Risk Behaviors Among Incarcerated Female Adolescents with a Diagnosed STD: An Opportunity for Intervention

Background:  Universal gonorrhea and chlamydia (GC/CT) screening at intake to Los Angeles County (LAC) Juvenile Hall (JH) has proven fruitful in finding and treating high-risk youth, including commercially sexually exploited children (CSEC). Data are presented on risk factors among a subset of CSEC to inform prevention and treatment interventions.

Methods:  Detailed risk assessments were conducted as part of a case manager-administered risk assessment for 159 young women ages 12-18 diagnosed with GC and/or CT at three LAC JH in 2012.  Descriptive data are presented on demographics, arrest charge, sexual risk behaviors, physical/sexual abuse history, alcohol/drug use, family situation and gang affiliation. 

Results:  Among the 159 girls in JH case management in 2012, 24 (15%) reported ever having traded sex for money, shelter, or food (CSEC).  Among the 24 CSEC, the average age was 14; 79% were African American and 45% were incarcerated for a prostitution-related charge. The average age at first sex was 12; 50% had 10 or more lifetime partners; 50% reported their first drink at age 13; and more than 90% reported marijuana and methamphetamine use in the previous year.  Only 21% of the CSEC lived with or received money from a parent or relative; 40% reported gang affiliation; 46% reported forced sex as young children and 25% reported physical abuse by a parent or relative.

Conclusions:  Among CSEC testing positive for GC and/or CT at JH, a large proportion reported early sexual debut, sexual abuse, alcohol and drug use and financial and social instability, underscoring the need for effective linkage to needed mental health, substance abuse and social services. In addition, since the average age of first sex was 12 and the average age of presentation at JH was 14, it is possible that interventions at an earlier age could interrupt the risk behaviors leading to CSEC.