Antisocial Psychopathy and HIV Risk among Alcohol and Other Drug (AOD) Abusing Adolescent Offenders

Emma J Brown,Robert M Malow,Madhavan Nair,Jessy Devieux,Seth C Kalichman,Robert Mcmahon,Rhonda Rosenberg

doi:10.3844/ajidsp.2007.230.239

Abstract

While the consensus is that HIV prevalence has remained low among adolescent offenders, the prevalence of STDs and HIV transmission risk behaviors is alarming, particularly for those abusing alcohol and other drugs and those displaying antisocial or conduct disorder characteristics. In the current study, 269 male and 110 female inner city, culturally diverse alcohol and other drug (AOD) abusing adolescent offenders completed measures of (a) psychopathy, using the Millon Adolescent Clinical Inventory (MACI) (b) HIV transmission risk behavior, (c) prevention skills and attitudes and (d) social desirability. Results showed that those with high levels of psychopathy reported more AOD use, overall unprotected sex and more sexual activity when influenced by alcohol and/or marijuana. High psychopathy adolescent offenders also reported lower self-efficacy and sexual response-efficacy, less favorable safer sex and condom attitudes and less favorable intentions to engage in safer sex behaviors, when controlling for social desirability. Data suggest that adolescent offenders, who are either in court-ordered treatment or detention, should be assessed for psychopathy and provided with tailored risk reduction interventions, geared toward attitudinal and behavioral change. A discussion of integrating neurobiological measures to improve the next generation of tailored interventions for this risk group is offered in conclusion.

Highlights

Progress in HIV behavioral prevention has been sufficient to establish effective interventions that can be identified by scientific panel and disseminated in a CDC compendium of effectiveness[1,2]
The concern of the present study is to evaluate the relationship between Antisocial Personality Disorder (APD) symptoms and HIV risk behaviors among an adjudicated, AOD abusing sample of adolescent offenders, court-mandated into a treatment or detention setting
Procedures: Measures included the psychopathy scale derived from the Millon Adolescent Clinical Inventory (MACI), an inventory measuring HIV transmission risk behaviors, skills and attitudes as detailed below and a measure of social desirability

Summary

Introduction

Progress in HIV behavioral prevention has been sufficient to establish effective interventions that can be identified by scientific panel and disseminated in a CDC compendium of effectiveness[1,2]. There is no comprehensive randomized survey or surveillance, the consensus is that HIV prevalence is low among juvenile offenders based on samples of detained adolescents and a 1994 National Institute of Justice/CDC study, all pointing to seropositivity at less than 1%[9]. Public health concern is deepened by an almost 50% increase in the number of juvenile cases in the correctional system, as gauged from 1987 to 1996[9] These adolescents face the risk of joining the adult prison population, in which the prevalence of AIDS is nearly 6 times higher than for the general U.S population[12]. This future risk is a shared one, since the adult prison population is not static, but frequently moves in and out, so that in any given survey of U.S populations, we can expect that

Methods

Results

Conclusion