Caregiver Involvement in Sexual Risk Reduction with Substance Using Juvenile Delinquents: Overview and Preliminary Outcomes of a Randomized Trial
Elizabeth J. Letourneau,
Michael R. McCart,
Pia M. Mauro,
Ashli J. Sheidow.
Background: Substance using juvenile offenders have some of the highest rates for engaging in risky sexual
behaviors compared to other adolescent subgroups.
Methods: An overview of the literature on sexual risk behaviors among these youth is provided, including the empirical
support for including caregivers/parents as critical partners in sexual risk reduction efforts with this population. In particular,
there is (a) evidence that family factors contribute to adolescent sexual risk, (b) emerging support for caregiver focused
interventions that target adolescent sexual risk, and (c) established support for caregiver focused interventions that
target other complex adolescent behavior problems. In addition, this paper presents preliminary results from a randomized
controlled trial evaluating a family-based intervention for substance using juvenile delinquents that combines contingency
management (CM) for adolescent substance use with a novel sexual risk reduction (SRR) protocol. Results through six
months post-baseline (corresponding with the end of treatment) are presented for intervention fidelity and outcomes including
number of intercourse acts (Sex Acts), use of condoms or abstinence (Safe Sex), and obtaining HIV testing (Testing).
Conclusions: In comparison to youth focused group substance abuse treatment, the CM-SRR intervention was associated
with significantly greater therapist use of SRR techniques and greater caregiver involvement in treatment sessions (supporting
treatment fidelity) and significantly lower increases in Sex Acts (supporting treatment efficacy). There were also
higher odds for Safe Sex and for Testing, although these results failed to reach statistical significance. Findings add to the
growing literature supporting the feasibility and efficacy of caregiver focused interventions targeting sexual risk behaviors
among high-risk adolescent populations.
Keywords: HIV prevention, sexual risk, juvenile offenders, substance use, randomized controlled trial.
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