Multiple psychosocial health problems and sexual risk among African American females in juvenile detention: A cross-sectional study

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ObjectivesAfrican American girls in juvenile detention are disproportionately affected by sexually transmitted diseases (STDs) and other psychosocial health problems, yet few studies have examined associations between experiencing multiple psychosocial health problems and sexual risk behaviors and STD diagnosis. MethodThe study included 188 detained African American girls aged 13–17 years. We conducted three sets of logistic regressions. First, bivariate analyses assessed associations among seven psychosocial factors (substance use disorder; depression; post-traumatic stress disorder [PTSD]; emotional abuse; pregnancy coercion; physical abuse; and sexual abuse) and four outcomes (early sexual initiation; condomless sex; multiple sexual partners; self-reported STD) to examine their interrelationships. Second, we examined associations between experiencing multiple psychosocial factors and outcomes. Third, psychosocial factors were categorized into four domains: substance use disorder; mental health (depression, PTSD); psychological abuse (emotional abuse, pregnancy coercion); and violence (physical abuse, sexual abuse) and included as independent associations with each outcome to assess their relative importance. ResultsMultiple interrelationships among psychosocial factors and outcomes were identified. An increase of one psychosocial health problem was associated with an 18% to 27% increased odds of sexual risk behaviors or a previous STD diagnosis. Reporting violence was associated with increased odds of having multiple partners (odds ratio = 3.31; confidence interval = 1.57–6.97), and experiencing psychological abuse was associated with increased odds of reporting an STD diagnosis (odds ratio = 3.95; confidence interval = 1.62–9.63). ConclusionMultiple psychosocial health problems, particularly psychological abuse and violence, are associated with sexual risk and STDs in this vulnerable population.