Racial/ethnic disparities in patterns and determinants of criminal justice involvement among youth in substance abuse treatment programs.

Adolescent substance abuse is a criminal behavior; however, not all criminal behaviors result in criminal justice involvement. This study examined disparities among adolescents aged 12 to 17 admitted to substance abuse treatment nationwide. Findings indicate significant disparities in patterns and determinants of criminal justice involvement between White and minority adolescents. Minorities were significantly more likely to be involved with the criminal justice system, even after controlling for criminal behaviors, substance abuse, mental health problems, and socioenvironmental risk. Findings reveal that connections to the educational system may be especially important for minority groups. The importance of developing systems of treatment for adolescents in the community and correctional system that are part of the same continuum of care is highlighted.

Disparities in the patterns and determinants of HIV risk behaviors among adolescents entering substance abuse treatment programs.

BACKGROUND: Black youth are disproportionately affected by the HIV/AIDS epidemic. This study examined disparities in patterns and determinants of sexual risk behaviors among black and white adolescents in substance abuse treatment programs. METHODS: We used pooled clinical data collected from 4,565 sexually active 12-17-year-old black (29.7%) and white (70.3%) adolescents entering outpatient and residential substance abuse treatment programs nationally. Multivariate logistic regression analyses were used to examine racial differences in patterns of sexual risk behaviors and the associations of these behaviors with demographic, socioenvironmental and psychosocial risk factors, including substance use and abuse, symptoms of mental disorders and criminal behaviors. RESULTS: Blacks were significantly more likely than whites to have had sex with multiple partners, purchased or traded sex and used substances to enhance their sexual experiences, even after adjusting for demographic, socioenvironmental and psychosocial risk factors. Substance use and abuse, internalizing symptoms and drug-related crimes were significantly associated with engaging in > or =2 sexual risk behaviors in both groups. Disparities in determinants of HIV risk were also found. For instance, male gender, single-parent custody and history of criminal justice involvement were associated with having had sex with multiple partners among blacks but not among whites. Demographic, socioenvironmental and psychosocial risk factors accounted for up to 30% of the variance in sexual risk in both groups. CONCLUSIONS: Black adolescents with substance use problems are at greater risk for HIV infection than their white peers because of their higher rates of sexual risk behaviors. Differences in co-occurring psychosocial problems did not fully explain racial disparities in sexual risk behaviors. HIV prevention programs for black adolescents in treatment should consider both individual and broader contextual factors that co-occur with sexual risk behaviors.