Intervention Mitigates New Cases of HIV Among Youth in the Criminal Justice System

A combination of risk-reducing interventions showed the ability to greatly reduce sexual risk-taking among high-risk teens in the juvenile justice system, according to a study published by Health Psychology. The study was funded by the National Institute on Minority Health and Health Disparities (NIMHD), a part of the National Institutes of Health.

A trial called PHAT Life: Preventing HIV/AIDS Among Teens used role-playing, video games, and skill-building exercises to increase knowledge about HIV/AIDS, coping skills, and problem-solving techniques.

More than 1 million youths are involved the US juvenile justice system each year, according to the NIMHD. These individuals have a higher burden of mental illness, substance use disorder, and sexually transmitted infections (STsI) compared with teens of the general population. The study authors noted that there are limited evidence-based interventions that address this discrepancy.

Included in the clinical trial were 310 urban teens aged 13 to 17 years who were on probation in Cook County, Chicago. The authors noted that 66% of participants were male and 90% were African American.

Individuals were randomized to enroll in PHAT Life or an intensive health information program, both of which included 8 sessions given over 2 weeks at 4 detention-alternative afterschool programs, according to the study.

The researchers tracked the degree of condom use and the number of sexual partners in the 6 months before and after PHAT Life. Participants completed a baseline assessment before the intervention and again after 6 months.

Among those who reported the highest-risk sexual behavior at baseline, participants in PHAT Life were more than 4 times more likely to report a decrease in the number of sexual partners and an increase in consistent condom use compared with those in the other cohort, according to the study.

Among participants who reported having sex prior to age 12, those in the PHAT Life cohort had significantly fewer sexual partners after 6 months compared with control group participants.

“These findings reinforce the need for effective HIV/AIDS prevention strategies among vulnerable populations. Programs like this present opportunities to use effective methods, which result in continual benefits,” said Eliseo J. Pérez-Stable, MD, director of National Institute on Minority Health and Health Disparities.

The CDC reported that 1 in 5 new cases of HIV in the United States in 2015 were among youth aged 13 to 24. This population also accounts for half of all new STIs, which suggests they may also be at a high risk for HIV infection.

“Uniquely tailored interventions like PHAT Life that reduce adolescent risk behavior are essential to mitigate young offenders’ poor long-term trajectories. Limited resources require evidence-informed decisions about who can benefit the most from HIV-prevention efforts,” said lead researcher Geri Donenberg, PhD. “Our findings suggest that PHAT Life can reduce sexual risk among the highest-risk teens.”

Next, the researchers plan to identify how to spread PHAT Life resources to ensure the program is sustained in the juvenile justice system, according to the study.