This study tested a
family-based human immunodeficiency virus (HIV)/sexually transmitted infection
(STI) prevention approach integrated within an empirically supported treatment
for drug-involved young offenders, Multidimensional Family Therapy (MDFT).
A
randomized, controlled, two-site community-based trial was conducted with 154
youth and their parents. Drug-involved adolescents were recruited in detention,
randomly assigned to either MDFT or Enhanced Services as Usual (ESAU), and
assessed at intake, 3, 6, 9, 18, 24, 36, and 42-month follow-ups. Youth in both
conditions received structured HIV/STI prevention in detention and those in
MDFT also received family-based HIV/STI prevention as part of ongoing treatment
following detention release. Youth in both conditions and sites significantly
reduced rates of unprotected sex acts and STI incidence from intake to
9 months. They remained below baseline levels of STI incidence (10%) over the
42-month follow-up period.
At Site A, adolescents who were sexually active at
intake and received MDFT showed greater reduction in overall frequency of
sexual acts and number of unprotected sexual acts than youth in ESAU between
intake and 9-month follow-ups. These intervention differences were evident
through the 42-month follow-up. Intervention effects were not found for STI
incidence or unprotected sex acts at Site B.
Intensive group-based and family
intervention in detention and following release may reduce sexual risk among
substance-involved young offenders, and a family-based approach may enhance
effects among those at highest risk. Site differences in intervention effects,
study limitations, clinical implications, and future research directions are discussed.
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- 1Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
- 2Department of Psychology, Sam Houston State University, Huntsville, TX.
- Fam Process. 2016 Feb 16. doi: 10.1111/famp.12206
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