work Public Heal. 2015;30:559–66.CrossRefGoogle Scholar
  62. 62.
    King KM, Voisin DR, Diclemente RJ. The relationship between male gang involvement and psychosocial risks for their female juvenile justice partners with non-gang involvement histories. J Child Fam Stud. 2015;24:2555–9.CrossRefGoogle Scholar
  63. 63.
    Dembo R, Wareham J, Schmeidler J, Winters KC. Longitudinal effects of a second-order multi-problem factor of sexual risk, marijuana use, and delinquency on future arrest among truant youths. J Child Adolesc Subst Abuse. 2016;25:557–74.CrossRefGoogle Scholar
  64. 64.
    Leve LD, Kerr DCR, Harold GT. Young adult outcomes associated with teen pregnancy among high-risk girls in a randomized controlled trial of multidimensional treatment foster care. J Child Adolesc Subst Abuse. 2013;22:421–34.CrossRefGoogle Scholar
  65. 65.
    Ramaswamy M, Faseru B, Cropsey KL, Jones M, Deculus K, Freudenberg N. Factors associated with smoking among adolescent males prior to incarceration and after release from jail: a longitudinal study. Subst Abus Treat Prev Policy. 2013;8:37.CrossRefGoogle Scholar
  66. 66.
    Seth P, Jackson JM, DiClemente RJ, Fasula AM. Community trauma as a predictor of sexual risk, marijuana use, and psychosocial outcomes among detained African-American female adolescents. Vulnerable Child Youth Stud. 2017;12:353–9.CrossRefGoogle Scholar
  67. 67.
    Thayer RE, Montanaro E, Weiland BJ, Callahan TJ, Bryan AD. Exploring the relationship of functional network connectivity to latent trajectories of alcohol use and risky sex. Curr HIV Res. 2014;12:293–300.CrossRefGoogle Scholar
  68. 68.
    Thornton LC, Frick PJ, Ray JV, Wall Myers TD, Steinberg L, Cauffman E. Risky sex, drugs, sensation seeking, and callous unemotional traits in justice-involved male adolescents. J Clin Child Adolesc Psychol. 2017;13:1–12.Google Scholar
  69. 69.
    Yeater EA, Montanaro EA, Bryan AD. Predictors of sexual coercion and alcohol use among female juvenile offenders. J Youth Adolesc. 2015;44:114–26.CrossRefGoogle Scholar
  70. 70.
    Feder KA, McCart MR, Kahn G, Mauro PM, Sheidow AJ, Letourneau EJ. Association of mental health symptoms and peer behaviors with risk for substance use and condomless sex among youths in juvenile drug court. J Child Adolesc Subst Abus [internet]. Taylor & Francis; 2018;0652:1–13.
  71. 71.
    Callahan TJ, Caldwell Hooper AE, Thayer RE, Magnan RE, Bryan AD. Relationships between marijuana dependence and condom use intentions and behavior among justice-involved adolescents. AIDS Behav. 2013;17:2715–24.CrossRefGoogle Scholar
  72. 72.
    Belenko S, Knight D, Wasserman GA, Dennis ML, Wiley T, Taxman FS, et al. The Juvenile Justice Behavioral Health Services Cascade: a new framework for measuring unmet substance use treatment services needs among adolescent offenders. J Subst Abus Treat. 2017;74:80–91.CrossRefGoogle Scholar
  73. 73.
    Tolou-Shams M, Harrison A, Conrad SM, Johnson S, Brown LK. Challenges to conducting adolescent HIV prevention services research with court-involved youth. Child Youth Serv Rev. 2017;83:201–8.CrossRefGoogle Scholar
  74. 74.
    Centers for Disease Control and Prevention. Preexposure prophylaxis for the prevention of HIV infection in the United States 2017 update: a clinical practice guideline. US Public Health Service. 2017. Accessed 15 Jan 2019.
  75. 75.
    Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367:399–410.CrossRefGoogle Scholar
  76. 76.
    Choopanya K, Martin M, Suntharasamai P, Sangkum U, Mock PA, Leethochawalit M, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet (London, England). 2013;381:2083–90.CrossRefGoogle Scholar
  77. 77.
    Thigpen MC, Kebaabetswe PM, Paxton LA, Smith DK, Rose CE, Segolodi TM, et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367:423–34.CrossRefGoogle Scholar
  78. 78.
    Van Damme L, Corneli A, Ahmed K, Agot K, Lombaard J, Kapiga S, et al. Preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2012;367:411–22.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Marina Tolou-Shams
    • 1
    • 2
    Email author
  • Anna Harrison
    • 1
    • 2
    • 4
  • Matthew E. Hirschtritt
    • 1
    • 5
  • Emily Dauria
    • 1
    • 2
  • Jill Barr-Walker
    • 1
    • 3
  1. 1.Department of Psychiatry, Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoUSA
  2. 2.Zuckerberg San Francisco General HospitalDivision of Infant Child and Adolescent PsychiatrySan FranciscoUSA
  3. 3.ZSFG LibraryUniversity of California San FranciscoSan FranciscoUSA
  4. 4.San Francisco Veterans Affairs Health Care SystemSan FranciscoUSA
  5. 5.Langley Porter Psychiatric InstituteSan FranciscoUSA

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